Infertility treatment
Once the infertility testing has been completed, doctors and fertility specialists will review the results and recommend a treatment plan. Nearly 90% of all infertility cases, both caused by male and female factors, are overcome through treatment, including surgical and medical techniques.Treatment goals may include one or more of the following:
Correcting or improving anatomical abnormalities
Enhancing the production of healthy eggs
Enhance sperms' ability to fertilize the egg
Assisting reproduction using specific technologies
Assisted reproduction
Intrauterine insemination (IUI) is a procedure in which sperm are placed directly into the uterine cavity through a catheter near the time of ovulation. This procedure is most commonly performed when there are problems with the sperm, such as low count or low motility, or an incompatibility between the sperm and the cervical mucus. IUI can also be performed to overcome problems due to impotence, premature ejaculation or other medical conditions. IUI increases the chances of pregnancy because the sperm are placed directly in the uterus, bypassing the cervix and improving the delivery of the sperm to the egg.
IUIs can be performed either with the partner's sperm or with donor sperm. It is recommended that the patient abstain from sexual intercourse for two to three days before the procedure. In some cases, it may be necessary for the female to take medication to induce ovulation if her cycles are not regular.
Intracytoplasmic sperm injection (ICSI) is a process that uses immotile sperm during in vitro fertilization. Doctors inject one sperm with a glass needle directly into a mature egg which is then incubated and transferred to the uterus.
In vitro fertilization (IVF), is a procedure that involves retrieving eggs and sperm from the bodies of the male and female partners and placing them together in a laboratory dish to enhance fertilization. Fertilized eggs are then transferred several days later into the female partner's uterus where implantation and embryo development will hopefully occur as in a normal pregnancy. IVF is performed by physicians who specialize in reproductive medicine and have received additional education and training in the evaluation and treatment of male and female infertility.
Medications
Ovulation induction medications, often referred to as fertility drugs, are used to stimulate the follicles in the ovaries. These medications are prescribed to stimulate the production of multiple eggs in one cycle. The medications also control the time that a woman releases the eggs during ovulations, so that sexual intercourse, intrauterine inseminations, and in vitro fertilization procedures can be scheduled at the most likely time to achieve pregnancy. Medications most commonly used in fertility treatment include:
clomiphene citrate
gonadotropins
Metformin
Parlodel
Surgery for men
Micro epididymal sperm aspiration (MESA) - Surgeons makes an incision in the scrotum and gather sperm from the epididymis, the elongated, coiled duct that provides for the maturation, storage, and passage of sperm from the testes. MESA is considered as microsurgery.
Percutaneous sperm aspiration (PESA) - A needle inserted is into the epididymis in an effort to locate and aspirate a pocket of sperm.
Testicular biopsy - Several small pieces of testicular tissue are removed and examined for sperm which can be used in fertility procedures.
Testicular sperm aspiration (TESA) - A needle biopsy of the testicle in which a sample of tissue is taken directly from the testis and used to extract sperm for IVF or ICSI.
Vasectomy reversal - A vasectomy reversal is often performed as an outpatient procedure and is done to reverse a previous vasectomy and restore the male's ability to release sperm into his semen from the testicles.
Surgery for women
Fallopian tube sterilization reversal - Also known as a tubal reversal or reanastomosis, this surgical procedure is performed to reconnect the two ends of the fallopian tubes in an effort to reverse sterilization.
Hydrosalpinx removal - A hydrosalpinx is an obstructed fallopian tube that leads to an accumulation of fluid. Removal of the affected tube can increase IVF success rates.
Hysteroscopy - A hysteroscopy is an outpatient procedure during which doctors use a narrow fiberoptic telescope inserted into the uterus through the cervix, to look for and sometimes remove adhesions inside the uterus.
Laparoscopy - A laparoscopy is an outpatient surgical procedure during which doctors use a narrow fiberoptic telescope inserted through an incision near the navel to look for and sometimes remove adhesions in the pelvic cavity, remove ovarian cysts or remove or repair a fluid-filled hydrosalpinx.
Ovarian drilling - This procedure is performed during laparoscopy and consists of a laser fibre or electrosurgical needle puncturing the ovary 4 to 10 times. This treatment results in a dramatic lowering of male hormones within days and is often performed in women who have polycystic ovary syndrome (PCOS).
