You may have heard of the myth that “trying is the only way to get pregnant.” When a couple has been trying for a year (six months for those above 35) without any results, they must see a fertility specialist. Infertility is a treatable medical condition. 

When considering infertility treatments, it’s crucial to address any underlying health issues that may impact fertility, such as sexually transmitted diseases (STDs). STDs can significantly affect reproductive health, and early detection and treatment are vital for improving fertility outcomes. Patients should be proactive in getting tested and treated for STDs to ensure they are not a barrier to successful conception. For those seeking more information on STD testing and treatment options, exploring the details can provide valuable insights into maintaining reproductive health and enhancing the effectiveness of infertility treatments. By addressing these health concerns, patients can better prepare for their fertility journey.

The sooner you get the issue diagnosed, the better the chances you’ll become parents to your biological children. Your doctor will treat the underlying cause of infertility, such as managing PCOS or performing surgery to remove fibroids and polyps, or they’ll recommend assisted reproductive technology. 

There’s no specific fertility treatment that works for everyone. The best for you depends on your cause of infertility, age, health, and other factors. If you are in search of the most suitable infertility treatments for you, keep reading. We’ve discussed all possible treatment plans. 

Understanding Infertility

Among dozens of factors that can interfere with your fertility, age is the most common and significant one. A woman’s ovarian reserve and egg quality remain suitable for a certain period. When she crosses her 40s, her egg count will likely diminish, and so will the egg quality. Spotting the signs that you or your partner could be infertile and seeking prompt care from a fertility specialist can do wonders for your parenthood goal. 

Male-factor Infertility

• Low or no sperm count 
• Poor sperm motility
• Misshaped sperm
• Blockage in the man’s reproductive tract

Female-factor Infertility

• Uterine anomalies
• Ovulation disorders
• Endometriosis
• Fibroids and polyps in the uterus
• Blocked fallopian tubes
• Low ovarian reserve 

Sometimes, there’s no obvious cause of infertility. In medical terms, it’s called unexplained infertility. Your healthcare provider will assess your health and run tests, like bloodwork, physical tests, imaging, hysteroscopy, semen analysis, a testicular biopsy, and other tests to check your hormonal balance or other reproductive issues, which might be the underlying factors in your infertility diagnosis.

Overview of Infertility Treatments

Infertility treatment comprises medication, hormone injections, and sometimes a minimally invasive surgical procedure. Let’s check out the popular treatment options that have worked for couples. 

IVF (In Vitro Fertilization): IVF works for male and female factor infertility. The procedure involves retrieving eggs directly from the woman’s ovaries and keeping them in the lab with sperm to facilitate fertilization. The resulting embryo is implanted into the uterus through a minor surgical procedure.

ICSI (Intracytoplasmic Sperm Injection) is part of the IVF cycle. For male-factor infertility, particularly in men with low sperm counts or poor motility, ICSI increases the chances of fertilization by manually injecting the sperm into the egg.

PGD (Preimplantation Genetic Diagnosis): PGD is another way to improve the success rate of IVF. It separates healthy embryos from abnormal ones. PGD screens the embryos for genetic mutations and chromosomal abnormalities that might result in a terminated pregnancy or cause congenital disabilities in the baby.

Test Tube Baby: It’s another medical term for IVF. 

IUI (Intrauterine Insemination): Women with cervical issues and men with poor sperm motility and unexplained fertility can opt for IUI. It directly injects the sperm into the woman’s uterus around the time the woman is ovulating. 

Azoospermia (Tese/micro-TESE): For men with azoospermia (low or no sperm found in the semen sample), microTESE — a surgical procedure is used to extract sperm from the testicles. Sperm retrieved are used for IVF. 

Factors Influencing Treatment Selection

Infertility diagnosis and all the mental trauma that it brings might be too overwhelming for couples to think about the appropriate treatment plan. Here are a few factors that can help you make an informed decision: 

Age: Maternal age has a substantial effect on the woman’s fertility and the success rate of the treatment. For women above 40, a more advanced treatment, like IVF, PGD, and frozen eggs, might be needed for successful conception.

Health Status: Existing medical conditions, like diabetes, heart disease, thyroid disorders, etc., can make you unfit for certain fertility treatments. If you’ve had tubal ligation, IVF might be your only option to conceive. Likewise, uterine conditions, like fibroids or polyps, might require surgical removal before a suitable fertility treatment plan is selected.

Causes of Infertility: Female-factor infertility because of PCOS, endometriosis, and hormonal conditions might require ovarian stimulation and IVF. For male-factor infertility, such as low sperm count and poor motility, couples can discuss IUI with their fertility specialist. In some cases, intracytoplasmic sperm injection (ICSI) is needed for egg fertilization outside the uterus.

Success Rates: Each treatment has a varying success rate. IVF, for instance, is comparatively more successful than IUI, but it’s expensive and more invasive. Couples with mild infertility issues can start with IUI.

Detailed Analysis of Each Treatment

Let’s look at the detailed process of each treatment and who it’s suitable for.

IVF

In-vitro fertilization is an assisted reproductive technology that’s recommended for patients with advanced fertility issues. For blocked fallopian tubes, hormonal disorders, low sperm count in men, and unexplained infertility, IVF can help. It’s also a viable option for couples who want to freeze their egg at a young age to achieve their pregnancy goals later. 

