The decision to start a family is momentous, bringing forth emotions that run the gamete from happy to nervous. You should not have to add worry to this mixture, especially if you choose to seek fertility treatment. At Shenandoah Women’s Healthcare, our staff is trained in all aspects of women’s health and fertility. We can provide gentle guidance, answers to your questions, and careful medical attention as you embark on this exciting time.
Understanding the Science
Infertility is defined as the lack of pregnancy after one full year of routine, unprotected sex. This time frame drops to six months for women who are 35 years of age or older.
Both men and women can experience infertility, and the word also refers to women who are unable to carry a pregnancy to term. In heterosexual couples, the rates of men who experience fertility problems are equal to those of women.
Infertility Risk Factors
Many factors must be considered when diagnosing infertility, which is why your doctor will perform an in-depth analysis of you and your partner before moving forward. Genetics, certain behaviors, and lifestyle choices can lead to reduced fertility in both men and women.
Additional causes include exposure to chemicals, smoking and/or alcohol and drug abuse, and health conditions like heart disease and high blood pressure. In women, the prevalence of gynecological disorders is another consideration.
It’s also no secret that, unlike in previous times, people are now waiting longer to start families. This fact weighs heavily on fertility, and many couples seek medical assistance to help them conceive. The problem is that, with age, women produce fewer eggs while men have lower sperm counts. Understanding the correlation between age and pregnancy helps us speak more frankly about fertility treatments.
What to Expect
We’ll start your journey by asking many questions, a process that helps us get to know you and understand how we can most effectively work together. During your first appointment, we’ll discuss female ovulation, male sperm quality, menstrual cycles, and daily stress levels – as each relates to you and your partner.
This all-encompassing approach looks at you as a whole, rather than a part or a piece, and will help us make an accurate fertility diagnosis. Your treatment plan will then be extensively laid-out and discussed with the care you deserve.
Fertility Treatment Options
Treatment options come after you and your partner have been fully evaluated and all tests ordered by the doctor have been completed. The plan we provide will be both personalized and comprehensive, reflective of the reasons for your infertility.
It will also take into account the goals you have for your fertility and how your present health situation can be connected to your personal wishes. We expect to have conversations with you and your partner that involve asking questions, collecting information, and making decisions as a team. Once you’re comfortable with the steps suggested, we’ll proceed.
In Vitro Fertilization
Commonly referred to as IVF, in vitro fertilization combines eggs and sperm within a laboratory to create an embryo. Once created and analyzed, the best embryo(s) is transferred into the uterus. While this treatment option sounds like a one-size-fits-all approach, it’s not.
We will customize the IVF process to suit your health and needs. For example, the number of embryos transferred will depend in part on your age and the number of IVF cycles you have already completed. IVF is the go-to option for fertility treatment because it yields the highest success rates.
As doctors become more informed and techniques become more refined, a woman’s chances of becoming pregnant significantly increase. For those under 35, success rates can be as high as 50% after undergoing three IVF cycles. This figure drops to around 12% for women over 40, but, again, these numbers can fluctuate with many variables.
Ovulation pills, which work like natural hormones, are given to stimulate ovulation in women who don’t spontaneously ovulate. They are also given to help ovulating women superovulate, or produce more than one egg. With this therapy, a couple can expect increased chances of successful fertilization.
If ovulation pills don’t work, a second option is injectable hormones, which can also stimulate ovulation. Both pills and injections have shown beneficial for polycystic ovarian syndrome (PCOS), a common disorder among women. The success rate of hormonal treatments is high at around 40%.
This option can be used alone or in conjunction with another therapy, such as IVF, to promote pregnancy. Hormonal treatments are considered non-invasive and can thus be used early in the fertility process. Patients are advised to eat plenty of fruits and vegetables, exercise regularly, and keep stress to a minimum to improve the likelihood of success.
Some women require surgery as an infertility treatment. This step is considered after careful consultation with your doctor and can correct and/or remove conditions like uterine abnormalities, ovarian cysts, fibroids, and polyps.
Surgical procedures typically yield high success rates and can even restore a woman’s fertility. Follow-up treatment may be required in some cases. Rest assured your doctor will fully discuss all options with you and ensure surgery is a viable option based on your health, lifestyle, and insurance.
