Your fertility team will work to build your fertility plan based on their clinical experience and your preferences
More than 7 million women between ages 15 and 49 in the US received infertility services between 2015 and 2019.
In 2019 alone, 330,773 assisted reproductive technology (ART)* cycles were performed in the US, according to the Centers for Disease Control and Prevention (CDC).
Let’s explore some potential treatment options
A laparoscopic procedure
Laparoscopy is a minimally invasive surgery that allows a doctor to look internally at the pelvis (including reproductive organs) with a camera to identify possible causes of fertility challenges. In some cases, they may be able to repair some problems during the procedure.
Laparoscopy is common: ~13 million laparoscopies are performed each year worldwide.
Exogenous hormone therapy involves providing your body with hormones to help address any issues.
Controlled ovarian stimulation, or COS, is a part of in vitro fertilization, or IVF. The goal of COS in IVF is to help multiple eggs (also known as oocytes) mature, prevent premature ovulation, and retrieve eggs for fertilization.
To help more oocytes mature, your fertility team may prescribe a treatment to increase or decrease the level of gonadotropin-releasing hormone (GnRH) in your blood.
Intrauterine insemination (IUI) is a procedure in which healthy sperm is placed directly into the uterus around the time of ovulation.
- Sperm can be from a partner or a donor
- Sexual intercourse is not necessary
- IUI can be done in an office or a clinic
Let's explore assisted reproductive technology, or ART
ART involves manipulation of both the egg and the sperm before embryo transfer. In vitro fertilization, or IVF, is a form of ART.
In IVF, sperm and an egg are combined in a lab before transferring the fertilized egg into the uterus. This procedure is called an embryo transfer.
Chorionic gonadotropin hormone test may also be performed at this stage. A human chorionic gonadotropin test, also called an hCG test, is designed to see if your body is making the right amount of this important pregnancy hormone. This can also be a way to confirm pregnancy.
Intracytoplasmic sperm injection (ICSI) is another form of ART. With ICSI, a single sperm is injected directly into the center of an egg. Once fertilized, the embryo is transferred into the uterus.
Genetic testing can be common during ART. Preimplantation genetic testing or screening (PGT or PGS) involves testing a small number of cells in embryos for genetic abnormalities. Once the eggs are fertilized, the lab retrieves a few cells to test the DNA.
Preimplantation genetic diagnosis (PGD) is a screening test similar to PGT or PGS. If you have a family history of genetic disease, your fertility team may suggest this test. PGD can screen for numerous genetic conditions.
Endometrial receptivity analysis (ERA) is another type of genetic testing. This test is often performed after an unsuccessful IVF attempt. In this test, a small piece of a woman's endometrial lining is taken to determine the best day during an IVF cycle to transfer an embryo.
Nationwide, about 3000 ART procedures are performed per 1 million women of reproductive age.
Let's explore egg/embryo preservation, donors, and
Egg or embryo preservation
Your team may suggest egg freezing. Egg freezing involves harvesting eggs from the ovaries and storing them, unfertilized, for later use. These eggs can be thawed, combined with sperm, and implanted at a later date via IVF.
Embryo freezing is also possible. Your or donor eggs are combined with partner or donor sperm to produce embryos. The embryos are then frozen to transfer at a later date.
Using a donor
You may use a donor egg, donor sperm, or a donated embryo as part of your fertility process. Donor eggs (retrieved from a donor female) and donor sperm (retrieved from a donor male) can be used in creating an embryo. A donor embryo is created with both donor sperm and a donor egg.
Donor sperm may be used for IUI or IVF, while donor eggs or donor embryos are used in IVF only.
For some people or couples, additional options are considered when looking to expand their family, including gestational carriers.
With gestational carriers, someone agrees to physically carry a baby for someone else. There are 2 types of gestational carriers:
- A typical gestational carrier will carry the embryo(s) from the intended parents
- A surrogate gestational carrier will provide the egg and carries the baby
Prior to working with a gestational carrier, all parties may be required to undergo additional screenings.