Here’s how it works

• FSH and LH hormone shots are administered to promote follicle growth and egg maturation in women. The fertility specialist will use an ultrasound test to track the follicle growth. 
• When your follicles are ready, the doctor will administer Gonadotropin injections to trigger ovulation.
• Around this time, they will schedule egg retrieval, which is the surgical way to collect mature eggs from your ovaries.
• The eggs are placed in a petri dish with sperm overnight so they can fertilize. An alternative technique, ICSI, is sometimes used for assisted fertilization.
• The doctor waits 3-5 days for the fertilized egg to become an embryo. It’s transferred to the woman’s uterus vaginally.
• You will also get progesterone shots, which make your uterine lining thick enough to support implantation.

You can take a pregnancy test 10-12 days after this procedure. The cumulative live birth rate after six IVF cycles in 35-below patients is 86%.

Coming to the downsides, IVF can lead to multiple births if more than one embryo is transferred. Multiple births come with their own challenges, such as premature delivery, low birth weight babies, etc. It can also lead to a painful condition called ovarian hyperstimulation syndrome (OHSS).

ICSI

If you are struggling with male-factor infertility, ICSI can be performed during your IVF cycle to maximize your chances of conception after embryo transfer. It’s needed when your partner’s sperm count is extremely low, or they have poor motility, which keeps sperm from combining with the egg naturally. 

Intracytoplasmic Sperm Injection involves all the steps mentioned above, but instead of leaving sperm with the egg in the hope that one of them will fertilize an egg, the doctors manually inject a live sperm into the egg. The most significant risk associated with IVF is the damaged egg. Although the risk is low, it’s possible.

IUI

For men and women with mild infertility, Intrauterine Insemination can be an effective way to conceive. It’s less expensive than IVF and is relatively less invasive. In IUI, your doctor separates healthy sperm from sluggish ones and injects them directly into the uterus through the cervical opening. This is scheduled when the woman is ovulating. 

The goal is to ensure the sperm reaches the egg, penetrates it, and the embryo is implanted into the uterus. Its success rate is 13% in women below 35 and 17% for male-factor infertility cases.

Here’s when IUI works and when it’s less successful:

Less successful: You have a thick cervical mucus that prevents sperm from reaching fallopian tubes, or your partner is diagnosed with low or fewer sperm.

High Chances of Success: The cervical mucus is absent, and your partner’s sperm count and motility are normal.

If you have had 2-3 failed cycles of IUI, chances are the subsequent cycles won’t work either, and it’s best to switch to a more invasive treatment, like IVF. IUI carries the same risks as IVF.

PGD

Preimplantation Genetic Diagnosis is an advanced fertility treatment that detects a chromosomal abnormality in the embryo. Your doctor may perform it as part of your IVF treatment. It’s recommended for couples with genetic disorders, those who’ve experienced repeated IVF failures, and those who want to balance their families by choosing an embryo of a specific gender. 

For PGD, your doctor collects one or two cells from the embryo and sends them to the lab for thorough screening. These cells are tested for genetic diseases like cystic fibrosis and sickle cell anemia. Scientists study the embryo’s genetic makeup to ensure it is free of genetic disorders and healthy enough to be transferred to the uterus.

Azoospermia-Specific Treatments

Microsurgical Testicular Sperm Extraction (MicroTESE) is recommended for patients diagnosed with azoospermia — a condition with very low or no sperm found in the man’s semen. It surgically removes viable sperm from the testicles through a fine needle. 

Here’s how it goes:

• The surgeon makes a small incision on the scrotum to access your testicles.
• They collect tissue samples and send them for testing.
• The scientist will test the sample under a microscope to see if there’s any sperm in the semen. If the sperm is found, they will use it immediately or keep it in liquid nitrogen for later use.

It’s performed under anesthesia so that you won’t feel anything. MicroTESE can retrieve sperm in 50% of cases. The procedure, however, carries certain risks, like bleeding, testicular damage, and infection.

How to Determine the Best Treatment for a Patient

Many considerations, like age, health, cause of infertility, and budget, are factored into when choosing the best treatment. Your fertility specialist will also study your case and offer personalized treatment advice. It’s advisable to work with a board-certified and reputable fertility specialist who chooses the most viable infertility treatment for your case.

FAQs

Can natural conception happen after treatment?

Yes, many patients go on to have natural pregnancy after IVF. That happens because of the ovarian stimulation shots that might result in ovulation and natural pregnancy.

How long does each treatment take?

IUI takes 1-2 weeks, and IVF requires longer, ideally 4-6 weeks. 

Are there any side effects or risks?

Yes, each procedure carries risks. Ovarian stimulation medication, for instance, can lead to OHSS. IVF can result in multiple births. IUI can lead to cramping and discomfort.

Does age significantly impact success rates?

Yes, age can significantly affect the success rate of infertility treatment.

Conclusion

Infertility treatment is a long journey that comes with physical and emotional challenges for couples. Even if the numbers look positive, there’s no guarantee the treatment will have positive pregnancy results for every couple. It’s essential to choose the best fertility clinic in lahore after careful consideration and reviewing their patient’s testimonials. Your doctor’s expertise can make a big difference to your experience and success rate.