Stork assistance: fertility treatment options

Some people may feel ready to undertake the great adventure that is parenthood, but find that they are not able to safely become pregnant on their own due to prior illnesses or biological barriers. However, that doesn’t mean that the door is closed forever, thanks to the wide range of fertility treatments that are available. Experienced consultant obstetrician and gynaecologist Mrs Ritu Rana explains the options for fertility treatments in further depth.

What are the causes of infertility?

Women may experience issues in getting pregnant due to issues like

• Genetic or hormonal disorders like hypogonadism
• Endometriosis and polycystic ovarian syndrome (PCOS), or other menstrual disorders
• Damage to the cervix and fallopian tubes
• Prior chemotherapy or radiotherapy treatment
• A history of eating disorders
• Substance abuse
• Stress
• Age and weight
• Sexually transmitted infections and diseases

Male infertility can be caused by some of the same issues, like prior chemotherapy or radiotherapy treatment, stress, and genetic or hormonal disorders, and some that are unique to their anatomy like erectile dysfunction and damage to the testes.

What fertility treatment options are available?

There are three main kinds of fertility treatments: medicinal, surgical, and assisted conception.

Common medications include drugs that facilitate the ovulation stage for women who have issues with this stage of the menstrual cycle, such as clomifene, and metformin which is particularly beneficial for women who have PCOS. These should only be prescribed once the core of the issue is known, as they might not be effective for women undergoing specific conditions.

If the issue can be corrected with surgery, then options include surgery to repair or remove blockages in the fallopian tubes, and laparoscopic surgeries for those suffering from PCOS, endometriosis, and fibroids. For men, there is a procedure where the sperm is surgically extracted if ejaculation is disrupted (epididymal blockage) or after a vasectomy, and the sperm is then cryogenically preserved.

For those who opt for assisted conception, the options include intrauterine insemination (artificial insemination) where sperm is released into the womb via a catheter, and in vitro fertilisation (IVF) where the egg is extracted from the ovaries and fertilised with sperm and once the embryo is viable it is replanted into the womb for the rest of the gestation.

Some patients may plan ahead of expected infertility (such as before starting chemotherapy, or planning for children only after a certain age when fertility is lower), and will choose to freeze eggs, embryos, and sperm with cryopreservation, so that the option for children remains an available avenue for them in the future.

If you’re experiencing issues with conception and fertility, Mrs Ritu Rana is available to book for consultation via her Top Doctors profile.