Discover the natural and assisted treatments used to treat infertility and what to expect with each.

Some couples can get pregnant quickly, while others can take longer. If you haven't been able to conceive after one year of trying (or six months if you are a female over the age of 35 or are aware of fertility problems), it is a good idea to see a fertility specialist. By evaluating your fertility through interviews, physical examinations, and blood tests, the specialist will see what could be causing problems and create an infertility treatment plan based on your personal history and needs.

In this article, we provide an overview of common natural and assisted treatments used to treat infertility. Before we explore fertility treatments, let’s review some infertility basics.

What is infertility, and how is it diagnosed?

Infertility is the inability to conceive a baby after one year of regular unprotected sexual intercourse (or six months if the female partner is over 35 years old). Infertility is a global condition and affects an estimated one in six couples worldwide.

Infertility may be diagnosed by your family doctor, a gynaecologist, or a fertility specialist (a medical doctor specialising in diagnosing and treating fertility issues). Your specialist will first try to diagnose the cause of your infertility by conducting a detailed interview. This interview may include questions about the following:

  • Your and your partner's medical history
  • Changes in the menstrual cycle
  • How long you have been trying to get pregnant
  • Previous conditions or illnesses
  • Age

After the interview, the specialist may conduct several tests to diagnose the cause of fertility. These may include a blood analysis, an ultrasound, and a semen analysis.

What can cause infertility?

There are lots of different factors and causes that affect your fertility. It is important to remember that the cause of infertility is not always clear. In fact, around 15-30% of couples who experience infertility are diagnosed with idiopathic infertility, or infertility that has no recognisable cause.

Infertility in couples may arise due to problems with the male, problems with the female, or a combination.

Male infertility often results from:

  • Low sperm count
  • Poor sperm movement
  • Misshapen sperm
  • Blocked sperm ducts

Female infertility commonly occurs due to:

Based on the examination results and the interviews, your specialist will develop a personalised treatment plan for you.

What fertility treatment options do I have?

From hormone therapy to assisted reproductive technologies (ARTs), there are many ways to treat fertility issues. You may only need one treatment, or you and your partner may need a combination of treatments. It all depends on your situation and health history.

Let's look at the treatment options available for couples or individuals looking to conceive.

Hormone Therapy

A hormonal treatment increases the likelihood of a pregnancy by stimulating or regulating the ovulation cycle. This treatment prompts ovulation in patients who do not ovulate spontaneously, which is most often seen in women with polycystic ovary syndrome (PCOS).

Various fertility medications may be given for hormonal stimulation or regulation. Some of the most commonly used fertility drugs are:

Intrauterine insemination (IUI)

Intrauterine insemination, a form of artificial insemination, is a procedure where sperm cells are placed directly inside your uterus at the time of ovulation. This helps healthy sperm get closer to your egg. IUI may be suggested if you or your partner are unable to have sexual intercourse, if there are risks to having unprotected sex (such as a sexually transmitted disease), or if you are a same-sex couple using donor sperm.

How does IUI work?

The first step is for a male partner to provide a semen sample. The specialist uses a vaginal ultrasound or blood tests to determine the time of ovulation in advance. Once the day and time have been fixed, the male partner arrives one or two hours before insemination to provide the semen sample. Alternatively, a frozen specimen of donor sperm may be used.

The sperm sample goes through a process called ‘sperm washing’, which uses a special fluid to help remove poor quality sperm. By selecting the best quality specimens, your chances of fertilisation improve.

IUI consists of depositing the high-quality sperm in the uterus using a flexible catheter passed through the neck of the uterine cavity. Reducing the distance that sperm has to travel increases the chances of successfully fertilising the egg, along with the chances of pregnancy. For a pregnancy to occur, a sperm must successfully fertilise the egg, and the fertilised egg must implant into the uterus lining.

Hormonal stimulation of the ovaries may be used to promote the production and maturation of eggs. A specialist prescribes hormones (either antiestrogens or gonadotrophins) to be taken orally or injected.

The artificial insemination procedure is done at your fertility clinic or gynaecologist. IUI is usually not painful, and you don't need anaesthesia, but some people experience mild cramping. After resting for 5-15 minutes, the patient can resume their normal activities.

The IUI procedure is relatively simple and can be less expensive than other fertility treatments. While it can increase your chances of getting pregnant, there is no guarantee that IUI will work.

Is IUI right for me?

IUI might be a good option if any of these factors apply to you:

IUI may not be for you if:

  • You have blocked fallopian tubes.
  • You are in menopause.
  • You have diminished ovarian reserve.
  • You have severe male infertility—if the sperm count or motility is very low.
  • You have severe endometriosis.

In vitro fertilisation (IVF)

In vitro fertilisation is when an egg is fertilised outside the body. Eggs are taken from the ovaries in an examination room. These eggs are then fertilised with sperm in a laboratory. A fertilised egg is then reinserted into the womb, where it can grow and develop.

How does IVF work?

The first step of in vitro fertilisation (IVF) is taking fertility medication for several weeks to suppress your natural menstrual cycle, promote ovulation (also known as ovulation induction) and the production of mature eggs ready for fertilisation. You may undergo regular ultrasound scans or blood tests to monitor hormone levels and track the development and number of eggs.

A fertility specialist will retrieve your eggs through a minor surgical procedure called egg retrieval once your ovaries have produced enough mature eggs. Around 36 hours before egg retrieval, your doctor will instruct you to take a shot of human chorionic gonadotropin (HCG), which helps your ovaries release mature eggs in anticipation of fertilisation.

