Fertility Treatments
Whether you’ve been trying to conceive without success, or you have a known medical condition affecting your fertility, there are a range of advanced fertility treatments available that can be tailored to your needs. Below is an overview of the various fertility treatment options, which are ultimately based on your diagnosis and family building goals.
1. Ovulation Induction (OI)
Ovulation induction is often the first line of treatment for women who are not ovulating regularly (known as ovulatory dysfunction) which typically presents as irregular or absent periods. This treatment involves using oral or injectable medications to stimulate the ovaries to release one or more eggs.
The most commonly used medications for ovulation induction are Clomiphene Citrate (Clomid) and Letrozole (Femara), which help recruit a dominant follicle for ovulation.
How It Works: Administration of ovulation medications being on cycle day 3-5 and are most often taken for a duration of 5 days. This is followed by ultrasound monitoring to ensure there is at least one dominant follicle that has been recruited. Once the follicle(s) reaches a mature size, a medication known as a “trigger shot” is used to reinforce ovulation followed and intercourse or intrauterine insemination (IUI) is timed accordingly.
Who is it for?
- Women with polycystic ovary syndrome (PCOS)
- Women with unexplained infertility (in combination with IUI)
- Women with ovulatory dysfunction
2. Intrauterine Insemination (IUI)
Intrauterine insemination (IUI), also known as artificial insemination, involves placing sperm directly into the uterus during the most fertile time of the woman’s cycle. This procedure increases the chances of sperm reaching the egg.
How It Works: Sperm is collected and washed in an embryology lab and placed in a syringe. Sperm is then inserted into the uterus using a thin catheter. This can be done with or without ovulation-inducing medications.
Who is it for?
- Couples with mild male factor infertility (mildly low sperm count or motility)
- Couples with unexplained infertility (in combination with superovulation)
- Women with mild endometriosis or cervical issues
- Same-sex female couples or single women using donor sperm
3. In Vitro Fertilization (IVF)
In vitro fertilization (IVF) is the most effective fertility treatment there is (with few exceptions of course). It involves retrieving eggs from the ovaries (after stimulating them), fertilizing the eggs with sperm in a lab, and transferring the resulting embryo(s) into the uterus.
Process (simplified):
- Ovarian Stimulation: Hormonal injectable medications are used to stimulate the ovaries to help grow the available cohort of follicles for that cycle.
- Egg Retrieval: Eggs are retrieved from the ovaries via a minimally invasive procedure using a needle to aspirate the content of each follicle under ultrasound guidance
- Fertilization: The eggs are fertilized with sperm in the lab (either via standard insemination or intracytoplasmic sperm injection- ICSI, where a single sperm is injected directly into the egg).
- Embryo Transfer: One or more embryos are transferred into the uterus either 3-5 days after retrieval or in a subsequent cycle after embryos have been frozen. Frozen embryo transfers are more commonly done over fresh embryo transfers, while awaiting genetic testing results for the embryos (called preimplantation genetic testing- PGT).
IVF success rates vary by age, with younger women typically experiencing higher success. It is also influenced by factors such as egg quality, sperm quality, whether or not there is uterine factor infertility and the lab used for treatment.
Who is it for?
- Couples with severe male factor infertility
- Women with blocked or damaged fallopian tubes
- Couples with unexplained infertility
- Women with endometriosis or recurrent pregnancy loss
- Women with advanced maternal age or diminished ovarian reserve
- Reciprocal IVF for same sex female couples
- Couples using third party reproduction (such as using a gestational carrier)
4. Intracytoplasmic Sperm Injection (ICSI)
ICSI is a technique used in assisted reproductive technology (ART) to help increase fertilization rates. It was initially used to overcome severe male infertility. In this procedure, a single sperm is injected directly into an egg. It is now more commonly used routinely for most patients undergoing IVF.
How It Works: After egg retrieval, a highly skilled embryologist selects a single healthy appearing sperm and injects it into the egg. ICSI is especially useful when the sperm count or motility is low.
Who is it for?
- Men with low sperm count or poor sperm motility
- Couples with previously unsuccessful IVF cycles
- Men with sperm obtained surgically due to severe oligospermia or azoospermia (little to no sperm in the ejaculate)
- Previously frozen eggs being thawed
5. Donor Egg or Sperm
For some individuals and couples, using donor eggs or sperm may be the best or only path to achieving a successful pregnancy. This option is recommended when one partner’s eggs or sperm are not viable due to age, genetic factors, or medical conditions.
Donor Egg: Women who cannot conceive with their own eggs (due to age, diminished ovarian reserve, or genetic concerns), can use a donor egg fertilized with their partner’s sperm or donor sperm.
Donor Sperm: Donor sperm can be used for men with no viable sperm or for single women and same-sex female couples.
Who is it for?
- Women with poor egg quality or ovarian failure (donor egg)
- Men with no viable sperm (donor sperm)
- Same-sex female couples or single women (donor sperm)
- Same-sex male couples or single men (donor egg)
- Those who have a heritable genetic condition
6. Preimplantation Genetic Testing (PGT)
Preimplantation genetic testing (PGT) is used in conjunction with IVF to screen embryos for chromosomal abnormalities and/or genetic conditions before they are transferred to the uterus. This can improve the chances of a successful pregnancy and reduce the risk of genetic diseases.
After the embryos are created through IVF, a few cells of the outer part of the embryo (which will become placenta, called trophectoderm) are biopsied from each embryo and tested for chromosomal abnormalities (PGT-A) or specific genetic conditions (PGT-M).
Who is it for?
- Couples with a history of genetic disorders
- Recurrent pregnancy loss
- Abnormal parental karyotype or translocation
- Gender selection
- Prior failed embryo transfer of untested embryos
- Anyone who wishes to optimize embryo transfer success
7. Surrogacy and Gestational Carriers
For women who cannot carry a pregnancy due to medical reasons, the use of a gestational carrier may be necessary. A gestational carrier is a woman who carries a pregnancy for someone else, using the intended parents’ embryo.
Who is it for?
- Women with absent or abnormal uterus
- Women with health conditions that make pregnancy unsafe
- Same-sex male couples or single men
- Recurrent unexplained implantation failure
8. Fertility Preservation
Fertility preservation allows individuals to freeze their eggs, sperm, or embryos for future use. This is particularly valuable for individuals undergoing medical treatments such as chemotherapy, which can affect fertility, or those who wish to delay childbearing for personal or professional reasons.
How It Works: Eggs or sperm are collected, frozen, and stored until the individual is ready to use them. Frozen embryos can also be created and stored.
Who is it for?
- Cancer patients
- Women delaying parenthood
- Men or women at risk of infertility due to other medical treatments or conditions
Want to learn more? Contact us at 310-943-5820 or email BH_Reception@havingbabies.com or fill out a form today to schedule a consultation!