What fertility treatments are available?

Most people have heard of IVF (in vitro fertilization).  But there are several treatment options for people who are having difficulty conceiving naturally.  Every case is different, and your GP and fertility clinic will be able to advise on the most suitable treatment for you, depending on your individual circumstances.

Fertility drugs

In most cases, it is the woman who will take any fertility drugs.  These might be 'ovulation induction' drugs, which trigger egg production in your body if you are not producing and releasing an egg each month. Sometimes, taking fertility drugs is all it takes to get pregnant. More often, they are used as part of another treatment, such as IVF or IUI. 

Surgery

Some cases of infertility can be helped with surgery. Fallopian tubes can be unblocked using keyhole surgery (blocking can happen as a result of inflammation and scarring from infections such as chlamydia, for example). For men who cannot produce sperm (if they have had a vasectomy, or a failed vasectomy reversal), sperm can be retried surgically for use in fertility treatment. 

IUI (Intrauterine insemination)

This is a treatment in which sperm is inserted into the womb at the woman's most fertile time (ovulation).  The sperm will have been sorted before treatment to make sure that only the healthiest are used. The whole process takes just a few minutes. It is particularly suitable if the male partner has a low sperm count or if the sperm is not surviving the journey to the womb.  It is also used when a woman does not have any known fertility problems but may not have a male partner and is trying for a baby using donated sperm.

GIFT (gamete intra-fallopian transfer)

GIFT was one of the earliest fertility treatments to be developed and is still used to great effect today. Eggs and sperm are collected as for IVF, and screened to find the healthiest ones. The sperm and eggs are mixed together and then placed in one of the woman's fallopian tubes. Fertilization takes place in the body, as it would have had you conceived naturally.  

IVF (in vitro fertilization)

The most well-known fertility treatment.  This is where a woman's eggs are collected and fertilized with her partner's sperm (or donated sperm) in a laboratory.  The fertilized eggs (embryos) are then put into her womb to implant and she becomes pregnant. This treatment is especially suitable for women with unexplained infertility, blocked fallopian tubes, or where other treatments such as fertility drugs or IUI, have been unsuccessful. A clinic may recommend using donated eggs for women who are over 40.

Natural cycle IVF

Natural cycle IVF involves collecting and fertilizing the one egg that you release during your normal monthly cycle. This avoids the side effects of fertility drugs and you are less likely to have twins or triplets. As your ovaries aren't being artificially stimulated, you don't need to rest as you would after conventional IVF. If your treatment is unsuccessful, you can try again sooner if you wish.

Pregnancy rates are more or less the same as with conventional IVF over three or four attempts.

It may be worth discussing this treatment option with your clinician if your periods are fairly regular and you are ovulating normally, but you have blocked tubes or unexplained infertility.

ICSI (intra-cytoplasmic sperm injection)

ICSI is the biggest advance in fertility treatment since IVF.  It is not a treatment in itself, but is used in conjunction with IVF.  ICSI involves injecting a single sperm into the center of an egg, giving it the best chance of fertilizing. It is often recommended if the male partner has a very low sperm count or if other problems with the sperm have been identified.   It can also be used if there are very few eggs collected from the woman that appear capable of being fertilized.

Surrogacy

Surrogacy is where another woman carries your baby for you. The baby can either be conceived by IUI (see above), using the surrogate's eggs and your partner's sperm.  Alternatively, the surrogate can have IVF treatment, with embryos created from your eggs and your partner's sperm, or from eggs donated by another woman (not the surrogate) and your partner's sperm.   Surrogacy is a very complicated legal area, and you will need to get legal advice before you go ahead.  However, surrogacy can be the only real option for women who have a medical condition that means it would be dangerous or impossible for them to undergo a pregnancy or give birth.  Some women also choose this option if they have been unsuccessful with IVF. 

Using donated eggs, sperm or embryos in your treatment

Sometimes a clinic may recommend using donated eggs, sperm or embryos in your treatment.  This is usually because treatment would be unlikely to be successful if you were to use your own eggs or sperm.  Using donated sperm is also an option for women who do not have a male partner.  If you are using donated eggs, sperm or embryos in your treatment, there are some complex issues to consider before starting treatment, and many people find it helpful to talk to a professional counselor.

The Government also changed the law around donation in April 2005.  Children born from eggs, sperm or embryos donated after this time will, when they are 18, be able to find out who the donor was.