Fertility Treatment Methods

There are 3 main types of fertility treatment:

• medicines
• surgical procedures
• assisted conception – including intrauterine insemination (IUI) and in vitro fertilisation (IVF)

Medicines

Common fertility medicines include:

• clomifene – encourages the monthly release of an egg (ovulation) in women who do not ovulate regularly or cannot ovulate at all
• tamoxifen – an alternative to clomifene that may be offered if you have ovulation problems
• metformin – is particularly beneficial for women who have polycystic ovary syndrome (PCOS)
• gonadotrophins – can help stimulate ovulation in women, and may also improve fertility in men
• gonadotrophin-releasing hormone and dopamine agonists – other types of medicine prescribed to encourage ovulation in women

Some of these medicines may cause side effects, such as nausea, vomiting, headaches and hot flushes.

Speak to your doctor for more information about the possible side effects of specific medicines.

Medicine that stimulates the ovaries is not recommended for women with unexplained infertility because it has not been found to increase their chances of getting pregnant.

Surgical procedures

There are several types of surgical procedures that may be used to investigate fertility problems and help with fertility.

Fallopian tube surgery

If your fallopian tubes have become blocked or scarred, you may need surgery to repair them.

Surgery can be used to break up the scar tissue in your fallopian tubes, making it easier for eggs to pass through them.

The success of surgery will depend on the extent of the damage to your fallopian tubes.

Possible complications from tubal surgery include an ectopic pregnancy, which is when the fertilised egg implants outside the womb.

Endometriosis, fibroids and PCOS

Endometriosis is when parts of the womb lining start growing outside the womb.

Laparoscopic surgery is often used to treat endometriosis by destroying or removing fluid-filled sacs called cysts.

It may also be used to remove submucosal fibroids, which are small growths in the womb.

If you have polycystic ovary syndrome (PCOS), a minor surgical procedure called laparoscopic ovarian drilling can be used if ovulation medicine has not worked.

This involves using either heat or a laser to destroy part of the ovary.

Read more about laparoscopy.

Correcting an epididymal blockage and surgery to retrieve sperm

The epididymis is a coil-like structure in the testicles that helps store and transport sperm.

Sometimes the epididymis becomes blocked, preventing sperm from being ejaculated normally. If this is causing infertility, surgery can be used to correct the blockage.

Surgical extraction of sperm may be an option if you:

• have an obstruction that prevents the release of sperm
• were born without the tube that drains the sperm from the testicle (vas deferens)
• have had a vasectomy or a failed vasectomy reversal

Both operations take a few hours and are done under local anaesthetic as outpatient procedures.

You'll be advised on the same day about the quality of the tissue or sperm collected.

Any sperm will be frozen and placed in storage for use at a later stage.

Assisted conception

Intrauterine insemination (IUI)

Intrauterine insemination (IUI), also known as artificial insemination, involves inserting sperm into the womb via a thin plastic tube passed through the cervix.

Sperm is first collected and washed in a fluid. The best quality specimens (the fastest moving) are selected.

Read more about IUI.

In vitro fertilisation (IVF)

In vitro fertilisation (IVF), is when an egg is fertilised outside the body. Fertility medicine is taken to encourage the ovaries to produce more eggs than usual.

Eggs are removed from the ovaries and fertilised with sperm in a laboratory. A fertilised egg (embryo) is then returned to the womb to grow and develop.

Read more about IVF.

Egg and sperm donation

If you or your partner has an infertility problem, you may be able to receive eggs or sperm from a donor to help you conceive. Treatment with donor eggs is usually done using IVF.

 

 

Fertility Treatment Methods

Ways to improve egg quality

ways to improve egg quality before pregnancy or IVF

 

1. DHEA Supplements

   – Dehydro-epiandrosterone or DHEA is a mild, well-tolerated, male hormone that can have remarkable results for women with diminished ovarian reserve.

   Very low levels of androgens in the ovaries may result in reduced ovarian reserve and poor-quality eggs, which can be turned around to a small extent with the supplementation of DHEA, as several trials have proven.

   The supplements can be taken as an oral dosage of 75mg-100mg (strictly after consultation with your doctor), for a period of atleast 2 months before ovum pick-up is done. The actual effect is known to peak in 4-5 months.

   Side effects, although rare, can be caused by the androgenous nature of DHEA. Some women may see acne, hair loss, abnormal growth of facial hair, etc. but even these tend to reverse as your hormones return to normal levels.

2. CoQ10 supplements

   – CoQ10 (Coenzyme Q10) is an anti-oxidant that helps improve the quality of eggs. It acts like a nutrient for the mitochondria, which is the energy-house of human cells.

   As you age, the number of healthy mitochondria and levels of CoQ10 decline. CoQ10 supplements can boost the energy in your egg cells.
   A Chinese study involving 169 women, found that the participants who were given CoQ10 supplements had higher number of eggs retrieved, better fertilization rates, better embryo quality, and hence, better chances of a successful pregnancy.

3. Glutathione

   – Another powerful anti-oxidant that fights free radicals and reduces the oxidative stress on your egg cells, resulting in healthier eggs and consequently, better embryos.

4. L-arginine –

   By helping improve the blood supply to the uterus and ovaries, L-arginine helps create a better environment for egg production and fertilization.

5. Myo-Inositol

   – PCOS often results in fertility problems as it causes the release of immature eggs, which cannot be fertilized well. Inositol supplements, especially when combined with Folic Acid, may improve your PCOS by reducing the level of triglycerides in the blood and improving ovarian function.

   As the insulin function improves the symptoms of PCOS get better and it may further help by promoting ovulation.

   Administration of inositol and folic acid in anovulatory women, taken daily for 3 months, was found to induce ovulation in 62% of the women in this study.

6. Nutrition

   – British researchers have found that female egg quality is affected by having too many refined carbohydrates, which break down quickly and cause a sudden spike in blood sugar.

   So, avoid excessive breads, pasta, processed foods, and sugar-rich foods.

    

   It is recommended that you have a balanced diet that comprises less than 40% carbohydrates, atleast 35% protein, and plenty of leafy greens, berries, and fruits that provide vitamins, minerals, and anti-oxidants.

7. Avoid smoking, caffeine, alcohol

   – Nicotine is known to be toxic to your cells, including egg cells. Also, caffeine and alcohol, when consumed in excess can be harmful to your pregnancy.

8. Exercise

   – Improving oxygen-rich blood flow to the ovaries can help improve the quality of eggs. Exercising and drinking more water is the simplest way to achieve that.

   Obesity can compromise mitochondrial function and increase oxidative stress on your cells. Having a normal body mass index (BMI) helps improve your odds of conceiving successfully.

9. Manage stress

   – While stress does not directly cause infertility, it can affect the quality of your eggs, causing them to function less. Prolonged stress also produces hormones such as cortisol and prolactin, which may interfere with normal ovulation.

10. Acupuncture and Yoga

    – Acupuncture and yoga can both reduce anxiety and stress, improve blood flow to the ovaries and help your body get rid of toxins—all factors that may, over time, result in improved egg quality and ovarian function.

    One of our own authors believes that acupuncture helps in conception as it did for her.