Your path to infertility treatment will be determined by your initial diagnosis as some require more invasive procedures and methods. 

The good news is that approximately 85-90% of infertility cases are treated with drug therapy or surgical procedures. Fewer than 5% need advanced reproductive technologies (ART) like in vitro fertilization (IVF).

If you’ve been diagnosed with endometriosis or uterine factors such as blocked tubes, fibroids, polyps and septums; your RE may opt to perform a surgical procedure such as hysteroscopy and laparoscopy to correct these anatomical factors and for you to continue to try to conceive naturally before drug therapy and ART are introduced. This is great news as these infertility treatments cost far less and are not as emotionally taxing. 

Severe endometriosis, DOR, the removal of tubes or an ovary or severe male factor may result in fast tracking directly to IVF. 

Each woman or couple’s path can be different, but in most cases once drug intervention is introduced, the following options are available:

Medicated Cycle with Timed Intercourse 

Timed intercourse is a simple and least invasive infertility treatment option for infertility. It involves monitoring your cycle via ultrasound and hormone testing. You’ll then having sexual intercourse around the time you are predicted to be most fertile. 

Medications such as Clomid and Letrozole/Femara are used to stimulate the ovaries, and are often coupled with ovulation induction to control the timing of your ovulation.

IUI / Artificial Insemination

A step above timed intercourse, Intrauterine insemination ( IUI ) – a type of artificial insemination — places Sperm that have been washed and concentrated directly in the uterus around the time your ovary releases one or more eggs to be fertilized.

IUI requires your cycle to be monitored via ultrasound and hormone testing. 

Depending on your diagnosis, you may try a natural or medications IUI cycle. Medicated cycles normally involve the low dosage use of ovarian stimulation and induction drugs to control the timing of your ovulation. 

IVF

In vitro fertilization (IVF) is the most advanced reproductive technology available to infertility patients today.

During IVF, the ovaries are stimulated to produce a large amount of follicles while being closely monitored via ultrasound and hormone testing. Mature eggs are then collected (retrieved) via a surgical procedure from the ovaries and fertilized by sperm in a lab. 

The fertilized egg (embryo) or eggs (embryos) are monitored and either transferred freshly to the uterus or frozen for transfer at a later date via an FET.

IVF with ICSI

Intracytoplasmic Sperm Injection (ICSI) is an add-on to IVF that helps fertilization occur when the sperm cannot penetrate (proven or suspected) the outer layer of an egg, for a variety of reasons. 

During ICSI, an embryologist identifies the best looking single sperm and injects it directly into the cytoplasm of the egg using a tiny needle called a micropipette. 

While ICSI greatly improves the likelihood of fertilization, it does not guarantee it. The ICSI procedure fertilizes 50 to 80 percent of eggs, but results vary depending on maternal age, egg quality, and sperm quality.