Fertility treatments can feel like learning a new language so here’s a little information to help. Fertility clinics have very effective procedures and specialize in certain treatments so deciding what you want, may determine where you go. Let’s take a look at the three major forms for fertility help.
Intrauterine Insemination, sometimes referred to as artificial insemination is the act of putting sperm (partner or donor’s) into a woman’s uterus during her ovulation. This “head start” increases the odds of pregnancy by ensuring more sperm reach the Fallopian tubes then with sex. But one sperm still has to reach the egg and fertilize it on its own.
IUIs can be done naturally, or with additional fertility medications that stimulate egg production. Your physician will discuss the pros and cons of each approach and give their recommendations. Natural cycles may be appropriate for some women with regular periods.
Also, semen should be ‘washed’ before the procedure to remove impurities and increase your odds of fertilization. Studies show washing sperm agitates it and makes it more likely to reach the egg and succeed with fertilization.
IUIs can be up to 20% effective for healthy couples with little to no fertility issues if done right and IUIs are less expensive than IVF. But one of the dangers is the process can lead to multiples. Multiples are a health risk to both the mother and the babies, often leading to premature birth.
In Vitro Fertilization is the most effective form of fertility treatments. A woman is given fertility drugs to stimulate the growth of multiple mature eggs during one cycle. Her eggs are collected (retrieved) from her ovaries and fertilized with sperm in a lab. Then, during a fresh IVF cycle, the fertilized egg (embryo) or eggs (embryos) are transferred to her uterus.
Frozen IVF cycles allow time between egg retrieval and fertilization and implantation. High-end IVF clinics grow the embryos then send out a biopsy of each (PGT or Preimplantation Genetic Testing) to check for chromosomal abnormalities before implantation. Embryos are frozen while waiting for results from the genetic lab. Once results are in, the chosen embryo will be thawed and implanted. This added step takes more time, but greatly increases the chance of success and allows us to protect the health of the mother by inserting one healthy embryo at a time. PGT can also help couples eliminate genetic disorders from their bloodline.
IVF offers many additional technologies to increase success such as ICSI and Assisted Hatching. Intracytoplasmic Sperm Injection (ICSI) is when an embryologist injects one chosen sperm into each egg. It is extremely effective when sperm quality is an issue or with older eggs that may have a tougher exterior.
Assisted hatching is when embryologists help the embryo “hatch” from its “shell” by creating a small crack in the zona pellucida with a tiny laser. It is believed that assisted hatching can help an embryo implant in the uterus, leading to higher pregnancy rates.
Intravaginal Culture is a newer procedure that aims to make IVF less expensive and more natural. There is not a lot of research to evaluate this process yet. Fertility drugs are given to stimulate multiple egg production, same as IVF but sometimes a smaller dose, and eggs are retrieved. They are then added to a device called INVOCEL along with sperm and the device is inserted into the vagina so fertilization can take place inside the woman’s body and not in a lab.
After about 72 hours, the device is removed, and the fertilized eggs, if there are some, are evaluated for transfer into the uterus. Often, they will insert two embryos to increase the odds of implantation and success. So far this option is about half as successful as traditional fresh IVF. The highest chance of success is with IVF, PGT biopsy, and a frozen cycle. IVC is less expensive than IVF, but it is not cheap (at least $7K+ medications) and it is not yet offered at most fertility clinics.
While all of these options use cutting edge technology, we have yet to figure out how to ‘grow’ an embryo into a baby – or sheep for that matter, in a lab. All of these technologies are natural as they require a living, healthy, happy womb. So please take care of yourself mentally and physically when going through any of these fertility treatments. We think conceiving a healthy child is a miracle however it gets done.