Options help overcome infertility

According to the American Society of Reproductive Medicine (www.asrm.org) infertility affects 10 percent of the reproductive-age population in the U.S. The good news is that an estimated 90 percent of all infertility cases—both male and female factor—are successfully overcome through treatment. There are a number of different regimens used to treat infertility. Some are medical, some are surgical and some are combinations of both.

Here’s a brief overview of the most common treatment options:

Ovulation Induction: Ovulation induction involves using medication— Clomid or injectable medications such as gonadatropins—to induce ovulation in patients who aren’t normally ovulatory. Clomid may also be used in other conditions where patients are ovulating regularly but haven’t achieved a pregnancy.

Superovulation with Gonadatropins: Gonadatropins—synthetic or purified human hormones—are used to enhance ovulation in patients with ovulatory impairment or who are unresponsive to Clomid. Gonada­tropins increase the total number of eggs released in a given cycle and also improve egg quality. When the greatest number of eggs are mature, a second hormone is used to stimulate ovulation. Superovulation is restricted to patients with normal tubal function and those whose male partners have borderline or normal sperm counts. Because gonadatropins are such powerful medications, close monitoring of the patient with ultrasound and blood estrogen levels is necessary. Superovulation carries a risk of multiple gestations. Of all pregnancies that develop through superovulation, 65 percent are likely to be singletons, 25 percent will be twins, and 10 percent will be triplets or greater.

In Vitro Fertilization: IVF is generally regarded as the best hope for many patients. Simply put, IVF in­volves superovulation (see above), plus removing the eggs for fertilization outside the body. IVF has become a very important technique in the treatment of patients who have been unsuccessful with superovulation, are unwilling to risk multiple gestations, have tubal disease, or whose infertility involves severe male factor issues.

Infertility Surgery: While IVF is the most successful therapy ever developed to overcome infertility, there is still a role for surgical intervention to diagnose and treat infertility. Studies reveal that surgery to correct endometriosis enhances fertility. Microscopic tubal surgery is still used in patients with tubal ligations who want to get pregnant. Results vary and are largely dependent on the condition of the tubes.

It’s important to note that 40 percent of all infertility is male factor. Many interventions are available to overcome male factor infertility; the first step is diagnosis using a simple semen analysis.

According to Doug Austin, MD, the first step in any infertility treatment program is determining and understanding the cause of the infertility. “People often balk at seeking treatment because they’re afraid it’s going to bankrupt them when, in fact, a vast majority of infertility cases are successfully treated with low tech options,” he says.

Paul and Raegan Chapman are expecting a baby next June after in vitro fertilization at The Fertility Center of Oregon. “We really liked Dr. Austin’s bedside manner,” says Raegan. “And the staff at The Fertility Center of Oregon made us feel like there are people out there who wanted to help and understood all we’d been going through. When I became pregnant and Dr. Austin told us we were done with treatments, we were extremely thrilled to be moving forward, but very saddened to be leaving the wonderful staff at The Fertility Center of Oregon.”