Getting treatment

Treatment options

There are three main types of fertility treatment:

• medicines to assist fertility,
• surgical procedures, and
• assisted conception.

Medicines to assist fertility

• Clomifene - this medicine helps to encourage ovulation (the monthly release of an egg) in women who do not ovulate regularly, or who cannot ovulate at all.
• Metformin - you may have to take this medicine if you have not responded to clomifene. It is particularly beneficial to women with polycystic ovary syndrome (PCOS) - see causes section.
• Gonadotrophins - medicines containing gonadotrophins can help to stimulate ovulation.

Surgical procedures

• Fallopian tube surgery - if your fallopian tubes have become blocked, or scarred, you may require surgery to help repair the tubes and make it easier for eggs to pass along them.
• Laparoscopic surgery - a laparoscopy involves having a small cut ( incision ) made in your abdomen . A thin, flexible microscope with a light on the end, called a laparoscope, is then passed through the incision . This type of procedure can be used to look at internal organs, take samples and perform small operations. It is often used for women who have endometriosis - see 'causes' section.
• Epididymal blockage - this type of surgery is used to repair the epididymis (a coil like structure in the testicles which helps to store and transport sperm). Sometimes, the epididymis becomes blocked which can stop sperm from being ejaculated normally.

Assisted Conception

Intrauterine insemination (IUI)

This procedure involves sperm being placed into the womb through a fine plastic tube. The tube is passed through the cervix and into the womb. Sperm is collected from the man and then washed in a fluid, after which the best quality specimens are selected. The sperm are then passed through the tube. This procedure is performed to coincide with ovulation and increase the chance of conception. You may also be given a low dose of ovary stimulating hormones to again increase to chance of conception.

IUI tends to be used when infertility cannot be explained, or when a man has a low sperm count, or decreased sperm mobility. It is also helpful for men who experience severe impotence. Provided that the man's sperm and the woman's tubes are healthy, the success rate for IUI is around 15% per cycle of treatment.

In vitro fertilization (IVF)

In IVF , fertilization happens outside the body. The female partner takes fertility medication to encourage the ovaries to produce more eggs than normal. Eggs are then removed from her ovaries and fertilized with sperm in a laboratory dish. The fertilized embryos are then put back inside the woman's body. The chance of multiple births is higher with IVF because more than one embryo is often put back into the woman's womb.

Egg and sperm donation

If a couple have an infertility problem, they may be able to receive eggs, or sperm, from a donor to help them get pregnant. Fertility treatment with donor eggs is normally carried out using IVF .

Anyone who registered to donate either eggs, or sperm, after 1st April 2005, can no longer remain anonymous and has to provide information about their identity. This is because a child who is born as a result of eggs or sperm being donated is legally entitled to find out the identity of the donor , upon reaching the age of 18.

Blastocyst transfer

Blastocyst transfer treatment is sometimes used for women who are able to make good quality embryos which fail to implant in the womb. In this procedure, embryos are allowed to develop for five to six days after fertilization before they are put back in the womb. .

Assisted hatching

In order to attach to the wall of the womb, an embryo first has to break out ('hatch') from the gel-like shell that it is contained in. This shell is called the zona pellucida and is harder in some embryos than others. Assisted hatching is when the doctor helps the embryo to hatch by making the shell of the embryo thinner, or by making a small hole in its shell.