Assisted Fertility Treatments
There are different types of assisted fertility treatments available, often suggested according to your situation or diagnostically, starting off with simple hormone stimulation to full artificial insemination.
Ovulation Induction
If your hormone levels are irregular or you do not ovulate, drugs can be given to help regulation. This is called Ovulation Induction (OI) and uses a drug called Clomiphene, often under the brand names Chlomed or Serophene.
Gonadotropin Therapy
If there is no response to Chlomiphene then hormone injections can be used to stimulate ovulation. Intercourse is then needed 24-36hrs following, to coincide with release of the egg.
Further Assisted Fertility Treatment
If hormone regulation has not produced the desired results, more advanced procedures such as Intra-Uterine Insemination (IUI) and In Vitro Fertilization (IVF) can be tried.
 Intra-Cervical Insemination (ICI)
This type of simple insemination can be done in your doctors’ surgery or at home, often referred to as Intra-Vaginal Insemination (IVI). This method is basically the equivalent to the penis ejaculating as fresh or thawed frozen sperm are injected via a thin flexible catheter via the vagina into the cervix. It is often carried out around ovulation with the aid of ovulation predictor tests.
Intra-Uterine Insemination (IUI)
This is often the next assisted step if hormone stimulating treatments have failed. It is often used in conjunction with hormone stimulation and is basically placing the sperm directly into the uterus, close to the egg at the time of ovulation. This is done using a thin catheter and injecting a small amount of semen which has been washed and prepared to help eliminate any slow or malformed sperm. Success rates often vary but are quoted at around 10% per cycle and up to 15% with stimulated ovulation.
This method is good for problems associated with sperm reaching the egg e.g. poor quality, reduced sperm-antibodies, hostile cervical secretions, high FSH. It is not suitable for problems associated with blocked tubes or very low sperm quantity.
The main differences between ICIs and IUIs are that with ICI fresh/thawed frozen sperm are placed lower in the cervix to begin their journey and in IUIs the sperm are washed to remove the additional unneeded seminal fluid as they are placed higher and closer to egg in the uterus.
In Vitro Fertilization (IVF)
IVF treatments differ from inseminations (IUI and ICI) because they involve the woman’s egg being removed and fertilized outside the body and are more complicated, using hormone treatments and surgery.
In vitro means in glass as the egg is fertilized with the sperm in a petri dish before being placed back in the uterus. For many it is often the final option when all of the previous procedures to conceive have failed. It is particularly useful for blocked or damaged fallopian tubes and in the use of donated eggs and older women.
Usually only one egg is matured and released down a fallopian tube to attempt to be fertilized. In IVF multiple eggs, usually between 1 and 20, are matured and collected. They are then mixed with the sperm and the best maturing fertilized eggs are placed back, usually 1-3.
Multiple pregnancies are a possibility and indeed higher than natural conception due to the multiple fertilized eggs being replaced. Another increased risk is that an egg will develop outside the womb, usually in the fallopian tube; this is known as an ectopic pregnancy.
An option away from the use of drugs and therefore side effects is what’s known as a Natural IVF Cycle. No drugs are given and only one egg is collected, fertilized and returned. This reduces the likelihood of multiple pregnancies and side effects but also has a lower success rate.
Success rates vary from clinic to clinic; they tend to be around 30% with increased chances if you both are under 40, have had a pregnancy before, have at least one ovary responding to stimulation, FSH levels below 10 on days 2-3 in your cycle and are you are using healthy sperm.
IVF Protocols
There are two common protocols used in IVF which are the Short Protocol (sometimes called the flare or boost) and the Long Protocol. The Short protocol matches your cycle, lasting about 4 weeks and is used when there are hormone level issues, previous insufficient egg responses or because of age. The Long protocol is used when hormone levels are ok and lasts about 6 weeks starting prior to the attempted menstrual cycle.
If you are interested in reading more on assisted fertility treatments in greater detail and find out how to improve your chances of success, the eBook How To Improve Your Fertility is full of valuable information to help you get pregnant.
Archived from How to Improve Fertility
Author
Ben Haugh BSc TCM MSc CHM MBAcC MRCHM
Tel: 07734355440
Email: bmhaugh@hotmail.com
Fertility Acupuncture, Swinton, Manchester
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