Fertility Treatment Options
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IVF or other advanced reproductive technologies are not always the treatments of first choice. Timed Intrauterine insemination (IUI) after Ovulation Induction with gonadotropins is also very effective. However, these therapies are best administered by a fertility doctor who has received advanced training in the use of fertility medications.
IVF-Orange offers care for all levels of infertility from the initial diagnosis to advanced reproductive technologies. We understand the importance of personalized care and deliver our services in a compassionate environment.
If I have fibroids, what can I do if I do?
If your doctor has diagnosed you with uterine fibroid tumors, there is a good chance your first reaction will be concern over the word “tumor.” Relax: while fibroid tumors can cause many kinds of difficulties, they are not cancerous, and are unlikely to prove life-threatening. Fibroid tumors can, however, affect your reproductive health, causing discomfort and interfering with the ability to achieve a pregnancy and carry it to term.
Fibroid tumors grow in, on, and around the uterus. Much of the time they cause little, if any, problems. You might never have noticed any symptoms at all, or have mistaken symptoms for ordinary variations in your periods. Fibroids can cause heavy menstrual flow, bleeding between periods, severe cramping, discomfort during sex, along with such unexpected symptoms such as gas and constipation: all conditions that might pass as ordinary human discomforts and nothing more.
If you are seeing a fertility doctor, though, there is a chance that fibroid tumors are interfering with your ability to have a child. You and your doctor will need to determine the extent of your tumors, their placement, and the best possible treatment that will permit you to attempt a pregnancy. This can be a challenge: in many instances, if a woman doesn’t want a pregnancy, doctors will recommend removing the uterus entirely. Surgery to remove fibroids while retaining a functional uterus is a more complex process.
Fortunately, great strides have been made in treatment of fibroid tumors, particularly in the area of minimally invasive microsurgery. Laparoscopic surgery allows your surgeon to use a combination of a tiny video camera and micro-surgical tools to perform surgery without a full open abdominal incision. Using only small “keyhole” or “bandage” incisions, your doctor can remove fibroids from most parts of your uterus without your undergoing the dangers of traditional surgery.
The circumstances in which your doctor is likely to recommend such surgery include (remember that this is not a comprehensive list, but does name some of the top reasons):
- When fibroids are physically interfering with implantation.
- When fibroids prevent carrying a fetus to term.
- When menstrual patterns are disrupted, reducing the chances of fertilization or implantation.
- When fibroids combined with rising and falling endocrine levels cause swelling and bleeding between periods.
- When pain and discomfort are sufficient to reduce quality of life.
In severe cases, it is possible that fibroid removal will still not permit a pregnancy to be carried to term. In those cases, your doctor is likely to consider a two-pronged exploration of other possibilities; on the one hand considering reconstructive treatment to further repair the uterus, and on the other looking into methods of harvesting your own eggs for in vitro fertilization and later implantation in a surrogate mother. These options, however, are often unnecessary. The ability to remove fibroids easily with only the most limited associated tissue damage improves both your chances of carrying a child to term and of living a full and comfortable life. By working with your doctor to plan fibroid removal, you can change your future.
If you are dealing with infertility as the result of a tubal ligation, you may be a candidate for tubal reversal procedure. Your original operation cut and tied-off the fallopian tubes, preventing pregnancy from occurring by keeping an egg from ever meeting sperm or entering the uterus. Tubal reversal surgery repairs the damage by opening the sealed ends of the remaining portions of the fallopian tubes, clearing the central passage, and rejoining the two ends. The result is a newly rebuilt tube that allows eggs and sperm free movement from the ovary to the womb. Although reversal of previous Tubal Ligation is an option for selected patents, with availability of In Vitro Fertilization to bypass Tubal factor is the recommended treatment option to overcome infertility.
Ovulation Induction in Fertility Treatments
When your doctor first mentions ovulation induction as a fertility treatment, you will probably be worried about what it is and why it’s being recommended. Ovulation induction is a set of infertility therapies used to make your periods more regular and to stimulate the production of mature eggs. In some cases, ovulation induction is used to encourage multiple mature eggs to develop and be released during a single period. These forms of fertility treatment are often used when egg production does not occur naturally. Ovulation induction is also used to increase the odds of pregnancy when low sperm counts or motility are an element in a couple’s infertility.
You may be offered ovulation induction when fertility tests show menstrual timing and hormone levels are interfering with ovulation, or when efforts to provide mature eggs will increase the opportunities for a sperm to fertilize an egg. PCOS (Polycystic Ovary Syndrome) is a classic condition in which ovulation induction would be suggested. A combination of the various treatments are common: while a doctor may prescribe one or numerous medications as a starting point, you can expect to spend a number of menstrual cycles refining the balance.
- Clomiphene citrate:Regularizes periods, promotes release of mature eggs. It’s administered by pill from the first day of menstruation for five to ten days. Repeated treatments are not uncommon.
- Glucophage: Reduces insulin levels which interfere with follicle development. It’s an oral medication given 1-3 times daily throughout therapy.
- Gonadotropins: Hormone treatments to stimulate egg production, including multiple eggs. It’s administered through intramuscular or subcutaneous injection given daily for 1-2 weeks per cycle, for as many as six full menstrual cycles before considering alternate fertility options.
- Bromocryptine mesylate: Lowers prolactin levels and promotes egg development and release. Taken daily with meals.