Basic Infertility Treatments
Most couples can become pregnant without in vitro fertilization (IVF). When an infertile couple decides to try basic treatments, they should understand that such treatments have a reasonable chance of success for them. It is strongly recommended that basic infertility treatments do not extend beyond six months because a woman’s fertility naturally declines with age which would affect the success of achieving a pregnancy using a more advanced technology such as IVF-ICSI.
If all results show nothing apparent in the tests done for both partners and there is no explained reason for infertility, the doctor may decide to time intercourse to immediately precede ovulation. Timing is usually done using urine ovulation predictor (LH) kits, while keeping an eye on blood tests and ultrasound. The doctor may also induce ovulation by administering an hCG injection if necessary.
Intrauterine Insemination (IUI) or Artificial Insemination
When the woman’s fallopian tubes are healthy and the husband’s sperm cannot swim to the uterus (low motility), we recommend IUI. The detailed journey is as follows:
- Day 2 of the menstrual cycle: wife will be assessed through ultrasound and blood tests. Based on the results, the doctor may offer minimal stimulation in order to produce more than one egg thus increasing the chances of conception.
- Day 8: Check the progress through an ultrasound and blood test.
- Day 10: Check if the eggs have matured through an ultrasound test. If there are too many eggs there is a risk of having a multiple pregnancy and therefore the cycle is cancelled. If there are no eggs seen, it is also cancelled. If a moderate number of eggs are mature, the wife is given an hCG shot in order for her to ovulate after 36-40 hours.
- Day 11 (36 hours after the hCG shot is taken), IUI procedure is done. The husband provides a semen sample where sperm are prepared, concentrated (washed), and placed in the wife’s uterus using a tiny tube (called a catheter) through the small opening in her cervix. This usually just takes a few minutes at the clinic. Although it is not a painful procedure, some women ask for sedation which we can offer at our clinic.
Ovulation induction is a very simple treatment that stimulates ovulation using medication. It is recommended to women who are not ovulating or who do not have a normal menstrual cycle. With this treatment, conception is achieved through intercourse. It simply involves having a blood test on Day 2 or Day 3 of the menstrual cycle, then taking oral or injectable medication starting Day 4 and is monitored throughout the cycle with blood and ultrasound tests in order to determine when the woman is about to ovulate (approximately Day 14). The doctor can then advise the best time for intercourse to achieve conception.