We believe in choosing the most simple, cost-effective treatment option that will create the greatest chance for your success.
When making this choice it’s important to weigh the monthly chances of becoming pregnant against the procedure costs and your physical and emotional involvement.
To judge the effectiveness of a treatment option, it is helpful to keep in mind the normal fertility odds of 25% chance of conception each month.
It is also useful to consider the mere 4%-5% success rate for young couples with unexplained fertility who undergo ‘no treatment.
Polycystic Ovarian Syndrome (PCOS) and other ovulation problems: not only are ovulatory issues the most common fertility problem, they are also the most simple to treat.
Letrozole and clomiphene (Clomid) are the oral fertility medications of choice because they are simple to use, inexpensive, and don’t have many side effects. Young women treated with oral fertility medications can expect a 15% to 20% chance of pregnancy each month with 50% to 60% of patients achieving pregnancy within 6 months of treatment.
In the event that woman does not achieve pregnancy within the first six months of treatment, further advanced diagnostic testing will be needed to determine additional issues.
Unexplained infertility: this diagnosis is given to a patient when they have normal ovulation, a normal semen analysis, and open fallopian tubes.
Clomid, oral fertility medication, is often chosen by gynecologists to treat these patients. However, with a success rate of only 4% per month, medical literature shows that treatment with Clomid is essentially the same as ‘no treatment’ [https://www.fertstert.org/article/S0015-0282(09)00866-8/fulltext]. Due to the low success rate, experts encourage patients to avoid this treatment option.
Many families find that the most cost-effective option is a combination of fertility medications and intrauterine insemination (IUI). This program also has a reasonable success rate of approximately 8% - 12% success per month
In vitro fertilization (IVF) is recognized as the standard of care and is expected to create a 40% to 60% chance of birth in a young woman.
Male Infertility: couples in which the male has mild to moderately severe infertility commonly use intrauterine insemination (IUI) due to the projected 8% - 12% monthly success rate. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4272842/].
A male with severe infertility (sperm cell counts less than 5 million per sample) has a success rate of well under 5% per month when IUI is used. That is also the success rate for couples who have undergone more than 4 months of IUI treatment.
The preferred treatment for men with severe male infertility is in vitro fertilization (IVF) with ICSI sperm microinjection. During the ICSI procedure, a single sperm cell is implanted directly into the gg via a micro-needle. Click to watch a video [https://www.youtube.com/watch?v=cVmQsv8tVMw] In a large majority of patients, improper sperm function issues are overcome through ICSI treatment. Young women, under the age of 35, may expect a promising range of 40% to 60% chance of delivering a baby after just one embryo transfer.
Damaged or blocked fallopian tubes: for women with damaged fallopian tubes, IVF is the only successful treatment option. Fortunately, the expected chance of delivery after a single embryo transfer is 40% to 60% in young women.
Endometriosis: the treatment of choice for women with endometriosis is often the same as women with unexplained infertility. Comparable to ‘no treatment’ at all, oral fertility medications like Clomid offer a pregnancy success rate of only 4% to 5% per month. Combining oral fertility medications with intrauterine insemination (IUI) may increase the success rate to 8% to 12% per month. The best success rate for delivery in young women, at an estimated 40% to 60% chance per month, is IVF. Laser surgery to remove endometriosis is another option but it is one debated by specialists as some believe it may temporarily improve fertility while others believe that success rates are not enhanced in the long term.
Tubal Ligation: there are many good options available for young women in particular. Surgical repair of the fallopian tubes can lead to a 60% chance of pregnancy in the two years after surgery. When all the embryos from a single egg harvest are transferred through IVF, the success rates are similar. Aside from less surgery, IVF has the advantage of achieving a pregnancy more quickly. If multiple pregnancies are desired, fallopian tubal reanastomosis can offer that chance. Chances of success are more limited if an older woman undergoes surgery and this option should, therefore, be avoided.
Vasectomy: options depend on the woman’s age and the duration from vasectomy to reversal. Young women whose partner is less than 10 years from vasectomy will often have good success with either vasectomy reversal or IVF with testicular sperm extraction (TSE) and ICSI sperm microinjection. Experts typically counsel treatment with IVF + TSE in older women, men who have been more than 10 years from vasectomy, and patients that have other infertility issues.
Women over age 40: women of advanced maternal age are often the most difficult patients to treat. Because women over age 40 loose as much as 50% of their fertility every 2 years, it is important to act quickly.
The success with IUI and oral fertility medications such as clomid is around 8-12% per month [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4106674/]. Most experts advise against this option for older women.
Treatment with IVF can yield a 15-25% success per cycle, depending on the patient’s age and ovarian health. Many women in their 40’s will need to consider egg donation which will commonly offer a 45% to 65% chance of success per embryo transfer.
Please note: the above information is provided for educational purposes only and is not meant to be a means of self-diagnosis or treatment for your medical condition leading to infertility. Meet with a physician for treatment counseling and to undergo necessary diagnostic testing before committing to a treatment option.