How is infertility treated?
Treatment is aimed at the cause of the infertility, if it is known. If there is a problem with a blockage in the fallopian tubes, then surgery may be the first treatment option. If endometriosis is affecting the tubes, surgery or drug treatment may be appropriate. In many cases fertility problems are hormonal and caused by problems with ovulation. Hormone therapy has a good success rate and is a simple and effective method of treating infertility. The usual drugs prescribed are estrogen antagonists such as clomiphene (Clomid). These drugs stimulate ovulation and are usually only given for three months.

In other problems relating to the ovaries, gonadotropins such as follicle stimulating hormone (FSH) (Bravelle, Gonal-F), luteinizing hormone (LH) (Luveris) and human chorionic gonadotrophin (hCG) may be prescribed. These may be used for women who have underactive pituitary glands and are usually given in injection form. Dopamine agonists such as bromocriptine (Parlodel) and cabergoline reduce prolactin levels in women who have higher levels than usual (hyperprolactinemic infertility). Gonadotropins are also used to stimulate the ovaries prior to assisted reproductive techniques and can result in multiple pregnancies. Conception can be assisted in various ways.

Artificial insemination using either the partner’s sperm or sperm from a donor involves the introduction of sperm into the cervical canal. The sperm may also be introduced directly into the uterus bypassing the cervical mucus. GIFT (Gamete Intra-Fallopian Transfer) is a procedure in which the sperm and egg are introduced together into the fallopian tubes prior to fertilization. In IVF (In Vitro Fertilization) the egg is fertilized prior to being placed in the uterus. Both GIFT and IVF require ovarian stimulation and subsequent surgical techniques to collect the eggs produced as a result of the stimulation. If there are religious or other objections to the creation and discarding of embryos, then GIFT may be the preferred option. If fertilization does not take place after IVF it is possible to observe what might be stopping a successful implantation; with GIFT no observations are possible. Therefore, as both require similar techniques, IVF is often the better option.

Further information

The National Women’s Health Information Center: http://www.womenshealth.gov/publications/our-publications/fact-sheet/infertility.cfm

Last Reviewed: May 2013