Other Fertility Treatment at Troché Fertility Centers
In Vitro Fertilization (IVF) usually receives most of the attention when fertility treatments are discussed. Nevertheless, most infertile couples who require treatment will achieve a pregnancy without IVF. Outside IVF, a couple's treatment options may be:
Ovulation Induction
Artificial Insemination (IUI, ICI)
Surgical Fertility Procedures
Super Ovulation or Controlled Ovarian Hyperstimulation (COH)
This treatment is frequently recommended to couples with unexplained infertility. These couples have completed a standard infertility evaluation and no explanation for their infertility was found. Unexplained infertility accounts for 10 to 15% of all causes of infertility. The goal of COH is to increase the chances of conception by increasing the number of eggs released at the time of ovulation. COH for unexplained infertility is usually performed in combination with intrauterine insemination (described below). In these patients this combination results in a higher pregnancy rate than when COH is performed in combination with timed intercourse. Both clomiphene citrate and the gonadotropin preparations are employed for COH. Clomiphene citrate is used in COH cycles at a dosage higher than usually needed to induce ovulation. Nevertheless, clomiphene citrate is not as effective as the gonadotropin preparations in inducing multiple ovulation, and as a result, in couples with unexplained infertility the pregnancy rate is higher in gonadotropin cycles as compared to clomiphene cycles. The risk of multiple pregnancies when gonadotropin preparations are used for COH is approximately 25%. With clomiphene citrate the risk for multiple gestations remains approximately 6%.
Expectant Management
Expectant management is a period of “wait and see” (no intervention or treatment) before attempting any fertility test, procedure or therapy. This approach is recommended to couples with unexplained infertility of short duration when the woman is under 35 years of age. In this group, the likelihood of a spontaneous pregnancy within a 2 to 3 year period is very good. These couples have a pregnancy rate of 35-50% after two years, and 60-70% after three years of observation. It is important to note that these rates decrease as the female partner's age and the duration of infertility increase. Treatment is recommended when no pregnancy occurs after an adequate period of observation.
In our experience most couples decline expectant management in lieu of further testing or treatment. Nevertheless, this is an option that is discussed with couples diagnosed with unexplained infertility.
Adoption
The treatment of infertility can be stressful and expensive. After a long and unsuccessful journey in the path to fertility adoption may become an alternative to childlessness. People making this decision face many challenges: stopping fertility treatment, making peace with the loss of the dream of making a baby, and facing fears and concerns about adoption and the adoption process which can be both confusing and intimidating.
Resolve - The National infertility Association - offers a very comprehensive guide to adoption as well as links to adoption agencies. We encourage you to explore these resources available at their website.
We want you to understand what all your options are (including IVF) in order that you might make an informed decision. Ultimately, our goal is to match you with the best treatment option consistent with your personal goals.
Last updated:
January 31, 2012
Reviewed by Dr. Vladimir Troché and his medical staff