The term ‘fertility treatment’ is used to cover a range of different methods of treating infertility, including medication, surgery and assisted reproduction techniques (ART). Infertility is defined as being unable to conceive after 1 year of regular unprotected intercourse. This may be caused by a number of factors, either male or female, and it is important to see your GP and attempt to get a diagnosis before beginning any fertility treatment.
There are a number of causes of infertility that can be treated using medication. One of the most commonly prescribed drugs for women is Clomid. This is used to stimulate and/or regulate ovulation. It is therefore often used for women with polycystic ovaries (PCO) or those with low ovarian reserves. Metformin is another drug which performs a similar function. For patients who have problems with their pituitary gland FSH or LH injections may be prescribed.
For male infertility, antibiotics may be used to treat infection/inflammation. In cases where no sperm are being produced (azoospermia) gonadotrophins may be prescribed, while there are also drugs to treat retrograde ejaculation.
Some fertility problems can be resolved through surgery. For example, fallopian tube surgery can be used to treat fallopian tubes that are blocked or scarred. If there are obstructions in the womb preventing implantation these can be treated with surgery to remove them, e.g. fibroids, polyps, cysts, endometriosis. Some patients with Polycystic Ovarian Syndrome (PCO) and sterilisation can also be treated with surgery. Every case is different and it is best to speak with one of our Consultants who can advise the best option.
There are surgical procedures available for males with known fertility problems. One of these is the Epididymovasostomy which is used to clear blockages in the epididymis (the tube between the testicles and the head of the penis). There is also surgery available to repair dilated scrotal veins which improves sperm concentration, mobility and morphology. For men who have undergone a vasectomy, in some cases this can be reversed through surgery. Our Consultant Urologist, Mr Nargund, would be the best port of call to find out more detailed advice.
Intrauterine insemination is a process whereby fast-swimming sperm are separated from slower-swimming sperm and introduced in to the uterus to coincide with ovulation. IUI can be performed with or without the use of fertility drugs. The development of the follicles may be monitored with ultrasound scans. When the egg is mature, the procedure is performed: the doctor uses a speculum to separate the vaginal walls (similarly to a smear test) before inserting a fine catheter into the womb and inserting the semen.
IVF is when an embryo is created outside a woman’s body. The process involves extracting eggs directly from a woman’s ovaries and fertilising them with a partner’s sperm/donor sperm in the lab. One or two fertilised eggs are then replaced in the woman’s womb. Many IVF treatments require the female partner to take stimulating drugs and have monitoring ultrasound scans before the eggs are collected.
ICSI is used in addition to IVF, when the male partner has a low sperm count. It involves the same procedure as IVF, with eggs being collected from the woman’s ovaries. However, rather than being left in a dish to fertilise, the sperm is directly injected into the egg. This is useful for when the sperm count is low, or if there are problems with the fertilisation process.