Understanding your fertility treatment options

When you are preparing for pregnancy, you might encounter something unexpected. Sometimes, after a year of trying, you do not succeed in getting pregnant. For couples dealing with fertility issues, trying to become a parent can be a challenging and emotional endeavor. Fortunately, nowadays, with the advancement of medical technologies, many infertile couples can overcome fertility problems and achieve their dream of having a happy family.

It can be difficult to find a solution to this problem. It is better to understand your and your wife’s fertility problem correctly by visiting a specialist doctor in the first step. Then, by checking and consulting with experts, get the necessary information about infertility treatment methods. Overall, your doctor is the best person to help you. According to your and your spouse’s conditions, the doctor can help you make an informed decision and choose the best treatment method.

Infertility treatment is not always done with complex methods such as IVF. Sometimes fertility problems can be solved with minor lifestyle changes or medication. The choice of each infertility treatment method depends on various factors such as the couple’s age, medical history, couple’s condition, doctor’s diagnosis, etc. In this article, we will introduce the methods of treating infertility from drug treatments, surgeries, and assisted reproductive technologies (ART) such as IUI, IVF, ICSI, egg donation, etc.

The best methods of infertility treatment

When it comes to infertility treatment, there are several factors to consider. No single method can be identified as the “best” method for treating infertility. Because choosing the best method of treatment depends on factors such as the cause of infertility, the duration of infertility, the age of the couple, the health of the couple, the state of eggs and sperm, medical history, etc. Therefore, a treatment method may be effective for one couple, but not for another. In general, all types of infertility treatment methods can be classified into the following 5 groups:

1. Lifestyle change

   In many cases, lifestyle change and weight loss can improve a couple’s fertility.

2. Pharmaceutical treatments

   This treatment usually includes the administration of hormonal medicines to improve the performance and fertility of men or women or both.

3. Assisted reproductive technologies (ART)

   Infertility treatment methods in which egg and sperm are inseminated outside the body and in a laboratory environment are called assisted reproductive technologies (ART). IVF, ICSI, and embryo genetic testing (PGS and PGD) methods are among assisted reproductive technologies. IUI is also one of the first methods of infertility treatment that is usually recommended before IVF.

4. Surgery

   Surgery can be used to correct reproductive system abnormalities such as uterine problems in women or varicocele in men.

5. Donor options and Surrogacy

   If the egg or sperm quality is low or there are no eggs or sperm for some reason, it is recommended to use donated eggs or sperm. If there is a problem in the structure of the uterus, a surrogate uterus (Surrogacy) is recommended for embryo transfer.

Which infertility treatment method is suitable for you?

Before choosing the infertility treatment method, your doctor will try to determine the cause of infertility by performing initial examinations, checking the results of the woman’s fertility tests and the man’s fertility tests, and preparing a complete history of sexual habits and medical records. Therefore, the doctor will suggest you the best method of treatment according to the reasons for infertility, the age of the couple, previous treatment attempts, etc. In this section, we will review the types of infertility treatment methods and the conditions for which each of these methods are recommended for treatment:

1-Healthy lifestyle

Lifestyle changes are recommended as the first step in treating infertility. Losing weight, proper nutrition, regular exercise, avoiding smoking and alcohol, reducing caffeine consumption, adequate sleep and stress management can help improve the quality of eggs and sperm and increase the chances of pregnancy. Lifestyle changes can improve fertility in cases where a couple has an unhealthy lifestyle.  Learn more about tips for boosting eggs quality: Solutions to increase egg quality

In some cases, lifestyle changes alone may not be enough to achieve pregnancy. But improving lifestyle along with other treatment methods can help increase the success of these treatments.

2-Pharmaceutical fertility treatments

The doctor may recommend the use of medicine to treat fertility problems in the following cases:

1. You are suffering from polycystic ovary syndrome (PCOS).
2. You have an irregular ovulation cycle and the time of ovulation is not predictable.
3. You or your wife have hormonal problems.
4. Your wife’s testicles produce a few sperms or the sperms have an abnormal movement.
5. You or your wife have a certain infection or disease that prevents pregnancy.

In cases where there are ovulation problems, the doctor may recommend the use of clomiphene, letrozole, etc. Taking metformin can improve the symptoms of polycystic ovary syndrome. Gonadotropin can help stimulate ovulation in women and improve fertility in men. Antioxidants and vitamins can also help to increase the quality of eggs and sperm. In cases where infection or certain diseases such as diabetes, hypothyroidism or hyperthyroidism, etc. cause fertility problems, the doctor prescribes medicines related to each disease.

In the note, medicine should be taken under the advice and supervision of a specialist doctor.

3-Assisted Reproductive Technologies (ART)

If the couple is of the right age, IUI is usually the first step in infertility treatment. In this method, sperms are washed in the laboratory environment and then directly injected into the uterine cavity near the ovulation period. In this method, sperm are washed in the laboratory and then injected directly into the uterine cavity near the ovulation period. This method is often used in cases where the sperm count or motility is low or there are ejaculation problems or the female is involved with mild endometriosis.

