Understanding Fertility Problems: Assisted Reproduction
Your doctor has suggested assisted reproduction technologies (ART). ART may be needed for certain fertility problems. Or it may be used if other treatments haven't helped. In most cases, these methods use hormone medications along with other techniques to increase the chances of success. Be sure to talk with your doctor about the details, success rates, and costs.
Intrauterine insemination (IUI)
IUI is a fertility treatment. It places sperm in the uterus during ovulation. It can be done in your doctor's office or a clinic. There are 2 main steps in the process:
- First, the man's semen is "washed" in a lab. This separates active sperm from the semen.
- The sperm are then placed inside a thin tube called a catheter. The catheter is inserted through the woman's cervix. The sperm are placed into the uterus.
In most cases, IUI is done along with taking hormone medications. They enhance a woman's fertility. This is called a "stimulated cycle." It can also be done without medications. This is called a "natural cycle."
In vitro fertilization (IVF)
During IVF, sperm and egg are combined outside the body in a lab. There are 4 main steps in this process:
- Medication is used to stimulate the ovaries. This helps them develop multiple mature eggs.
- The mature eggs are retrieved from the ovaries. This is done by guiding a thin needle through the vagina. Sedation is used to prevent pain.
- Sperm are combined with the eggs in a lab. If there are problems with fertilization, one sperm can be injected directly into an egg. This process is called intracytoplasmic sperm injection (ICSI).
- A few days after fertilization, one or more embryos are placed into the uterus. Using more than one embryo improves the odds that at least one will implant. But it also means there is a chance of a multiple pregnancy.
A thin tube called a transfer catheter is used to transfer embryos from the lab into a woman's uterus. This is often done about three days after fertilization. In some cases, your doctor may wait a day or two longer to use a more developed embryo. This embryo is called a blastocyst.
Using frozen embryos
Many embryos are created during an IVF cycle. But only a certain number are placed into the uterus. The remaining embryos may then be frozen for later use. This prevents the woman from having to go through another cycle of egg stimulation and retrieval.
If there are problems with a man's sperm, donor sperm can be used to inseminate the woman. The sperm may be from a known donor or a commercial sperm bank. Be assured that all donors are tested for diseases. This includes HIV/AIDS. They're also tested for genetic diseases, such as cystic fibrosis. Sperm banks allow you to match the donor's physical traits to the male partner.
Egg donation may be an option if other treatments don't work. The eggs can come from a known donor, such as a sister. Or, they can come from a commercial agency. Like sperm donors, egg donors are tested for sexually transmitted diseases and certain genetic problems. You may also match the donor's physical traits to the mother.
Surrogacy means that another woman carries and gives birth to your child. The child may be conceived with her egg and your partner's sperm. This is called traditional surrogacy. Or, the baby may be conceived with your egg and your partner's sperm. This is called gestational surrogacy. Surrogacy can have legal and emotional aspects. Be sure to explore them carefully.