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What to expect
The formal definition of infertility is failure to conceive after one year unprotected intercourse. Usually, conception will take place within 6 months of trying and the full year allows for those cycles in which either ovulation did not take place or sperms were too late or too early for conception.
Gynecologists will recommend that the patient monitor her cycles with temperature charts or over-the-counter ovulation predictor kits to check whether ovulation is taking place. This also serves to verify whether the couple is having intercourse at the right time of the month. If pregnancy is still not achieved, it is usually at this point you may be referred to our practice for further diagnosis and treatment.
Clomiphene citrate given to the woman to encourage ovulation, may be the next step. Various diagnostic tests might be ordered by our physicians such as a semen analysis for the man, HSG (hysterosalpingogram) to see if the tubes are clear, laparoscopy to rule out endometriosis, and hormonal blood tests.
Testing is essential to reach a diagnosis for the couple's infertility. If the woman is not ovulating, ovulation induction will be necessary. If the husband has low sperm concentrations, sperm processing can concentrate the available good sperm which can then be used and intrauterine inseminations. If these treatments are not effective in achieving pregnancy over a period of three to six months, it may be necessary to consider other forms of treatment.
About 15% of couples have no apparent cause for their infertility. These couples have Unexplained or Idiopathic Infertility. Fertility drugs are used in such cases although they may not always work.
The final step in the journey of infertility is IVF or In Vitro Fertilization and is the classic treatment for infertility that cannot be treated by simple means. Procedures like ICSI in conjunction with IVF have allowed us to treat severe male factor infertility. These procedures fall under Advanced Reproductive Technologies.
While advanced reproductive technologies have allowed us to treat many causes of infertility successfully, it is still an emotionally and financially taxing journey for the infertile couple. It may be necessary to undergo more than one cycle of IVF. To ensure that the couple gets the best care possible, it is very important to select a center with well qualified and dedicated physicians and clinical staff.
The costs of IVF vary from center to center and also according to the treatment protocol that works best for each couple. ASRM (American Society for Reproductive Medicine) estimates that the average cost of an IVF cycle in the US at $12,400. It is therefore essential to compare the costs of IVF at various centers before the couple chooses one to undergo treatment.
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