Overcoming Fertility Problems
If you have been trying to conceive a baby for a long time without success and have seen your doctor for investigations into your or your partner's fertility problems, the next step is to start treatment. There are four basic methods: drug treatment, sperm and egg donation, surgery and assisted conception, such as in vitro fertilization, or IVF.
The stress factor
For many couples, the stress and anxiety involved in trying for a baby are to blame for difficulties in conceiving. It is easy to get hung-up on counting fertile days, filling in charts and having sex to order, but becoming obsessive about these things can often have the opposite effect to the one you are looking for. If conception is taking a few months, try to be relaxed about it. Remember that sex should be fun and a way of showing your love for each other, not just a way to make a baby. You may find that, if you stop counting, plotting and measuring and just try to have lots of sex without thinking too hard about the consequences, you will get lucky.
Drug treatments stimulate ovulation. They are often the first port of call for women with fertility problems, as they are relatively simple to use, very safe and have been used successfully for many years.
Ovulation is controlled by a finely balanced combination of hormones. Some of the hormones are collectively called follicle-stimulating hormone (or FSH). Clomiphene causes your body to produce FSH, which makes your ovaries produce the follicles in which the eggs can ripen.
One cycle of clomiphene treatment consists of a 5-day course of pills. You will be monitored while taking the drug so that your doctor can determine whether any mature eggs are being produced. However, it may be a couple of months after you take the drugs before you start to ovulate regularly.
Sperm and egg donation
Some couples do not conceive a baby for the simple reason that the woman is not producing any eggs or the man is not producing any sperm.Treatments such as IVF rely on a couple's sperm and egg being fertilized outside the body, so if one of you is not producing sperm or ovulating, then your only chance of having a baby may be to accept sperm or eggs from a donor.
This procedure is a good option if the woman is fully fertile but the man is experiencing fertility problems and treatments used to boost his sperm count have failed. The donated sperm will have been frozen and are defrosted immediately before the procedure. The clinic will work out when you are ovulating and will sometimes recommend that you take fertility drugs, such as clomiphene, to make absolutely sure of this. The defrosted sperm are usually inserted directly into your uterus.
If a woman is not ovulating and drug therapies, such as clomiphene, have not helped, but the man is producing healthy sperm, then egg donation could be a good option. The quality of the eggs that a woman produces declines as she ages, so this procedure can help women who choose to become mothers in later life. It can also help if your eggs have been destroyed by cancer treatments. You and your egg donor will take drugs to synchronize your cycles, so that she is producing eggs at the time your uterus is ready for an egg to implant. Once her eggs have been removed, they will be combined with your partner's sperm just as in normal IVF.
Some couples who have extra embryos, created by IVF, donate them to other infertile couples. Receiving an embryo in this way is an option if there is a risk of you and your partner passing on a genetic disorder of which you are both carriers. It involves the same basic technique as IVF.