Understanding Infertility -- Treatment

How Do I Know If I Am Infertile?

In tracing the cause of infertility, a doctor usually begins by asking both partners about their health histories, their use of medications, their sexual histories, and their sexual practices. The man often undergoes a physical exam first. Male infertility is usually related to sperm health or function, which is usually tested with a semen analysis.
For the woman, testing generally begins with a full physical and a pelvic exam. The doctor then makes sure that she ovulates regularly and assesses whether her ovaries are doing their job of releasing eggs. Having regular menstrual cycles and a biphasic basal body temperature curve usually confirms that ovulation is regular. Blood tests can measure hormone levels.

What Are the Treatments for Infertility?

Many couples once pronounced "barren" can now produce their own child. Common-sense steps that raise the chances of conception may help.
Couples who want children should have intercourse during the five to six fertile days of her cycle, which means the four to five days before she ovulates plus the one day of ovulation.
A tip-off to ovulation is that there is a sustained rise in basal body temperature about one to two days after ovulation. A home testing kit can also be used to detect chemical changes in the urine. A newer device is able to detect ovulation from a single drop of saliva.
If the cause of infertility is that the man doesn't have enough sperm, then attempts should be made to find and treat the sperm problem. If, for example, he has varicocele (a condition in which veins in the scrotum are dilated), then surgery can sometimes improve the sperm count.
If the woman does not ovulate, then the cause of her ovulation problem should be found and treated. Sometimes, inducing ovulation with hormones or fertility drugs can quickly result in pregnancy.
The small percentage of couples whose infertility cannot be corrected can try artificial fertilization. In intrauterine insemination or artificial insemination, the woman's uterus is injected, around the time of ovulation, with carefully prepared sperm from the husband, partner, or a donor. This is the easiest and usually least costly method. In the procedure known as IVF (in vitro fertilization), the egg is fertilized outside the woman's body and then placed in the womb or fallopian tube. In another procedure, called GIFT (gamete intrafallopian transfer), egg and sperm are brought together in one of the fallopian tubes. Both methods rarely succeed on the first attempt.