Infertility Treatments Tips

Surrogacy

For those unable to conceive a child, surrogacy is one infertility treatment option to consider, especially in cases where a woman is unable to carry a child due to an existing medical condition, such as hysterectomy, severe endometriosis or brittle diabetes.

In surrogacy situations, a woman, other than the would-be-mother, agrees to carry a child to term for the individual or couple. At birth, the surrogate relinquishes her parental rights to the child. This is normally conducted as a business agreement, and necessitates a lawyer to ensure that all State legal requirements are met.

A fertility clinic which offers surrogacy as an infertility treatment option will be familiar with the legalities of this type of treatment, since surrogacy is illegal in five (5) of the United States: Arizona, Michigan, New York, Utah and Washington, and there are strict laws and guidelines in other States.

Generally, surrogates meet certain criteria, which include, but not be limited to:

• age betwteen 18 and 35
• married, employed and middle class
• good medical health
• stable emotional and psychological health
• pass a criminal background check
• have a satisfactory psychological evaluation
• maturity
• become pregnant easily with no problems carrying to term

Since the law vary from state to state, and there is legal paperwork that must be completed related to this infertility treatment option, it is best to consult an Agency or lawyer who specializes in surrogacy, to ensure the rights of each party, and the best outcome for the child.

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Factors in Considering Infertility Treatment

Generally, for a woman under the age of 35, infertility doctors recommend attempting natural conception with unprotected sex, for one year, before seeking infertility treatment. For women older than 35, they suggest 6 months as a guideline, since it becomes harder to achieve pregnancy as you age, and it can be more difficult to sustain a pregnancy in the face of infertility.

However, age is only one factor when considering infertility treatment. Other factors can include:

• Cost - This should be part of the discussion when determining your infertility treatment. Since insurance may not cover fertility treatments, cost is an important factor in deciding on a treatment modality.
• Type of infertility - If infertility is related to a correctable hormone imbalance, such as what might cause irregular ovulation, treatment options are non-invasive with a lesser chance of adverse side effects. If surgical treatment is required, there are greater risks in treating the infertility. This is especially key if you have underlying medical conditions that may make getting pregnant, or maintaining a pregnancy to full term, more difficult.
• Laws in your State - These should also be taking into consideration, especially if sperm donation, egg donation or surrogacy are among your infertility treatment options. Since laws vary from State to State, in terms of the legality of fertility-related services and parental rights, it is important to understand the laws in your State and how they may impact your fertility treatment. Your fertility clinic should be able to provide with information about the laws in your State and guide you through the legalities of your chosen infertility treatment, if necessary.

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Reproductive Endocrinologist

Each body system is capable of developing disease. There are physicians (specialists) who are specially trained in providing care for diseases of each system. These Specialists have all of the training of a general practitioner, then receive additional training and education in order to practice in their specialty. This is true for physicians who opt to become Infertility Doctors.

Even within some specialties, there are physicians who choose to select a very specific component of the disease or body system, on which they focus their education and skills. This is called a Sub-Specialty.

A Reproductive Endocrinologist (pronounced "en-doe-krin-all-oh-jist) is a sub-specialty of Infertility Doctor, which utilizes expert training specifically aimed at hormone-related infertility.

Since hormones play such a significant role in reproduction, from regulating ovulation to managing sperm production, the Reproductive Endocrinologist has the necessary expertise to assess and treat hormone-related conditions that can contribute to infertility.

Talk to your Fertility Clinic about a Reproductive Endocrinologist and how they may help you overcome infertility.

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Sperm Donation

Sperm donation has become a very important part of infertility treatment, since the advent and advancement of In Vitro Fertilization (fertilizing an egg in a test tube and implanting it in a woman's uterus) and In Utero Fertilization (instilling sperm directly into the uterus). A fertility clinic relies on donated sperm to assist couples in whom the man is sterile or to assist single women to achieve conception.

Like Egg Donors, Sperm Donors are screened by the fertility clinic to ensure that healthy sperm will be collected, including testing for sexually transmitted diseases. A medical history is obtained, in addition to a physical exam, to provide information on the health of the donor.

Sperm donors generally meet certain criteria, including:

• age between 18 and 35
• able to provide medical history information about both sides of the family
• testing negative for STDs and infectious diseases
• free of chronic health problems
• ability to commit to providing necessary samples

Sperm donors report to the fertility clinic and provide the ejaculate for use in donation. The sperm is then stored until used for fertilization. The process can be anonymous or you can have your identity released.

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Fertility Drugs

Since hormonal imbalance is one of the most common causes of infertility, in both men and women, hormones and fertility drugs are the first options chosen by fertility doctors, in treating infertility.

Use of fertility drugs is generally low risk and less expensive, when compared to other fertility treatments options, and they are easily administered and monitored.

The drugs primarily used to treat infertility include:

• clomiphene (pronounced "klo'-muh-feen") - used to stimulate hormones in your brain to prepare eggs for ovulation
• gonadotropins (pronounced "go-nad'-uh-trow-pins") - stimulate your ovaries to produce eggs, stimulate the production of luteinizing hormone, which prepares your uterus to receive a fertilized egg
• bromocriptine (pronounced "bro-mow-crypt-een") - used to reduce prolactin levels. High prolactin levels decrease estrogen production, which inhibits ovulation.

