When you’re trying for a baby, each month you don’t conceive can feel like forever. But there are fertility treatments that can help you fulfil your dream of welcoming a bundle of joy. Each treatment has different pros and cons, and certain fertility treatments are more appropriate for some people than others. That’s why it’s so important to speak to a fertility specialist to find out which personalised fertility treatment might be best for you.
Update for Feb 2021: Advice for COVID Vaccine and Fertility Treatments
Overview of the different fertility treatments available
Intrauterine insemination (IUI)
Once known as artificial insemination, intrauterine insemination (IUI) is a fertility treatment that takes specially washed and concentrated semen and implants it directly into the uterus. The semen is inserted into the uterus around the time of ovulation (when the egg is released) to increase the chances of fertilisation.
IUI can be performed for a number of reasons, including when donor sperm is being used; when sperm has weak motility (ability to swim towards the egg), or when sperm is found in weak concentration. This fertility treatment is often performed as a first-line option when there is no cause found for infertility.
In-vitro fertilisation (IVF)
In-vitro fertilisation (IVF) is a procedure whose aim is to fertilise an egg outside of the body. The first step of this fertility treatment involves the use of fertility drugs to stimulate the production of eggs by the ovaries.
Once those eggs have been produced, they are collected from the woman’s body and mixed with a man’s sperm in a specialised laboratory. The resulting embryo can then be placed back inside the uterus, and remaining good quality embryos are frozen for future treatments.
In this process, the ovaries are stimulated to undergo ovulation to produce eggs. People who do not ovulate naturally may undergo ovulation induction in a bid to help them ovulate and fall pregnant with timed intercourse. See more information about Ovulation Induction here.
Elective egg freezing
If you’re not ready to have a baby right now but think you may want to be a parent down the track, you might consider freezing your eggs. This procedure is often considered an ‘insurance policy’.
That is because a woman’s chances of falling pregnant drops with increasing age. If you freeze your eggs now and then choose to use them later, your chances of conceiving relate to the age at which your eggs were frozen, not your current age.
The first part of this procedure involves taking medication that stimulates the production of eggs. You will then undergo a short procedure to allow your doctor to retrieve your eggs. Once these eggs have been assessed, they can be frozen and accessed at a later date.
What tests do I need if I’m struggling to conceive?
There are a number of reasons why a couple may have difficulty falling pregnant. Depending on your situation, your doctor may recommend undergoing certain tests to check for an underlying cause before possibly initiating fertility treatment.
Your doctor may then order one or more of the following investigations:
- Semen Analysis: A semen analysis can be done to check for the concentration of sperm, their motility (ability to swim towards an egg), and their morphology (whether the sperm look normal).
- Blood Tests: Your fertility specialist may also order blood tests to check for levels of the hormone testosterone, or to check for genetic issues that may affect fertility.
- Imaging: There are a number of imaging tests that may be performed to investigate potential causes of infertility. These may include an MRI of the brain (for example, to rule out the presence of an abnormality leading to changes in hormone production) or a scrotal ultrasound (to check for causes of abnormal semen analysis results).
- Testicular Biopsy: If your fertility specialist is concerned about a testicular abnormality which may be impacting fertility, a testicular biopsy may be recommended. Alternatively, this procedure may be performed in order to retrieve sperm for fertility treatments such as IVF.
- Blood Tests: Before undergoing a fertility treatment, your fertility specialist may recommend having blood tests to check the level of hormones that influence factors such as ovulation. These may test for levels of ovarian hormones (that influence the release of egg, or ovulation), and pituitary hormones (those that control reproductive processes), as well as an assessment of how many eggs are still in the ovaries (AMH or ovarian reserve test).
- Pelvic Ultrasound: If your fertility specialist is concerned you may have an issue with your uterus or ovaries, a pelvic ultrasound may be recommended.
- Ovulation Tests: Some women may not produce eggs at the time of ovulation. Ovulation tests can help determine whether this is the case for you.
- Hysterosalpingography/HyCoSy: This investigation is performed via X-ray using contrast. The aim is to check there are no blockages or other issues inside your uterus, or in your fallopian tubes, which are the tubes leading from your ovaries to your uterus. In order to check there are no blockages or other issues, contrast dye is injected into your uterus and an X-ray is taken to see whether the fluid leaks out. A similar test can be done with saline and ultrasound scan- HyCoSy.
- Hysteroscopy/Laparoscopy: Less commonly, your fertility specialist may recommend having a hysteroscopy or laparoscopy. These procedures involve minor surgery to look at your uterus, ovaries, fallopian tubes, or a combination of these structures. The aim is to see whether there are any abnormalities such as scarring, blockage or endometriosis that may be impacting your chances of falling pregnant or carrying a baby.
What medications are available to boost fertility?
There are a number of reasons why your doctor might advise taking medication to help you in your journey to becoming a parent. These are some of the more common medications your doctor may recommend:
- Ovulation Stimulating Medication: Your fertility specialist may recommend using a fertility drug to stimulate ovulation. Fertility medications that stimulate ovulation aim to boost the release of eggs. Medications which stimulate ovulation include:
• Clomiphene citrate (known as Clomid)
• Letrozole (known as Femara)
• Anastrozole (known as Arimidex)
• Gonadotrophins, including FSH, LH or a combination of the two.
Letrozole is often the first drug a fertility specialist will opt for to stimulate ovulation.
- Medications to treat clotting disorders: Blood clotting disorders can lead to recurrent miscarriage. If your fertility specialist thinks this is an issue for you, you may be advised to take medications which aim to thin the blood and prevent clots, such as aspirin tablets or Clexane injections.
- Progesterone: The hormone progesterone is produced by the ovaries after ovulation. It is needed to help the uterus prepare for pregnancy. During certain fertility treatments such as IVF, production of progesterone can drop. This is why your doctor will recommend taking progesterone after your eggs have been collected. Progesterone comes in a number of formats, including injections, and a vaginal gel or a tablet to be placed in the vagina.
Find out 7 ways to optimise female fertility here.
How much do fertility treatments cost?
The cost of fertility treatments differ depending on the type of treatment you need, the clinic you attend, and which country you live in. If you would like more information about the cost of a specific fertility treatment, please discuss this with your fertility specialist.
How can I find a fertility specialist?
ANZSREI offers access to the most advanced specialists in fertility in both Australia and New Zealand. These specialists have up-to-date knowledge in all fertility treatments. Find a CREI qualified specialist near you. If you have any further questions, please don’t hesitate to contact one of our qualified fertility specialists.