After the physician has determined possible causes of the infertility, a course of treatment is planned.
- Simple instructions, like knowing when to have sex to increase chances of pregnancy,
- Surgery or
Other treatments (Second-line treatment) like
If medications are unhelpful or surgery is not appropriate, other specialized techniques will be offered.
Medications can help solve hormonal problems and ease infections in women with fertility problems. Surgery to repair reproductive organs may also resolve a woman’s infertility.
If the woman isn’t producing eggs, often she can be helped with fertility drugs. Fertility drugs are fairly safe, although some researchers have voiced concern that they may increase the risk for ovarian cancer. Several of the most recent studies, however, have found no increased risk of ovarian cancer and suggest that the drugs may even protect against cervical cancer. Fertility drugs include:
Clomiphene: This drug triggers the release of FSH and LH, boosting egg growth and helping the ovaries release a monthly egg. The drug is considered safe, is fairly inexpensive, and carries less risk of multiple births than other drugs. Women who have polycystic ovary syndrome or menstruate irregularly apparently benefit most from this drug. Sixty percent of women on clomiphene successfully ovulate, and about 30 percent of women become pregnant in the first three months of being on the drug. Side effects may include nausea, insomnia, breast tenderness and headaches.
Bromocriptine: This drug suppresses a hormone called prolactin, which, if released in excessive amounts, may cause a woman to stop ovulating. Ninety percent of women on bromocriptine release eggs while on the drug. It’s considered fairly safe, but side effects may include nausea, dizziness, headaches and low blood pressure.
Human Menopausal Gonadotropins (HMG): If other drugs don’t work, the doctor may prescribe HMG. This drug is comprised of hormones extracted from the urine of postmenopausal women and contains large amounts of LH or FSH. Women who have trouble ovulating, endometriosis, infertility caused by cervical problems or unexplained infertility are good candidates for this drug. To monitor the woman’s progress, the doctor will order regular ultrasounds to check the quality and number of eggs being released.
Luteinizing Hormone-Releasing Hormones (LH-RH): LH-RH drugs are used when the pituitary or hypothalamus gland is not producing hormones. They are also used to treat endometriosis. Most women must administer these drugs themselves with a portable pump, and the equipment is unwieldy and expensive. Risks include an increased chance of infections and clotting, and multiple births.
Human Chorionic Gonadoptropin (hCG). Chorionic gonadoptropins are often prescribed with HMGs, and sometimes with clomipheme, to stimulate the release of the egg. They may also be used to treat endometriosis. One of these drugs, Humegon, has resulted in pregnancy in more than 26 percent of cases in clinical trials. Possible side effects are ovarian enlargement, ovarian cysts and multiple births.
Urofollitropin (FSH): This drug is made up of FSH taken from the urine of postmenopausal women. It can be used with hCG to bring on the release of an egg. It’s an effective drug for women with polycystic ovary syndrome, for whom clomiphene has been ineffective.
Other medications that may cure fertility problems include:
Antibiotics – They may cure infections in the reproductive system, such as in the cervix or lining of the uterus, and some sexually transmitted diseases.
The hormone progesterone – This hormone develops the lining of the uterus and helps a fertilized egg implant.
Corticosteroids -These may be prescribed for the treatment of endometriosis.
Oral contraceptives, antiandrogens, and drugs to reduce insulin levels – These drugs are used in women with polycystic ovary syndrome to restore regular periods and ovulation and to reduce symptoms stemming from an oversupply of male hormones.
Surgery may cure infertility, then depending on the cause, surgery may be used to deal with:
Fibroids or defects in the woman’s uterus.
Endometriosis in the woman. In these surgeries, the doctor removes the uterine tissue that has grown outside the uterus.
A scarred fallopian tube in the woman. In surgeries for this problem, the scarred tissue is removed or the entire scarred section of the tube may be cut out. The tube is then rejoined and reattached to the uterus.
A number of drugs can be prescribed to ease male fertility problems, but their effectiveness varies widely. Here’s a look at some of them:
Hormones – Though hormones can be quite successful in women, they are only occasionally effective in men. Hormone drugs for men include testosterone, menotropins, GnRH medications, bromocriptine, clomiphene citrate and human chorionic gonadotropin (hCG). Many of these drugs are quite expensive, however.
Antibiotics – These may help treat sexually transmitted diseases and other infections.
Corticosteroids – These drugs can aid men who make antibodies to reject their own sperm, but they may also have serious side-effects after long use.
Viagra – This is a newly developed medicine for male impotence. The man takes Viagra an hour before having sex. The medication improves blood flow to the penis, resulting in an erection. Studies have revealed that 70 percent of men who used Viagra improved their ability to maintain an erection. The drug can have severe side effects for certain men, however, especially those with heart disease. Men with heart disease, who have had a heart attack, or those with low blood pressure should not take the drug.
What Surgeries Treat Male Infertility?
If investigations suggest that surgery may help with male infertility, then depending on the cause, surgery may be used to deal with: Varicose (or swollen) veins in the man’s scrotum, helping to restore proper sperm movement. An obstruction in the man’s reproductive organs, including the epididymis, vas deferens and ejaculatory duct. These blockages can halt the sperm’s passage or prevent it from mixing with semen.