Once you and your partner have had a fertility evaluation, it’s time to start considering your treatment options. Fertility treatment typically refers to medications that stimulate egg or sperm production, or procedures that involve the handling of eggs, sperm, or embryos.
However, treating infertility goes beyond fertility treatments. Infertility treatment can also include surgical interventions, lifestyle changes, weight loss, or treatment of an underlying medical condition.
Your infertility treatment plan will depend on the cause or causes behind your infertility, whether the problem is from the woman’s side, the man’s side, both sides, or remains unexplained.
The good news is that 85 to 90% of couples dealing with infertility are treated with low-tech treatments, like medication or surgery. Less than 5 percent are treated by assisted reproductive technologies like IVF. Of those who receive fertility treatments, just under half will have a baby.
Egg freezing, also known as mature oocyte cryopreservation, is a method used to preserve reproductive potential in women. Eggs are harvested from your ovaries, frozen unfertilized and stored for later use. A frozen egg can be thawed, combined with sperm in a lab and implanted in your uterus (in vitro fertilization). Egg freezing or oocyte cryopreservation is a method of fertility preservation where a woman’s eggs are harvested, frozen and stored. In this procedure eggs are extracted from the ovaries, which are stored and then preserved for future use. Women with certain medical conditions required to undergo chemotherapy, radiotherapy or surgery which could affect the functioning of the ovaries take egg freezing into consideration. Couples who plan to delay parenthood also opt for this medical procedure. Once the eggs are extracted, their maturity is assessed under a microscope, and those eggs that are mature are cryopreserved. Storing the eggs for longer duration does not appear to have negative effects. When one chooses to use their frozen eggs, they are thawed, fertilized with sperm in a lab, and implanted in the patient or a gestational carrier uterus.
Endometrial Receptivity Analysis (or Array)
It is a genetic test that uses a small sample of a woman’s endometrial tissue to evaluate whether or not the endometrial lining is prepared to accept an implanting embryo. ERA is a genetic test that evaluates the expression of genes to evaluate whether the endometrial lining is properly developed to accept an embryo. This technique helps evaluate the woman’s endometrial receptivity from a molecular perspective. ERA indicates the window of implantation (WOI), increasing your chances of successful embryo transfer. Endometrial Receptivity Analysis requires a sample of the uterine lining obtained at a very specific time in the cycle. An endometrium is receptive when it is ready for the embryo implantation. This occurs around days 19-21 in each menstrual cycle of a fertile woman. ERA helps reveal the patient’s personalized window to determine the best time during their cycle that the uterus is most receptive, allowing the embryo to stick and grow. This analysis can be completed before starting assisted fertility treatment, IVF.
Ovulation induction is the stimulation of ovulation by medication. If a woman is not ovulating by herself then ovulation induction may be required. The most common causes of failure to ovulate are stress, weight fluctuations and Polycystic Ovarian Syndrome (PCOS). Other causes may include disorders of the pituitary gland, thyroid gland and raised prolactin levels. In some cases failure of ovulation is due to the ovarian failure. This may occur following treatment for cancer or may be the start of the menopause – premature ovarian failure. It is usually used in the sense of stimulation of the development of ovarian follicles to reverse anovulation or oligoovulation, but can also be used in the sense of triggering oocyte release from relatively mature ovarian follicles. If a woman has an irregular menstrual cycle, monitoring with ultrasound scans (follicle tracking) and hormone assessments may help to identify the fertile time of the month and so improve the chances of natural conception. Before ovulation problems can be treated it is important to undertake certain tests to establish the cause.