The Fertility Diaries: 3 Friends, 3 Paths to Pregnancy
Fertility Treatment: First Steps continued...
Medications: If you're not ovulating regularly — caused, for instance, by
menstrual irregularities or polycystic ovarian syndrome, a hormonal disorder —
your doctor may prescribe oral fertility drugs, like Clomid or Serophene, which
induce regular periods and stimulate egg production; they help 20 percent to 30
percent of women conceive within six cycles. If that doesn't work, you may
undergo injections of gonadotropins, hormones that stimulate the ovaries to
develop multiple eggs, for eight to 12 days; this helps 30 percent to 40
percent of women to conceive.
Surgery: Anatomic problems such as blocked fallopian tubes or fibroids in
your uterus may require corrective surgery using a laparoscope (a thin tube
with a tiny camera that's inserted through an incision) or lasers. "But
surgery is less common now because IVF can be a quicker and more cost-effective
way to bypass the problem area," says Adamson. Success rates of different
surgical procedures range from 10 percent to 80 percent, depending on the
Intrauterine insemination (IUI): If you have cervical problems such as
infection, or if your partner has a low sperm count, your doctor may suggest
IUI, a straightforward outpatient procedure in which highly mobile sperm are
injected directly into the uterus. Pairing IUI with fertility meds that
precisely time ovulation doubles the pregnancy rate for the procedure, to 10 to
In vitro fertilization (IVF): In about 5 percent of infertility cases,
especially those involving blocked fallopian tubes and male infertility,
couples proceed to IVF. After fertility meds are injected to stimulate egg
production, the eggs are removed with a thin needle and combined with sperm in
a laboratory dish for fertilization. Three to five days later, the resulting
embryos are placed directly into your uterus via a catheter that's passed
through the vagina. About 30 percent of women who try IVF will have a baby.
How to Find the Right Fertility Doctor
Choosing a specialist that you trust can make all the difference in your
comfort level — and therefore, the outcome. "It's not just money and time
at stake — it's your hopes, your dreams, your life," says David Keefe,
M.D., chair of ob/gyn at the University of South Florida. Start by checking a
clinic's success rates on the Society for Assisted Reproductive Technology
(SART) Website (sart.org). Even if rates are high — above 45 percent for women
under 35 — don't stop there. "The clinic may not be highly skilled in the
procedures you need," Keefe says. Here, what to ask:
Are you board certified as a reproductive endocrinologist? A "yes"
means she's had four years of training in ob/gyn and three in infertility
procedures, plus she has passed rigorous national exams.
Does your clinic belong to SART? Member clinics must follow strict ethical
guidelines and use up-to-date procedures.