Your TTC Strategy 11: Know Your Options--Infertility Evaluation and Treatments

Where there are obstacles to conceiving, there are ways around them. If ovulation is a problem, there are oral and injectable medications that enhance ovulation. Intrauterine insemination can be used to get the sperm closer to the egg. When sperm quantity or quality is an issue, varicoceles (varicose veins of the testicles that cause the sperm to be overheated) can be repaired, intrauterine insemination can be performed, the sperm can be placed inside the egg (intracytoplasmic sperm injection, or ICSI), or donor sperm can be used. Surgery is indicated to remove fibroids, endometrial polyps, endometriosis, and adhesions and to repair tubal damage. When tubes are blocked and cannot be repaired or when other treatments have failed, in vitro fertilization (IVF) allows the sperm and eggs to be fertilized in a dish and placed in the uterus. For women who do not produce eggs because of age or ovarian failure, egg or embryo donation provides an alternative.

Appropriate therapy allows pregnancy to occur in 50 to 60 percent of previously infertile couples. When IVF is used, an additional 35 to 50 percent conceive with each IVF cycle. In contrast, without any treatment intervention, 15 to 20 percent of couples previously diagnosed as infertile will eventually become pregnant.

Although infertility itself does not cause physical illness, it can have a major emotional impact on the couples and individuals it affects. Feelings such as anger, sadness, guilt, and anxiety are common and may affect your self-esteem and self-image. It is important to know that these feelings are normal responses to infertility and are experienced by many couples. Although a physician will describe various treatments and realistic odds of success with treatments, you must decide how far you will go in your attempts to conceive.