Struggling To Conceive? It May Be Infertility
The unfortunate news of infertility can make this dream of parenthood a challenge. Infertility is a medical condition where an individual or couple is unable to conceive naturally after at least 6 months of consistent, unprotected sex. The condition impacts about 11% of adults and can be a devastating diagnosis. What once felt hopeless can be addressed thanks to the many advancements in reproductive medicine. Fertility clinics that specialize in reproductive treatment can help hopeful couples with a roadmap to achieve pregnancy.
A medical roadmap to pregnancy
A reproductive specialist or fertility clinic must confirm this diagnosis and then come up with a plan to increase the chances of pregnancy. In most cases, the medical team will recommend assisted reproductive technology (ART), a range of methods to spark pregnancy. Based on health, individual circumstances, family goals, and other factors, the team will lay down the best plan. ART is arguably the most effective way to help with pregnancy, with more than 80,000 successful live births occurring yearly since 2018. Each roadmap will be unique to the patient but at the core, all patients will go through a similar diagnosis to treatment timeline.
First, an effective diagnosis
Couples failing to conceive for 6 or more months are encouraged to visit a reproductive specialist immediately. Both men and women struggle with infertility. Therefore, the first step involves testing to find the root cause of infertility. For men, this involves a comprehensive semen analysis to check for sperm count, mobility, and general shape, which all impact fertility. Additional physical tests can determine if there are blockages, infections, or even cancers disrupting fertility. Women may need more in-depth analysis. Poor ovarian reserve is a common issue, as there may be insufficient healthy eggs for pregnancy. A series of reproductive conditions, such as endometriosis, fallopian tube blockages, or polycystic ovaries, may be the root cause. Both men and women also require hormone testing to determine if there is the right balance to achieve pregnancy. Test results will further advise the medical team.
Next, choosing the best course of action
Testing can reveal if the issue is female or male-related. Sometimes, both parties need fertility support. In some cases, the patients appear healthy, and there is no clear sign of an unhealthy reproductive system, a circumstance called unexplained infertility. The medical team may first consider actions to reverse underlying medical conditions. Lifestyle changes, disease management, or surgical procedures, for instance, can lay the groundwork for better fertility. Common examples include surgery to remove varicoceles in men or fallopian tube blockages in women. These are an effective first step. If there is no improvement, the doctors will recommend the most appropriate form of ART. Common examples include intrauterine insemination (IUI), in vitro fertilization (IVF), or a combination of strategies.
Taking a conservative approach with IUI
If the couple are ideal candidates, the next step involves using IUI. This procedure takes a prepared sperm sample and medically inserts the sperm into the woman's uterus. IUI is timed appropriately with ovulation to increase the chances of success. Before IUI, men and women may benefit from hormone medication. The fertility team will recommend hormone therapy to regulate or supplement the hormones responsible for fertility. A sperm sample is then taken, tested, and prepared for IUI, which is performed at the appropriate time. Hopeful couples may require several cycles of IUI spaced months apart.
Turning to IVF
If IUI fails, IVF is the next recommended step. Some cases of severe infertility, such as azoospermia, a diminished ovarian reserve (DOR), or damaged fallopian tubes, will go straight to IVF. With IVF, both egg and sperm are extracted to create viable embryos. One or more embryos are then surgically implanted into the woman's uterus. To develop these embryos, the woman will take specific injectable hormones that rapidly mature multiple follicles in the ovaries. The fertility team closely monitors this process and then surgically extracts the follicles at the ideal time. A lab then combines the egg with the provided sperm to create the embryos. At the ideal time, the embryos are transferred, with a test for pregnancy coming at least 14 days later. IVF is considered the gold standard of ART and has favorable success rates.
Success or failure? What's next
Even with all the steps successfully performed, success is not guaranteed on the first try. Studies show that IUI has a 20% success rate. IVF has a 40% success rate, depending on factors like age. In almost all cases, at least 1 cycle is required to achieve pregnancy. Sometimes, multiple cycles increase the chances of a live birth. An unsuccessful cycle is not seen as a failure but as part of the process. If the couple has made several IVF attempts without success, the fertility team can recommend other steps. Donor eggs and sperm, surrogacy, or more advanced forms of ART may be required. These all help with the outcome of finally achieving pregnancy.
A long but rewarding journey
Infertility can be a disappointing diagnosis, yet there is hope. Fertility treatments have helped hundreds of thousands of couples start or grow families successfully. At the same time, this is a complex roadmap that includes testing, diagnosis, hormone therapy, and ART. There are also different challenges in between each step. Couples who understand the journey can work with the fertility team to increase the chances of success. Through planning, consistency, and effective treatment, overcoming fertility and finally having a beautiful child is possible.