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    Mother Nature vs. Infertility Treatment

    Still not pregnant? When to seek infertility treatment and when to let nature take its course.

    Troubleshooting Your Fertility Problem

    If a problem is identified in terms of the ovulation process, the first-line infertility treatment is typically Clomid or Serophene, drugs that work by stimulating ovulation. "This is usually paired with intrauterine insemination (IUI)," Shaffran says. IUI is a fairly low-tech procedure in which sperm is injected directly into the uterus to meet - and hopefully fertilize -- a waiting egg.

    "We try this for three to six months and if we are unsuccessful, then I may try an injectable and IUI," she says. Injectable drugs also stimulate ovulation, but are stronger than Clomid. As such, the use of injectables has an even greater risk of multiple pregnancies.

    "If that fails, we may advance to something like in vitro fertilization (IVF)," Shaffran says. IVF involves combining eggs and sperm outside the body in a Petri dish. Once an embryo or embryos form, they are then placed in the uterus where they will hopefully implant. After several failed courses of IVF, couples may consider using donor eggs or adoption.

    Sometimes the cause of the infertility is unexplained. "This can be harder to treat, as there is nothing particular that we can identify as the problem," she says. "If tubes are blocked, at least we know that the tubes are blocked and we can take steps to overcome it," Shaffran says.

    Sometimes de-stressing and taking the focus off of conception is the missing link. "There are studies that suggest stress plays a role in infertility and as a result, we offer mind and body programs that involve counseling as well as acupuncture and massage therapy," she says.

    Infertility Treatment: Risk vs. Reward

    We all know the (presumptive) reward of infertility treatment - a beautiful bouncing baby girl or boy (or both), but there are risks, says Millie Behera, MD, a reproductive endocrinologist at Duke University Medical Center in Durham, N.C.

    "The biggest risk seen with any type of infertility treatment is multiple pregnancies," she says. Risks inherent in multiple pregnancies include preterm labor and birth, which poses greater risks of illness, disability, and death. There is also a higher chance of miscarriage and other maternal complications with multiple births.

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