Reproductive medicine techniques can help many couples have children. Beginning in the late 1970s, techniques like in-vitro fertilization revolutionized the world of reproductive medicine. Today there are many other options, from egg donation and freezing to intrauterine fertilization and uterine transplants. Here are some of the current options.
Assisted Reproductive Technology
Assisted reproductive technology (ART) is the term for medical treatments used to correct or resolve fertility problems. ART is used for both men and women. In some cases, it might be a simple technique like timing intercourse. In others, surgery might be required in men to correct problems like a varicocele (rather like a varicose vein that occurs inside the scrotum). The reproductive process in women is much more complex and some women may need more than one kind of treatment. For example, hormonal treatments may be used to promote ovulation, while in-vitro fertilization may also be necessary to have a viable embryo.
Fertility Medications
Fertility drugs like Clomid, Femara and medications that affect the female sex hormones typically increase the number of eggs released during ovulation or affect ovulation in other ways. They are used in combination with other treatments to increase the chances of getting at least one good egg as well as to treat ovulation disorders. Other medications may be used to help support the pregnancy and decrease the risk of miscarriage.
Insemination and Fertilization Procedures
Sometimes the woman’s cervical mucus creates an environment in which male sperm can’t survive, even though she has healthy eggs. Intrauterine insemination bypasses the cervix and allows egg and sperm to combine in the uterus so pregnancy can take place. In-vitro fertilization is the oldest and probably best-known ART technique. IVF involves collecting mature eggs from the woman and adding healthy sperm in a petri dish in the laboratory. Once the eggs begin to develop, they are placed in the uterus.
Surgical Procedures
Intrauterine scarring and endometrial polyps can prevent pregnancy; surgery can correct these problems. Uterine transplant is a very new technique that may help women who have undergone hysterectomy have children. Penile transplant is another possibility for men (again, still experimental). Other surgical procedures can include reversing the effect of a tubal ligation or vasectomy.
Donations, Transfers and Surrogates
IVF can be used with eggs donated by another woman, often a relative, and then implanted in the patient’s uterus. Embryo donation is a related procedure. The patient carries the baby to term as she would her own biological child. A woman’s own eggs or those of a relative can be fertilized by her male partner and carried to term by another woman; the embryo is implanted into the surrogate’s uterus with IVF techniques. A related treatment uses genetic material from two women and one man in cases of genetic disease that occurs in the mother.
Timing and Maturation Issues
Timing a pregnancy can be an issue for many younger women who are trying to establish careers or for women who have been diagnosed with cancer. Egg freezing allows the woman to save her eggs and use IVF or another ART at a later date. Helping eggs mature before they are fertilized can increase the chances of success with IVF. Scientists gently “squish” the eggs to measure resilience, which indicates the stage of maturity (still experimental).
ART can help you have children. Each couple has individual issues that can make certain treatments more or less beneficial. Consult a fertility expert for an assessment and recommendations.