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Surgical Treatment - Male

Men can also have structural problems within their reproductive organs which can contribute to infertility. One infertility treatment involves the use of surgery, to correct the structural problem. These procedures are performed by qualified infertility doctors and surgeons at a fertility clinic.

Some of the structural problems that can occur in men, include:

• congenitally blocked vas deferens, the tube that carries sperm to the sperm storage area
• undescended testes, in which one or both testes remain within the pelvis rather than moving down into the scrotal sac
• cysts on the testes or within the scrotal sac
• erectile dysfunction - the inability to attain or maintain an erection - that cannot be corrected with medication or other non-surgical treatment
• scarring with ejaculatory or other ducts related to infection, such as sexually transmitted disease
• hypospadias (pronounced "high-po-spade-ee-us), where the opening normally at the tip of the penis is on the underside of the penile head

Talk to your infertility doctor about the surgical options for structural causes of infertility.

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In Utero Fertilization

There are many ways to assist with conception, from fertility drugs to surgery. There are also several assistive reproductive technologies that a fertility clinic may use, such as In Vitro Fertilization and In Utero Fertilization.

In Utero Fertilization involves instillation of sperm into the uterus, at the appropriate time during the menstrual cycle. The sperm then swim into the fallopian tubes and fertilize an egg, resulting in conception and pregnancy.

This procedure works well for most women with infertility, except those in which there is poor egg production, blocked or severely damaged fallopian tubes, or in those who have undergone menopause.

The risks are limited to discomfort comparable to that of a pap smear. Since a thin flexible catheter is used to instill the sperm, risk of making a hole in the uterus is exceptionally small. Infection is also a possible complication, but is very rare.

Talk to a Fertility Clinic about In Utero Fertilization, to see if this might be the right treatment to help you conceive.

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Fertility Clinic

Just as there are speciality clinics for persons with heart disease, orthopedic injuries and neurological problems, there are also specialty treatment centers designed to treat infertility.

Infertility is a medical condition, which requires specialized evaluation and intervention. Since you would not go to a foot doctor to treat your asthma, it makes sense that you would also seek out a qualified professional in infertility medicine to treat your infertility.

Staff at fertilities clinics include:

• lab technicians - process blood, urine, semen and other body specimens to help identify barriers to fertility
• radiologic technicians - perform x-rays, ultrasounds and scans to help identify structural causes of infertility
• nurses - to assist in the assessment and care of infertile persons
• infertility doctors - these are physicians who have had additional education and training in the evaluation and treatment of infertility, and may include:

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Surgical Treatment - Female

There are many cause of infertility from hormonal variations to underlying medical conditions. Some women are infertile due to structural problems within their reproductive organs. These problems may be congenital - present at birth - or acquired. Some of these anomalies include:

1. malformed uterus, such as a tri-corn uterus, which has 3 chambers rather than just one
2. fallopian tubes blocked related to atresia, where the end of the tube is congenitally blocked
3. scarring of the fallopian tubes related to pelvic infection or sexually transmitted diseases, which obstructs the tube or makes the opening so narrow that it cannot function properly
4. ovarian cysts, which can impair the function of the ovary, impeding ovulation
5. severe endometriosis - formation of uterine tissue in areas other than the uterus - can block the fallopian tubes, damage the ovaries, cause adhesions/scars that attach the reproductive organs to the intestines, and disrupt proper functioning of the ovaries causing irregular menstruation associated with irregular ovulation

Talk to your fertility clinic, or an experienced infertility doctor, about your fertility concerns, and to have a complete evaluation to see if structural problems are at the root of your infertility

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In Vitro Fertilization

In Vitro Fertilization is the fertilization of an egg with sperm inside a test tube or petri dish. The fertilized egg is then implanted in a woman's uterus. Your infertility doctor will consider IVF after more conservative methods of treating infertility are not effective, or are not considered to be appropriate, based on the status and needs of the couple or woman seeking to conceive.

Traditionally, IVF involves several steps:

• administration of fertility drugs to the woman
• collecting of eggs
• fertilization of eggs in a petri dish or test tube
• transfer of fertilized eggs into the woman's uterus
• storage of any remaining fertilized eggs by freezing

Talk with your fertility clinic, or infertility doctor about IVF and whether this is a viable option for treating your infertility.

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Egg Donation

For women who have gone through early menopause, who produce inadequate numbers of eggs, or who have failed IVF using their own eggs, egg donation is a viable option to assist them in achieving pregnancy.

According to fertility clinics, egg donation can be expensive. It can also be an emotional experience, and it has a variable success rate, however the pregnancy rate is better than that normally achieved using In Vitro Fertilization and the woman's own eggs.

The egg donation process usually includes:

• screening for the appropriateness of receiving a donor egg
• finding a donor - the donor should be less than 35 years of age, without chronic health problems or genetic diseases, and should match most of your donor criteria, be it physical attributes, intelligence or creative gifts.
• compensating the donor - up to $5000
• hormone therapy to prepare your uterus for the egg
• egg donation
• pregnancy testing to confirm pregnancy or lack thereof
• if positive, ongoing hormonal therapy for at least 2 months

As with any medical procedure, there are some risks. The risks of egg donations are similar to those associated with egg retrieval for In Vitro Fertilization: bleeding at the needle insertion site, pelvic or vaginal tenderness or ovarian cyst production. Infection, internal bleeding or puncture of the bowel may also occur, however these are very rare.

Talk to your fertility doctor, or contact a fertility clinic to obtain more information about Egg Donation.

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