If IUI is not successful, then IVF and ICSI are recommended IVF and ICSI are methods of in vitro fertilization in which sperm and egg are combined in the culture medium of the laboratory and an embryo is formed. The difference between IVF and ICSI is the method of fertilization of the egg. In the IVF method, the sperms enter the egg by their own movement, but in the ICSI method, the sperms are injected into the egg through a special needle. IVF and ICSI methods are mostly used in the following cases:

• Low sperm quality (low number, low motility, or abnormal shape of sperms)
• Obstruction of uterine tubes
• The low number of eggs due to aging or ovarian failure
• Infertility with an unknown cause
• Older age of the couple

In cases where the couple has a history of genetic diseases in their family or has experienced repeated miscarriages, it is recommended to perform PGS genetic tests on the embryos formed in the IVF or ICSI process in order to select healthy embryos for transfer to the mother’s uterus. In addition, couples who are interested in having a child of a specific gender can use PGD to determine the gender of their embryos.

4-Surgery for fertility treatment

Sometimes the doctor uses surgical methods to check and solve fertility problems. Surgical procedures are usually used when structural abnormalities in the reproductive system prevent pregnancy. Surgery may be recommended for women with the following conditions:

• Blocked Fallopian tube

  If the fallopian tubes are blocked or damaged, surgery to remove the blockage and adhesions can help. Learn more about pregnancy with blocked fallopian tubes: Chances of getting pregnant with blocked fallopian tubes

• Endometriosis

  Endometriosis is a condition in which uterine tissue grows outside the uterus. Removal of endometrial tissue by laparoscopy or hysteroscopy can help to improve fertility.

• Polyps, fibroids, or adhesions

  The presence of polyps, fibroids, or adhesions in the uterus can interfere with fertility. Therefore, the removal of polyps, adhesions, and fibroids can increase the chance of pregnancy.

Surgery can also help men improve their fertility. Cases in which surgery can be used to treat male infertility are:

• Ejaculatory duct obstruction

  Ejaculatory duct obstruction prevents the exit of semen. Surgery can be used to remove the blockage of the ejaculatory duct.

• Varicocele

  The varicocele (swelling of the testicular veins) can affect sperm production and quality. Surgery can help improve varicocele and increase male fertility.

• Azoospermia

  Azoospermia is a condition with no sperm in the semen sample. If azoospermia is due to obstructive reasons. Surgery can help remove the blockage and allow the sperm to pass from the testicle to the sperm ducts. If the azoospermia is non-obstructive or the sperm quality in the semen is low, testicular tissue sampling can be used to extract sperm for in vitro fertilization.

5-Donor options and Surrogacy

When the quality of eggs or sperm is not appropriate for embryo formation and pregnancy, it is prudent to contemplate the use of eggs or sperm donation for the IVF process. Moreover, if there is a problem with the uterus, it is advisable to consider a surrogate mother.

Egg donation

The quality and number of female eggs decrease with age. So that after age 37, the ovarian reserve decreases rapidly, and from age 40, the menopause process starts and the ovulation process gradually stops. Menopause may occur in some people before the age of 40, which is called premature menopause. If a person does not have high-quality eggs for IVF or does not have adequate ovarian reserves due to menopause, the doctor recommends using donated eggs.

In IVF with donor eggs, the eggs of young donors are used for insemination in the laboratory. Donated eggs are fertilized in the laboratory with the sperm of the egg recipient’s wife and an embryo is formed. Embryos are transferred to the recipient’s uterus after the initial stages of development.

Sperm Donation

 If the quality of the sperm is low or because of azoospermia, sperm cannot be produced in the testicles, the use of donated sperm can help in conceiving a child. In this method, another person’s sperm is used in the IVF method for insemination with eggs.

Sometimes, the use of donated eggs or sperm is also recommended for couples who cannot have a healthy child due to genetic problems.

Surrogacy

 Sometimes pregnancy is not possible due to structural abnormalities of the uterus or some diseases such as cancer. In this case, the doctor recommends that the embryos formed in the IVF process be transferred to the uterus of another person who has suitable conditions for pregnancy.

Selection of infertility treatment center

The first and most important step in infertility treatment is to choose an advanced infertility treatment center and an experienced and specialized doctor. A specialist doctor can offer an effective and appropriate treatment method to the couple by timely and accurate diagnosis of the cause of infertility. In addition to the doctor’s experience, the well-equipped and advanced treatment center is also influential in the quality and success of the treatment process. Therefore, before starting the treatment, it is better to get information about infertility treatment centers and different doctors to choose the best treatment center and the best doctor.

The best infertility treatment centers in Iran with the cooperation of the best Iranian doctors, experienced personnel, and advanced equipment are always the choice of many infertile couples from all over the world.

For more information about infertility treatment in Iran, you can contact us.

References:

https://www.nhs.uk/conditions/infertility/treatment

https://www.hfea.gov.uk/treatments/explore-all-treatments/fertility-drugs