Infertility Treatments

General measures

Fertility can often be affected by lifestyle issues. The frequency that the couple are having sex is a very important factor, which many times is undervalued. Regular sex 2-3 times a week is important in order to achieve the best chances for conception.
Both partners should stop or at least reduce bad habits like smoking and drinking.
Men should avoid hot showers and tight underwear and women may need to lose or gain weight.  

Surgery

Surgery may be done to open fallopian tubes or repair other problems of the reproductive organs. It may be done to remove growths such as polyps or fibroids.
Surgery also may be done to remove scarring that occurred as a result of a previous surgery, infection, or endometriosis.
 If endometriosis is found, surgery may be done to treat it. Success rates depend on the nature and extent of the problem.

Ovulation Induction

If the woman has a problem with ovulation, cer¬tain medications can help her to ovulate. She also can be given medication to increase the number of eggs released.
The medicine used most often is clomiphene which is a pill given by mouth to help women who have problems with ovulation to release an egg. A number of treatment cycles may be needed, and dosage and medication may need to be altered.

If pregnancy does not occur after several treat¬ment cycles with clomiphene, other more potent treatments may be tried. This is in the form of hormonal injection which stim¬ulates the ovaries to mature and produce eggs. Blood tests and ultrasound often are used to moni¬tor the effects of this treatment. This is important in order to avoid certain side-effects of this treatment such as multiple pregnancy and ovari¬an hyperstimulation syndrome.  This syndrome may present if too many eggs develop at the same cycle and may cause painful swelling of the ovaries and fluid in the abdomen and lungs. In this case it may be decided to stop the treatment in order to reduce the chance of this syndrome occurring.

Most women who take ovulation-induction drugs respond to the treatment and begin to ovu¬late regularly. If no other problem requires treatment, more than half become pregnant within 6 cycles. If a woman still hasn't started ovulating, she may have special investigations to find the reason.

Assisted Reproductive Methods

Assisted reproductive technology (ART) includes treat¬ments that involve a laboratory which with technical means, improve the sperm quality or treat human eggs and sperm  to help an infertile couple conceive a child.
The following are some of the ART treat¬ments available to couples trying to conceive.

Intrauterine Insemination

With this method, at the time of ovulation, the doctor using a fine tube, places the partner’s sperm into the woman's uterus. In most cases, the sperm are treated in a lab to increase the chances for fer¬tilization.

In Vitro Fertilization

With in vitro fertilization (IVF), eggs from the woman and sperm from a man are fer¬tilized outside the body in a lab. The fertilized egg then is placed in the woman's uterus to grow.
The eggs are removed from the ovary just before ovulation. Medication is used most of the time to help the ovaries to produce more than one egg. Eggs usually are removed by inserting a needle through the vagina into the ovary under ultrasound guidance. The eggs are withdrawn through the needle. Analgesia or a sedative may be given.
The eggs then are combined with sperm and are observed to see if fertilization occurs.
A few days later, one or more fertilized eggs (embryos) are placed in the woman's uterus through her vagina. This is called embryo transfer. The unused fertilized eggs can be frozen and stored for later use.
The success rate of IVF depends on the woman's age and the reason for the infertility.
Its possible side effects are the same as those from ovulation medications.

Intracytoplasmic Sperm Injection (ICSI)

With intracytoplasmic sperm injection (ICSI), one sperm is placed directly into an egg to fertilize it. First, sperm are removed from the semen. One sperm is injected into each egg's center. They are checked to see if the eggs are fertilized. Once fertilized, the eggs are placed in the woman's uterus to grow, or they are frozen for later use. This technique is fairly new and little is known about any long-term effects.