Infertility Treatment Options for Women
Infertility impacts men and women equally. About a third of the time the causes of infertility are related to the female. Some of the barriers faced by women trying to get pregnant may include ovulation disorders, such as polycystic ovary syndrome (PCOS) or premature ovarian failure (POF) or physical issues with the reproductive system, such as fibroids or damaged fallopian tubes.
Depending on the nature of the infertility, there are many treatment options for you to choose from, including:
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Ovulation Induction (OI) – hormonal therapy to stimulate egg development and release. Oral or injectable fertility medications are used to regulate or promote ovulation in women, resulting in the production of a single healthy egg, or to increase the number of eggs reaching maturity in a single cycle to increase chances for conception.
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Intrauterine Insemination (IUI) – fertility treatment where sperm is placed inside a woman’s uterus to facilitate fertilization
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In vitro Fertilization (IVF) – process in which both eggs and sperm are retrieved and fertilized outside of the body, then implanted back in the woman’s uterus. This process also entails ovulation stimulation and takes place over several weeks and stages (typically referred to as a cycle)
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Reproductive Surgery – may occasionally be necessary to remove uterine growths or damaged tissue
- Acupuncture – an ancient Chinese treatment designed to promote mind-body balance. At RMANJ our certified acupuncturists are thoroughly trained in this traditional approach with a particular emphasis on fertility and reproductive wellness
- Diet & Nutrition – a healthy and balanced diet can play an important role in fertility and pregnancy, particularly with the management of PCOS
- Counseling – our team of specialists at RMANJ provides problem-solving strategies in a supportive environment through physician recommended methods in individual and couples counseling, specialized support groups, third-party reproduction-specific counseling, and patient-to-patient support networking
Female Infertility Factors
When it comes to overcoming infertility, age is our biggest barrier to success. For example, at birth, a woman will have all the eggs she will ever have in her lifetime, nearly 1-million. But by the time she’s in her early 30’s her pool of eggs has decreased substantially to less than half that. A secondary challenge for women is one of egg quality: by the time a women is in her late 30’s nearly 40% of her eggs will be of low-quality due to genetic imbalances or other issues related to her age.
The American Society for Reproductive Medicine (ASRM) recommends seeing a reproductive specialist if you are a woman under 35 and trying to get pregnant for 12 months without success. If you’re over 35 ASMR recommends you see a specialists after 6-months of trying without success.
Female Evaluation
Hormonal evaluation studies help identify hormonal imbalances that may impair your fertility.
Hormones control every step in achieving pregnancy — from stimulating the development of an egg to ovulation and implantation of a fertilized egg in the uterus. Each hormone that plays a role in conception must be produced in a specific amount at a precise time in your menstrual cycle. Hormonal studies measure the levels of certain hormones produced by your body during your cycle. You are likely to have a series of simple blood tests at various points in your cycle. The tests your doctor orders may help determine your diagnosis as well as identify the best treatment options.
Hormones that control ovulation and implantation of the egg:
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Estradiol – stimulates the growth of the follicles and the production of fertile mucus from the cervix, and prepares the uterine lining for implantation of a fertilized egg
- Anti-Mullerian Hormone (AMH) – the level of AMH in a woman’s blood is generally a good indicator of ovarian reserve
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Follicle-stimulating hormone (FSH) – stimulates the development of the egg
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Luteinizing hormone (LH) – stimulates the release of the egg from the follicle (ovulation)
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Progesterone – stabilizes the uterine lining for implantation of a fertilized egg and supports early pregnancy
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Androgens – normally, small amounts of androgens — testosterone and DHEAS (dehydroepiandrosterone sulfate) — are produced in women; excess production may interfere with development of the follicles, ovulation, and cervical mucus production
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Prolactin – stimulates milk production; blood levels may be higher than normal in certain disorders or if you are taking certain medications
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Thyroid – underactive thyroid (hypothyroidism) can result in high prolactin levels
Treatment Options
Ovulation induction with medications stimulate many follicles in your ovaries to develop multiple eggs. Your doctor will evaluate you frequently during this time to make sure your follicles (egg sacs) are developing properly and to evaluate the right time for egg retrieval. Once your follicles are developed, your doctor will retrieve the mature eggs.
What to expect during ovulation induction:
Ovulation induction involves treatment with medications to stimulate follicle growth. A GnRH analog may be used to control follicle growth. Your treatment will depend on your specific needs.
- A few days after your period begins, you may start treatment with follicle-stimulating hormones (FSH) and/or human menopausal gonadotropins (hMG).
- For the next week or so, your doctor will evaluate your hormone levels and examine your follicles by ultrasound frequently, to evaluate their development. Your doctor will also be monitoring you for potential medication side effects.
- When your follicles are almost mature, your doctor will tell you when to take your human chorionic gonadotropin (hCG) injection. hCG causes the final maturation of the eggs. The hCG injection is usually given about 35 hours before egg retrieval is scheduled.
For more information on female infertility treatment options in NJ, please contact us today.