While the first measures in dealing with subfertility symptoms usually include non-invasive or non-drug methods like fertility charting, improving diet and health, correcting weight variables, ovulation predicting / timing intercourse correctly, or using fertility supplements, sometimes it is necessary to turn to prescription drugs like clomid, or even minor surgical procedures to unblock a fallopian tube or correct male reproductive problems.

However, in some less frequent cases, IVF or Assisted Reproductive Technologies may be required. Such infertility cases include situations in which the male is unable to ejaculate normally during sex, or in cases where female physiological issues prevent conception (for examples, extreme problems with cervical mucous or obstructed fallopian tubes, etc). In cases where the woman can ovulate, artificial insemination is one alternative where sperm is directly place into a woman's womb using a flexible catheter-like delivery system.

For more complex fertility cases, new ART procedures (assisted reproductive technologies) are now coming into vogue. In vitro fertilization (IVF) makes it possible to fertilize an egg in the laboratory - and then implant the embryo directling into the endometrium (or uterine lining). IVF can be used in cases of a blocked fallopian tube, for example. The procedure is complex but technologies have been refined over the past decades. In IVF, the first step is to simulate the ovaries into producing multiple ova (or eggs). Once the ova have developed, they are removed from the ovaries and, in the lab, fertilized with the male sperm (creating an embryo). Multiple embryos are created and then incubated in the lab for about 48 hours. After the incubation period, the embryos are implanted in the woman's womb.

Within the spectrum of assisted reproductive technology procedures, there are a number specific treatments based on the same fundamental principle. For example, there is gamete intrafallopian transfer, in which ova and sperm are placed together within a woman's fallopian tube for natural fertilization and implantation within the woman's body. Zygote intrafallopian transfer is a variation of this in which the ova are removed and fertilized in a laboratory and then returned to the fallopian tubes (instead of the uterus). Donor egg IVF is for cases in which the woman cannot produce ova and healthy eggs are donated by another woman, fertilized with the partner sperm, and then the embryo (or embryos) are transferred to the woman.

There are complications and risks associated with ART and concomitant drug treatments and procedures. Because multiple embryos are implanted in a woman during some of these procedures, about 1/3 of ART procedures do result in twins (and a smaller percentage triplets, etc). Also, there may be short and long term risks associated with fertility drugs. It should be noted that some elements of the "infertility industry" may push you down certain treatment paths too quickly. Do not be afraid to ask for a second opinion, particularly if you feel that simpler explanations or treatment alternatives have not been exhausted first.

Return to Related Articles:
Go Back to Part 1: Diagnosing and Treating Infertility
Go Back to Part 2: Ovulatory Disorders, PCOS, and Male Infertility