How to Manage Infertility

Couples who desperately want to conceive but continue to be unsuccessful may begin questioning their fertility. That’s normal. After all, so many friends and family members are seemingly getting pregnant easily, yet here you are struggling. If you’ve had unprotected sex for 12 consecutive months with no pregnancy (6 months if you are a woman over 35), it’s time for a fertility evaluation.  

While infertility diagnosis is difficult, the road ahead doesn’t have to be bleak. Depending on your diagnosis and cause, there are ways and treatments to help overcome your infertility and conceive. Here we offer some insight into infertility and the most common treatments so that you can grow your family.   

Common Reasons Behind Infertility  

First, let’s take a look at the common causes of infertility. As mentioned above, infertility is generally defined as an inability to conceive after 6 to 12 months of unprotected sex. The reasons for infertility, which impacts one in eight couples in the United States, vary. For example, infertility sometimes solely relates to either a male or female reason, and sometimes both partners have issues making pregnancy difficult. In other cases, no real cause is found, in which case doctors will diagnose unexplained infertility. 

Age-related infertility is a common issue. A woman’s fertility peaks in her 20s, and by age 30, women have a 25-30 percent chance for a natural pregnancy each month. At 40, that number drops significantly to around 10%, due to a decrease in hormones and viability of your eggs or ovarian reserve. 

Certain health conditions also contribute to a woman’s infertility risk:  

• Polycystic ovarian syndrome (PCOS) affecting your hormone levels and ovulation
• Endometriosis causing inflammation in your pelvic region, making conception extremely difficult  
• Uterine disorders or growths such as polyps or fibroids  
• Blocked fallopian tubes as a result of scar tissue  
• Diminished ovarian reserve or poor egg quality  
• Being over or underweight 
• Autoimmune disorders

You can learn more about these conditions here.

Male infertility may stem from a variety of causes:  

• Hormonal disorders
• Vas deferens (the tube that carries the sperm) blockage due to cysts, scar tissue, or growth  
• Testicular issues such as a varicocele (enlarged vein in the testicles which impairs sperm production) or undescended testicles  
• Erectile dysfunction  
• Scar tissue from prior surgeries  
• Medications such as anabolic steroids or cancer medications  
• Infections 

You can learn more about conditions causing male infertility here.

Seeking Treatment  

Once you have a diagnosis, even if your doctor can’t determine the exact cause of your infertility, you have options. Medical science related to infertility treatment continually advances, and there are a variety of treatments to help couples and individuals succeed in growing their family. Of course, your diagnosis determines the best course of treatment for you. Below are the most common treatments to manage infertility.

Common Initial Treatments for Male and Female Infertility  

Depending on their diagnoses, both men and women who have infertility generally do have a few options before moving on to assisted reproductive technology (ART) for treatment again.  

For Men:  

• Surgery can address a varicocele or blockage of the vas deferens  
• Hormone medications that treat imbalances affecting fertility  
• A course of antibiotics for infection impairing fertility  

• Medication for erectile dysfunction  

For Women:  

• Hormonal medication to increase ovulation or treat a hormone imbalance  
• Surgery to remove the endometrial-like tissue impairing fertility   
• Surgery to remove the blockage and open fallopian tubes
• Ovulation induction with timed intercourse (Also used with IUI and IVF as your needs determine.)   

Common Treatments Related to ART  

Again, depending on the diagnoses and whether any of the above options are successful, there are specific ART treatments to help couples and individuals overcome infertility and conceive. The success rates vary, and depending on your specific diagnosis and unique circumstances, you and your doctor will decide which one of these treatments is your best option.  

Intrauterine Insemination (IUI)  

IUI is typically the first course of treatment prescribed for couples prior to in-vitro fertilization (IVF). IUI is less costly, minimally invasive, and a safe and straightforward procedure that takes place right in your doctor’s office. IUI works best in cases of ovulatory dysfunction, endometriosis, and male factor infertility where the sperm benefits from a little extra help.   

The doctor aligns IUI with the woman’s ovulation and very often in conjunction with ovulation induction. The lab collects and washes the male partner’s sperm to select the strongest sperm, and your doctor uses a small catheter to place the sperm directly into your uterus. This enables the sperm to take a much shorter route than would otherwise be the case with the egg awaiting fertilization in the fallopian tube. The procedure is painless and takes just a few minutes. To learn more about IUI at our clinic, go to https://reproductivehealthwellness.com/iui/   

In Vitro Fertilization (IVF)  

IVF, undoubtedly the most successful treatment for many infertile couples, has certainly come a long way in the last nearly half-century since the birth of the first “test-tube baby.” Although much more involved than IUI, it’s also five times more successful in overcoming infertility.  

Your IVF journey, after diagnosis and discussion of treatment, begins with ovarian stimulation. Both oral and injectable hormonal medications are used daily for about ten days. Over that period, you visit your doctor’s office regularly for ultrasounds and hormonal blood tests to gauge ovulation. Once your doctor determines ovulation, it’s time for the next step: egg retrieval.  

During egg retrieval, you’re under anesthesia as your doctor inserts a very small needle into your ovaries and removes the eggs. An embryologist then assesses your eggs for viability and count.   

Next comes fertilization. Using your partner’s sperm or donor sperm, the embryologist mixes the sperm with the egg in a laboratory setting. When male infertility specifically affects the ability to conceive, the embryologist may use intracytoplasmic sperm injection (ICSI) to inject a single sperm directly into the egg, facilitating fertilization.   

The lab observes the fertilized eggs for five days to determine development. In addition, some couples opt for genetic testing which identifies any chromosomal abnormalities or genetic conditions which may result in birth defects or increased risk for miscarriage.   

The embryo transfer comes next. Your doctor assesses the growth of your uterine lining, sometimes helping it along with a hormone injection. Under ultrasound guidance and using a very small catheter, your doctor then places the embryo into the top of your uterus, where it attaches and develops until birth. 

Third-Party Reproduction  

In some cases of infertility, it’s necessary to involve a third party. This may be due to the need for donor sperm, donor eggs, or a gestational carrier (surrogate). 

What You Can Do  

Fertility-wise, both men and women benefit from lifestyle changes that promote better health. These include:  

• A healthy diet consisting of whole foods, lean proteins, and plenty of fruits and vegetables  
• Exercising 30 minutes per day, five days per week (But check with your doctor first!)  
• Limiting alcohol consumption  
• Stopping smoking  
• Cutting out recreational drug use
• Striving for healthy and restful sleep  
• Maintaining a healthy BMI  

Your infertility diagnosis creates a rollercoaster ride of emotions for both you and your partner. Be aware, be sensitive, and do what you can to manage your emotional well-being together and individually. Talk with a therapist or join a peer support group. Most of all, understand there is hope ahead. Reach out to the caring and compassionate team at Reproductive Health and Wellness, and we’ll find a path to manage infertility together.