Fertility Doctor

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There are many treatments for infertility available for women in the Cedar Rapids and Iowa area. If you’ve been trying become pregnant for six months or one year, it’s an ideal moment to talk with your doctor about fertility treatments that might be the right choice for you. There are a variety of ways to increase your chances of becoming pregnant. “A majority of couples believe that fertility specialists only offer IVF however the majority of my patients are able to start with non-invasive, less expensive alternatives,” says our own Dr. Rexroth.

This article is focused on fertility treatment options for women with a sperm-producing partner who haven’t yet been capable of conceiving through sexual relations.

Know Your Numbers

You can check your levels at home but they will never be as accurate as those taken from a lab. Many false readings can be obtained from home methods.

What are the treatments for infertility?

Treatments for infertility may involve medications or surgery, or both, to improve the odds of fertilization (when sperm cells enter an egg) and then implanting into the uterus. Researchers began to study fertility around the year 1600 but it took a long time to come up with treatments such as synthetic hormones, first employed in the 1940s. Then there was IVF, which became popular in the 1980’s following the birth of first IVF baby in the year 1978.

The field of fertility remains exciting and is constantly evolving. The most frequently utilized fertility treatments include:

  • Oral medication
  • Intrauterine insemination (IUI)
  • In vitro fertilization (IVF)
  • Laparoscopic surgery
  • Injectable drugs (gonadotropins) 

The best treatment for you will depend upon your current age and objectives and the underlying issues you or your partner who provides sperm may be suffering from.

Other alternatives are to use donated eggs or donated sperm, and/or donated embryos, or the use of a gestational carrier or surrogate.

Who is likely to require a Fertility Treatment?

If you’re less than 35 and have been trying to become pregnant for at least a year, you’re likely an ideal candidate for fertility treatment. If you’re older than 35 most clinics recommend to schedule an appointment after 6 months of trying because fertility declines with the advancing years. Treatments for fertility may help in the event that you’ve been able become pregnant but have had a recurrent loss of pregnancy.

If you’re experiencing difficulty getting pregnant, your doctor usually will conduct a fertility exam to determine what treatments are most effective for you. The typical evaluation includes:

  • A look at your medical past
  • A physical examination
  • A pelvic exam
  • Blood Work to determine hormone or health issues
  • An x-ray image of the fallopian and uterus tubes (called an HSG)
  • A sonogram that examines the uterus and ovaries

Patients who are considered for treatment to improve fertility could be affected by:

  • Polycystic Ovarian Syndrome
  • Endometriosis
  • Blocked fallopian tubes
  • Low egg count
  • Unexplained infertility

Your sperm-providing partner will undergo a fertility test to determine the health and the motility in their sperm. Based on the outcome, your physician might recommend that your partner undergo treatment prior to proceeding in any one of the procedures discussed in the article. For some concerns with sperm, the suggestion could be to go straight towards IUI as well as IVF.

Different types of fertility treatments

When your fallopian tubes aren’t blocked, and your partner’s sperm tests are normal it is possible that you are eligible for oral fertility medications. These are usually small, low-cost pills that are taken daily for around five days of the menstrual cycle. The most popular oral medications are clomiphene citratethat is that is sold by the name Clomid and letrozole available as a brand Femara. 

The drugs work slightly differently but, in the end they “send signals to the brain, causing it to release more hormones that stimulate the ovary” claims Dr. Rexroth. Contrary to what you might think, the science relies on decreasing the levels of estrogen in your body (or at the very least, inducing your brain to believe that’s the case). Why? The hormone that assists in making the eggs mature, referred to as follicle-stimulating hormone, or FSH, can also boost your estrogen levels. If your estrogen levels drop the pituitary gland responds by producing more FSH.

If you aren’t able to ovulate regularly the surge in FSH could help you shed eggs. If you do cycle regularly orally, a fertility pill could trigger a superovulation, a menstrual cycle during which you produce more than one egg.

Here is some basic information on the way these medications differ. Your doctor will recommend what oral fertility medicine is suitable for you.

Typically, you will take tablets every day for five days. If you are unsuccessful, your physician might increase the dosage to 2 or 3 tablets daily during the next menstrual cycle.

In the case of patients who have infertility that is not explained, an estimated 10% up to 15% probability of having a healthy pregnancy and live birth in accordance with the latest research in medicine, but the success rate is difficult to determine. 

Letrozole is an effective first-line treatment for fertility in patients suffering from Polycystic Ovarian Syndrome (PCOS) a condition that can cause irregular menstrual cycles. Contrary to Clomid, that only tricks our brains into believing that that estrogen levels are low,Letrozole can affect the production of estrogen. It is an aromatase inhibitor which means it stops aromatase, an enzyme that is found in the fat tissue of your body that produces estrogen. 

Typically, you will take between one and three 2.5-milligram tablets every day for five days throughout menstrual cycles and your sex scheduled according to coincide with your ovulation window. Studies suggest that a higher dose could be beneficial for women who have difficulty in achieving ovulation with the regular doses .

A single cycle of one of these drugs will probably run less than $10 when it is covered by your insurance. It could cost you between $20-$50 per cycle without coverage.

Negative Side Effects of Oral Medications

The most frequent adverse reactions associated with Clomid are hot flashes, mood swings, and pelvic pain.

The most frequent adverse effects of Letrozole are dizziness and fatigue. 

Due to the risk of superovulation, using Clomid or Letrozole could result in the birth of multiple babies (such as triplets or twins). We generally estimate around an 8-10 percent risk of twins and less than one percent risk of triplets or higher-order multiples. 

Intrauterine Insemination (IUI)

If you’re not successful using oral fertility drugs the next step could be intrauterine fertilization, or IUI by injecting sperm directly in the uterus. IUI “puts the eggs closer to the sperm and increases the chance that the egg and sperm will cross paths,” says Dr. Rexroth.

What happens during IUI?

The doctor cleans the sperm (collected on the same day as the procedure) is then placed in a catheter before injecting it into the uterus. “The wash could take up 2 hours or more, however the procedure is just five minutes” according to Dr. Rexroth. The procedure also includes an examination.

Fertility Surgery

Laparoscopic surgery, or laparoscopy is a minimally-invasive procedure which can identify and fix issues with your uterus, your ovaries, and/or fallopian tubes that may make it difficult for you to become pregnant.

With laparoscopy A doctor can diagnose and/or treat

  • The fallopian tube is blocked for example, from the fluid that results from a previous pelvic infection or surgical procedure
  • Endometriosis lesions
  • Uterine fibroids
  • Adhesions to the pelvic organs

The process typically requires a small cut in the navel and smaller cuts around the navel–to insert a fiber optic lens and tiny surgical instruments to burn or cut off lesions, fibroids and other obstructions.

The procedure could cost between $5,000 and $10,000 out of your pocket. In the case of your particular circumstances, it might be beneficial to inquire with your doctor whether they are able to bill the procedure as the treatment of endometriosis. 

 

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Iowa Women’s Health Center is interested in talking to you about your decision when choosing which medical options are best for you.  IWHC is an advanced women’s health clinic located in Cedar Rapids, IA. We service all women through central Iowa and in neighboring states for progressive and advanced gynecological care.

We provide the latest and least invasive women’s health medicine throughout Linn County.

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