Treating Fertility Problems or Infertility Issues
From Ovulatory Disorders and PCOS to Sperm health

As indicated in part one of this article, male or female infertility issues are complex. That said, many "fertility problems", if not most, can be treated through various means (from simply improving your health and diet to measures like taking fertility pills (clomid) or ART/ IVF procedures). However, any fertility expert will tell you that the first step in increasing your odds of becoming pregnant is to be at the proper weight, eat right, exercise regularly (without over-exertion), know when you are most fertile (via predicting ovulation and fertility charting), and make love regularly. There are risks and side effects associated with fertility drugs and ART procedures; unless you exhibit clear symptoms of infertility problems, ensure that you have taken all the proper natural steps first in trying to conceive before jumping on the fertility drug wagon.

In some cases, the simple and safe first steps can not only increase your odds of conceiving, but they can also help you find out if there are perhaps other issues to consider that may be hindering or delaying conception. For example, if you are fertility charting and discover that you produce very little cervical mucus (which aids in conception), then you can use a product like Pre-Seed (a sperm-friendly lubricant) that will compensate for low amounts or hostile (acidic/dry) fertile cervical mucus. Furthermore, if you are bbt charting and discover that you do not have a midcycle temperature increase (after you would ovulate) or if you have a very short luteal phase, then you may discover fertility issues based on hormonal imbalances that can be corrected.

Stress and anxiety, of course, do not help when it comes to conceiving a baby. But in most cases, TTC stress is typically a result of trying and trying and trying rather than a cause of infertility issues. That said, being as relaxed as possible is great for fertility - and decreasing stress can be effectuated through simply exercise, yoga, breathing exercises, and by simply "taking charge of your fertility" though self-education and fertility charting. Good communication between partners is also vital for TTC couples. TTC message boards and fertility forums also provide a public space to share thoughts and vent frustrations.

Of course, sometimes these 'front line' fertility-enhancement solutions are not sufficient in dealing with diagnosed ovulatory disorders, extreme reproductive hormonal imbalances, ovulation issues, physiological issues (blocked fallopian tubes or low sperm count or motility), or problems like PCOS. Here, other fertility treatments and therapies may be indicated, including the use of prescription fertility drugs such as Clomid or Serophene (clomiphene citrate) or Pergonal, Humegon or Metrodin. Such fertility drugs are are prescribed to help induce ovulation or to promote hormone imbalance. In some cases, surgery may be required to 'unblock' a fallopian tube or correct reproductive organs harmed by disease or congenital defects. In vitro fertilization or high-tech solutions like ART or less frequently indicated in about 10% of serious infertility cases. Success rates may vary, of course depending on how serious the infertility problem - but sometimes a 'lighter' solution like fertility supplements will succeed when a 'harder' fertility drug like clomid does not. When it comes to the fertility industry and more austere treatment options, do not be afraid to seek a "second opinion", particularly if you feel that simpler explanations or treatment alternatives have not been explored first. There are risks and side effects with some prescription medications and procedures.

When or How do I know if I have a Fertility Problem?

By most allopathic standards, an infertility issue is typically indicated after a couple has been actively TTC for one year. However, if you have been casually trying to become pregnant (without charting fertility, predicting ovulation, or regular lovemaking) then the problem may not be related to fertility issues. Here, the solution may simply be 'front line' ttc methodologies like using a basal thermometer and timing intercourse for your most fertile days.

It's important to note that even young, health couples may not get pregnant during the first cycles. On average, it takes about 6 months for couples to get pregnant (with a twenty percent pregnancy success rate each menstrual cycle). To increase the odds of pregnancy, timing intercourse just prior to ovulation is key - and this will certainly help in increasing your overall odds. If, after a year of timed lovemaking and fertility awareness, you do not become pregnant, then you may consider visiting a doctor or specialist for an evaluation. Age is a factor here as well. If you are in your 30s, you may want to consider an evaluation sooner rather than later. For women, the age factor is more important than for men, and issues like ovarian reserve and hormonal balance become fertility variables relatively soon. Though sperm health, count, and motility may decrease as men age, the decline is slower and men can still be fertile even into their seventies.

Clearly, seeing a medical professional is a good idea of you have ovulation problems (ovulatory disorders) or are not menstruating regularly (or at all). These symptoms indicate the need for an immediate evaluation. Frequent miscarriages can also indicate a fertility issue (including hormonal imbalance as certain reproductive hormones like progesterone need remain high in early pregnancy). An evaluation may help a couple determine the cause of an issue (sperm count, PCOS, hormonal imbalance, blocked tube, etc) and indicate possible treatment solutions (from better timing lovemaking with ovulation to using clomid to induce ovulation).

Testing Male Fertility: There are home sperm tests that can test for one basic sperm parameter (count). However, the home tests do not display results for variables like motility or shape. The most basic clinical sperm tests indicate sperm count, but can also determine motility, viability, a proper morphology (shape). An x-ray test can reveal certain causal physiological issues, including damage to the vas deferens. The Mucus Penetration Test (or Mucus Penetrance Test) can help determine if there is a problem with sperm motility (ability to efficiently swim in a sustained, forward direction). The Mucus Penetrance Test can also reveal if the cervical mucus quality is hostile, or inimical to sperm transport.

Testing Female Fertility: The first step in determining female fertility issues is to find out if the woman is ovulating regularly (each month). As indicated above, fertility charting, using ovulation tests, and observing natural fertility signs can help a woman determine if she is ovulating or not. A doctor can also use ovarian ultrasound to find out if a woman is ovulating, as well as employ certain hormone tests. A hysterosalpingogram is a test designed to determine if the fallopian tube is partially obstructed or blocked. A laparoscopy is an examination (using a viewing apparatus) of the fallopian tubes and uterus to determine if their are any physiological issues or pathologies. An endometrial biopsy is a test on the uterine lining to determine if the endometrium (or lining of the uterus) is undergoing normal monthly changes during the menstrual cycle. Cervical mucus tests (like the Mucus Penetrance Test) can indicate issues with cervical mucus (hostility), including antibodies attacking the sperm.

Today, most infertility issues are treated with either supplements, fertility drugs, or minor surgeries to clear a fallopian tube - with IVF or ART alternatives constituting a smaller minority. For women with ovulation disorders (or not ovulating at all), drugs like clomid, etc, may be prescribed. Clomid induces ovulation. Milder fertility supplements may be used for cycle irregularity or hormonal imbalance. If you are not ovulating at all or do not have a menstrual cycle, fertility supplements are not advised; rather, it is recommended that you visit your doctor. Please note that fertility drugs like clomid may have side effects, from dry cervical fluids to more serious but rarer issues. Also, with fertility drugs, multiple births do occur in about ten to twenty percent of successful pregnancies (milder fertility supplements, however, should not have side effects, nor should not they increase the odds of multiple births).

Other Treatments: Assisted Reproductive Technologies
Go Back to Part 1: Diagnosing and Treating Infertility