Intrauterine insemination (IUI) is often referred to as artificial insemination. It is a recommendation for couples with unexplained or male infertility, as well as single mothers and lesbian couples who want to have a child.
The simple process of placing sperm directly into a woman’s uterus for fertilization comes with success rates of between 5% and 15% per month, depending on the male’s sperm quality. The chances for pregnancy rise as the number of completed IUI cycles increases.
Male Infertility Options
Male infertility is diagnosed with a semen analysis. Once a semen sample is collected, it is examined to determine the semen’s number, shape, and movement. Any identifiable abnormalities will give way to further analysis. As a baseline, a low sperm count is considered to be less than 39 million sperm per ejaculate.
Fortunately, many options exist for males with low sperm counts. As recommended by your doctor, these include:
- Prescription hormones
- Weight loss
- Herbal supplements
Success rates for these treatment options vary. For instance, a woman can often conceive if the only issue is the man needs to make simple lifestyle adjustments like quitting smoking or losing weight to improve sperm quality.
Another option available to couples is intracytoplasmic sperm injection (ICSI), which involves the injection of one sperm into an egg’s interior using a very thin needle. This can be done only during an IVF cycle but affords a high success rate. If a male has sperm in his testicle, ICSI can effectively help a couple gain pregnancy.
As discussed earlier, age weighs heavily on a woman’s chances of getting pregnant. A successful pregnancy is unlikely without ovulation and healthy egg quality, and the potential for both decreases as a woman ages.
On average, a healthy woman at age 40 has only a 5% chance of getting pregnant each month. By contrast, a woman in her 20s has around a 25% chance of pregnancy in any given month. For this reason, your doctor may suggest egg donation, a process by which an older woman can successfully carry a pregnancy to term using eggs donated by a younger woman.
This is a relatively simple option that allows you to choose your donor – either anonymously or a friend or family member – and employs IVF. The father can be your partner or, again, an anonymous sperm donor. The success rate stands between 55% and 65%, meaning it’s a viable option even for women who no longer ovulate.
Surrogacy provides yet another treatment option for pregnancy. In this process, the surrogate mother receives an embryo transfer – using the sperm of your partner or a donor – and carries the pregnancy to term. A woman without a uterus, who has suffered recurrent pregnancy losses, or has serious medical problems may elect to have a surrogate.
The process is the same as that of egg donation, except the intended mother does not carry the pregnancy herself. Surrogacy can also enable gay male individuals or couples to start families. This treatment comes with extremely high success rates. Surrogate mothers undergo extensive screening, and it is preferred they be under 40 years old and have previously carried at least one successful pregnancy to term.
Intended parents can be deeply involved throughout the pregnancy, thereby strengthening their bond with their unborn child. An attorney must draw the necessary legal paperwork to ensure all parties involved in surrogacy are equally protected.
Lesbian Parent Options
It is our goal to give support and compassion to lesbian women and couples who long to have families. We discussed artificial insemination (IUI) earlier and want to again point to it as an option with great flexibility and high success rates. This treatment takes place during the natural menstrual cycle, and sperm can come from someone you know or a donor. Older women may be given fertility drugs with IUI to increase the chances of conception.
Co-IVF provides another, more modern option for lesbian couples. With this process, one woman takes injectable hormones to produce eggs, and the other carries the pregnancy in her uterus. It is important to keep in mind, however, that just as with all the treatments listed here, your doctor will need to first conduct a thorough review of your family and medical histories, current health, age, and lifestyle. This will help us determine the plan that makes the most sense for you and your partner.
Success Rate Numbers
We understand that knowing the success rates associated with each treatment is an important part of your fertility journey. But we want to remind you that much more than numbers will indicate the likelihood of your conceiving and having a child.
Your age, overall health, and the reason(s) for your infertility will help determine your unique plan; the success of that plan ultimately depends upon your lifestyle, reaction to the treatment, and the number of repeated attempts. We, therefore, recommend you use statistics only for guidance.
Find Out More for Yourself
Fertility is a sensitive issue, one that requires a safe place where you can speak openly. Visit us at Shenandoah Women’s Healthcare today, where we have the knowledge and experience necessary to maximize your chances of getting pregnant. We are not only honored to help you have the family you want, but we are 100% committed to giving you the best fertility experience possible.