Ins & outs of fertility treatments

Here’s the deal—before starting treatment, you’ll have to have some tests done. These tests, or fertility evaluations, help your fertility specialist (or reproductive endocrinologist) figure out what makes sense for you.

Fertility evaluations may include:

Blood work

To check for hormonal abnormalities or potential genetic factors that can contribute to infertility

To check your ovarian reserve

Ultrasound

To count the number of small follicles in the ovary (also known as an antral follicle count)

To check the uterus and ovaries for abnormalities such as fibroids and ovarian cysts

Semen analysis

To determine if sperm quantity and quality are normal

HSG test

Also called a “hysterosalpingogram test”

To help the doctor check for blockage and show the path leading through your fallopian tubes

Diagnostic hysteroscopy

To check your uterus for any potential abnormalities that could contribute to infertility

Josephine Atluri, @josephineratluri

OUT LOUD INSIDER

Often times, infertility leaves you without answers.
So for me, I was all for getting tests and evaluations that would help me make informed decisions.

How we can help

We want you to get the most out of talking with your fertility specialist! We’ll send information that will help with understanding fertility challenges and treatment options—so you can stay informed and know the right questions to ask.

Now what?

Once your fertility specialist has a better sense of what’s going on, you’ll talk about your options. And since every person’s body is unique, your plan of action may look different than someone else’s. But in many cases, you’ll discuss one or more of the following treatments:

Ovarian induction (OI)

is one of the first treatment options your doctor may discuss. During OI, fertility drugs are used to stimulate eggs to grow and be released from the ovaries to help increase the chances for conception.

Medications may include:

  • Follicle-stimulating hormone (FSH)
  • Clomiphene citrate
  • Letrozole
  • Human menopausal gonadotropin (hMG)
  • Human chorionic gonadotropin (hCG)

IUI, IVC, and IVF

You may have heard of IUI and IVF, but IVC is another option that can be used to treat infertility. Let’s break down the differences.

What is IUI (intrauterine insemination)?

Usually, IUI is one of the first treatments your fertility specialist might recommend, after commonly used oral or injectable fertility medicines. During the procedure, sperm is placed directly into the uterus in order to bypass the cervix and place the sperm closer to the egg.

But while IUI is often less expensive, it only offers about an 8%—10% chance of pregnancy per cycle.

What is IVC (intravaginal culture)?

With IVC, eggs and sperm are placed in a device, and then the device is positioned in your vagina for fertilization and incubation. After an incubation period, your doctor removes the device and transfers one or more viable embryos into the uterus. IVC could be an option for women who want a more effective fertility treatment than IUI (IVC has about a 25% success rate per embryo transfer) but are concerned about the cost of other options like IVF.

Get the details on IVC >

What is IVF (in vitro fertilization)?

With IVF, sperm and eggs are combined outside the body in a laboratory. Fertilized eggs are grown into embryos which are then transferred into the uterus in hopes of achieving pregnancy. While IVF is the most effective fertility treatment option with a 48% success rate,* it’s also among the most expensive.

*Success was defined in clinical data as live births per cycle.

Get the details on IVF >


Surgery to correct medical conditions

Certain medical conditions, such as problems with your fallopian tubes, endometriosis, or fibroids, can cause fertility issues. In many cases, surgery can treat these problems, restoring your chance to conceive. And thanks to medical advances, most of these procedures are minimally invasive and have a short recovery period.

Here’s a list of common fertility-related surgeries:

Laparoscopy: Sometimes used as a diagnostic tool, laparoscopy involves the insertion of a small, lighted camera into the pelvic cavity, which allows your doctor to check for things such as scar tissue, endometriosis, and blockages impacting the outer wall of the uterus, as well as the fallopian tubes and ovaries. If issues are discovered, your surgeon may use additional surgical tools to correct the problems.

Operative hysteroscopy: In addition to being a diagnostic tool, a hysteroscopy can also be used to remove tissue or growths that interfere with fertility. Unlike laparoscopy, which allows your doctor to examine and treat the inner wall of the uterus, operative hysteroscopy can provide a view of fibroids, scar tissue, polyps, and abnormalities inside the uterine cavity.

Myomectomy: Myomectomy refers to the removal of uterine fibroids and is sometimes called fibroidectomy. It’s often done through laparotomy (which is a major surgery—see below), but can sometimes be done via laparoscopy or hysteroscopy, which are less invasive.

Laparotomy: If minimally invasive procedures are not feasible, your doctor may recommend laparotomy. This is a major surgery, performed under general anesthesia on an inpatient basis (which means you’ll be spending time in the hospital).

Check your coverage

Your insurance coverage can have a huge impact on your fertility journey. It can influence things like fertility treatment decisions, testing, and whether telehealth appointments are an option. Decode the ins and outs of insurance coverage >

Fertility Out Loud