During the egg retrieval procedure, you will be sedated. The doctor will use a vaginal ultrasound to visualise your uterus and ovaries and guide the insertion of a thin needle through your vagina and into the ovary where your eggs are. The needle is attached to a gentle suction device that removes the eggs from the follicles (the fluid-filled sacs where eggs mature).

In the laboratory, the eggs are combined with sperm cells from your partner or a donor in a process called insemination. The eggs and sperm are kept in a particular container where fertilisation occurs. If the sperm have low motility, they may be directly injected into the eggs to increase the chances of fertilisation (a process known as intracytoplasmic sperm injection or ICSI). The specialists monitor the development of the embryos as the cells divide and multiply.

Around 3-5 days after the egg retrieval, one or more embryos will be placed into the woman's uterus in an embryo transfer. The specialist will insert the embryo into your uterus by passing a thin tube through your cervix and into your uterus. Pregnancy will occur if any of the embryos attach to the lining of your uterus. The embryo transfer procedure is performed at the fertility clinic and is typically not painful. You are recommended to rest for the remainder of the day after the transfer, but you can return to your regular activities the following day. To support the embryo's survival, you may be prescribed pills or receive daily progesterone injections for the first 8-10 weeks after the transfer. These hormones will make it easier for the embryo to thrive in your uterus.

What else should I know?

IVF can be stressful for the person having the procedures and their partner. Talking with people who have been through IVF can be helpful if you feel overwhelmed or anxious. Online and physical communities are good places to meet people who understand what you are going through and can offer advice and support. Therapists can also be sources of comfort.

Is IVF right for me?

IVF may be a good option if you have these diagnoses:

IUI vs IVF: Success Rates

Although an IVF cycle is more costly than an IUI cycle, it may still be a better option for some patients depending on your unique situation.

What can affect a successful IVF outcome?

Any of the following factors can interfere with the success of IVF:

  • Cause of infertility
  • Female age
  • PCOS
  • The total number of embryos

Egg Freezing

Egg freezing is a technique that helps women preserve their fertility prospects for the future by freezing their egg cells.

How does egg freezing work?

After two weeks of ovarian stimulation through daily injections, egg freezing is performed by removing mature egg cells (ova) in a medical procedure while the patient is under anaesthesia. The eggs are then stored at sub-zero temperatures in a technique called cryopreservation.

This freezing technique allows human egg cells to maintain their fertility potential by stopping any cell metabolism processes that might cause damage or aging. The egg cells retain their fertility potential from the time they are frozen until the patient is ready to continue with treatment. At this time, the egg cells will be fertilised with the partner's sperm in the IVF laboratory. The resulting embryos are then transferred into the woman's uterine cavity.

Is egg freezing right for me?

This procedure is recommended if you:

  • Are under the age of 35
  • Have a family history of early menopause
  • Are undergoing treatment for a medical condition that could affect your fertility
  • Are considering having children later on

What are natural ways to improve fertility?

Your reproductive health is affected by your lifestyle and dietary choices. Here are some strategies that you can use to try and improve your fertility naturally.

Stress Management

It is normal to feel stressed, especially during struggles with conception. Monitoring stress levels is always advisable. Exercise, mindfulness practices, therapy and support from loved ones can all play a role in helping you feel more in control.  For couples, seeking support and incorporating psychological interventions has been shown to reduce stress levels and improve pregnancy outcomes.

Diet

Eating a diet rich in fruits, vegetables, and whole grains can help you maintain a healthy weight and provide essential antioxidants, such as vitamins C and E, beta carotene, folate, and lutein. Nuts, seeds, avocados, olive oil, and canola oil are all packed with monounsaturated fats, which have anti-inflammatory properties that can improve fertility.

Vitamins

Vitamins contain essential micronutrients that play crucial roles in fertility. For women, consuming multivitamins may reduce the risk of ovulatory infertility. Women trying to conceive may particularly benefit from a multivitamin containing folate. In one study of 232 females treated with artificial reproductive technologies, increased folate consumption was associated with a higher likelihood of egg implantation, clinical pregnancy, and live birth.

Research about how antioxidants impact male infertility remains relatively divided, and there is a need for more studies.

Exercise

Weight has a significant impact on both male and female fertility. Both being underweight and overweight can result in decreased fertility. In women, obesity has been linked to ovulation irregularities and impaired egg development and quality. In men, obesity is associated with reduced semen and sperm parameters, hormonal imbalances, and erectile dysfunction.

Engaging in moderate physical activity can positively affect fertility, particularly those who are obese. In contrast, excessive high-intensity exercise has been associated with decreased fertility. If you plan to increase your activity, ensure that your fertility specialist is aware.

Takeaway

Advancements in reproductive medicine and technology have increased the possibility of treating infertility. Common fertility treatments include hormone therapy, IUI, IVF, and egg freezing. Stress management techniques, exercise, diet, and nutrition can also improve your chances of getting pregnant.

During an initial fertility consultation, your fertility specialist will ask about your medical history, age, weight, lifestyle factors, and how long you have been trying to conceive. Depending on your diagnosis and specific needs, your fertility specialist will create a customised treatment plan that includes one or more treatments for you, your partner, or both.

If you are trying to get pregnant, contact our compassionate team of specialists. They will assess your fertility and guide you with a personalised care plan based on your needs. Reserve your spot for a free consultation today.