There are many different fertility treatments available, ranging from the relatively inexpensive and straightforward IUI to the much more complicated ICSI. Which treatment is the right one for you depends of course on the underlying fertility problem. Therefore, getting a clear idea of what is causing the problem is imperative.
Ovulation problems
In case of a lack of ovulation, the first step would be to restore regular ovulation. Reducing stress, gaining or losing weight to get near the recommended weight and a generally healthier lifestyle are the first steps. If that is not enough (or if it doesn’t appear that any of these factors are involved) fertility drugs may be used. Often Clomiphene is the first choice for increasing ovulation. Gonadotropins, which are usually administered through injections, are a stronger measure. When using fertility drugs it is important to avoid ovarian hyperstimulation syndrome which not only carries an increased risk for higher order multiples but can also be quite dangerous itself.
Low egg quality
Treatment options for low quality eggs are limited. One option is to try IVF. By using hormones to stimulate the ovaries it is possible to harvest a greater number of eggs at one time. This increases the chances for a successful pregnancy. However, this will only help if the overall egg quality is not too low. If there are no viable eggs, donor eggs might have to be considered.
Obstruction of tubes
In the case of obstructed tubes, one possibility is to surgically repair the tubes. However, this is a complicated procedure with limited success. Generally, IVF is used instead to circumvent the tubes. By harvesting the eggs, fertilizing them with sperm in a petri dish and then replacing them directly into the uterus, the need for the eggs to pass through the fallopian tubes is eliminated.
Low sperm quality
IVF or ICSI are options if sperm quality is inferior. By putting the sperm right next to the egg, the demands on the sperm are reduced. It need no longer conquer the long path to the fallopian tube. Also, the difficulties that are often caused by the timing aspect due to the limited life span of egg and sperm are reduced. ICSI (intracytoplasmic sperm injection) is a special version of IVF in which sperm is directly injected into the inner egg. In this case, one or two healthy sperm are sufficient to fertilize an egg, even if their mobility is impaired. Still, if no viable sperm at all is present, donor sperm is the only alternative.
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