Infertility is a problem that many couples face today. It's not always necessary to rely solely on in vitro fertilization (IVF) to resolve it. Treatments can also be conducted using other methodologies and technologies. What alternatives to IVF for infertility exist and are currently employed? Let’s explore!
What is Infertility?
A marriage is considered infertile if a pregnancy does not occur after one year of regular sexual intercourse without contraception (i.e., using no contraceptive methods). Unfortunately, infertility is not just a medical diagnosis; it impacts various aspects of people's lives (both women’s and men’s). Patients suffer from physical and psychological issues, and family relationships may become strained.
Don't despair! It's essential to consult specialists! The earlier you do so, the more chances you have for conception, successful pregnancy maintenance, and the birth of a child!
Where to Start?
It's important to understand that the causes of infertility can lie in both the physical and mental health of women and men. In the initial stages of treatment preparation, a medical history must be gathered.
This includes the physician determining:
- Whether the woman has ever been pregnant and the outcome of that pregnancy
- Whether previous infertility treatments have been attempted, and which methods were used
- If either the man or woman has any chronic illnesses or other pathologies
- Whether the woman has menstrual cycle irregularities
- Other individual characteristics of both partners
Additionally, a comprehensive examination is conducted, which may include:
- Gynecological examination
- Pelvic ultrasound
- Blood tests for hormones (LH, FSH, AMH, TSH, etc.)
- Ovulation tests
- Testing for sexually transmitted diseases
- Semen analysis
- Diagnostic laparoscopy
Any deviations from the norm generally lead to further testing. If necessary, patients are referred to specialists such as andrologists, urologists, neurologists, cardiologists, endocrinologists, etc.
Typically, identifying the causes of infertility takes 2–3 months. Based on the findings, medication or other therapy is selected. Only when that is ineffective might IVF be recommended.
When the Cause is Already Known...
Infertility treatment without IVF can be either medical or surgical. The choice of methods depends on the underlying issue.
The most common today is tubal-peritoneal infertility, occurring in nearly 40% of cases, often caused by adhesions in the pelvic area. Laparoscopy is performed for treatment, utilizing minimally invasive techniques.
This allows for:
- Separation of existing adhesions
- Restoration of tubal patency
- Removal of ovarian and uterine neoplasms
- Elimination of endometriosis foci
Often, hysteroscopy is also performed simultaneously during diagnosis. This procedure enables the removal of various pathological conditions and abnormalities, including polyps, intrauterine adhesions, and uterine developmental anomalies.
In a third of cases, the cause of infertility is endocrine. Patients may have elevated or reduced levels of various hormones, as well as thyroid and other organ dysfunctions. In such cases, endocrinologists and reproductive specialists may conduct infertility treatment without IVF.
Up to 15% of infertility cases are caused by immunological factors. Today, there are special diagnostic methods to assess the so-called biological compatibility of couples in advance. There are instances where a woman’s body produces antibodies that inactivate her partner's sperm, making conception impossible. To address this issue, donor sperm may be recommended.
Reproductive function is also influenced by several other factors, including overall health, emotional state, lifestyle, and more. If such factors are identified, they can be corrected and/or eliminated. Both men and women might be advised to see a psychologist, undergo psychotherapy, change their diets, adopt healthier lifestyles, and quit harmful habits.
Important! There are also situations where the cause of infertility cannot be determined. In those cases, patients are referred to specialized centers where further examinations are conducted, and assisted reproductive technologies (ART) are selected for successful conception.
Other Ways to Address the Problem
If a woman experiences anovulation, medication-induced ovulation is recommended. This treatment involves an initial assessment of the patient's gynecological status, the therapy itself, and monitoring ovarian condition via ultrasound.
Important! Don’t expect pregnancy to happen immediately; it may take several cycles of stimulation. If normal tubal patency is established in advance and there are no abnormalities in the man’s semen analysis, the likelihood of success with this treatment is fairly high.
Intrauterine insemination (IUI) can also be performed. Artificial insemination with the husband/partner's sperm (or donor sperm) is effective in cases of:
- Mild reductions in sperm quality
- Ejaculation disorders
- Long absence of a sexual partner
The procedure involves inserting pre-processed sperm directly into the uterine cavity. Manipulations take place during the natural menstrual cycle, and ovulation induction may be ensured if necessary. The treatment can be performed multiple times, with an effectiveness of up to 20%. This method is close to natural conception and falls under the category of assisted reproductive technologies (ART).
When is Pregnancy Impossible Without IVF?
Generally, in vitro fertilization is recommended:
- In cases of absent fallopian tubes
- In male factor infertility
- In endocrine infertility when hormonal therapy is ineffective
- When IVF is the quickest and most efficient way to achieve pregnancy
There are other indications for IVF as well. The chance of pregnancy in one cycle can range from 30% to 45%. If necessary, fertilization attempts may be repeated.
Important! If there are no contraindications, IVF can be performed for any form of infertility. Currently, in vitro fertilization is the most modern and effective of all reproductive technologies. Thanks to it, millions of couples worldwide are becoming happy parents.
In recent years, donor programs have been actively developed. These utilize donor eggs and sperm, and surrogates may also be involved. These women carry the couple's child.
Another promising direction in in vitro fertilization is preimplantation genetic testing (PGT). This allows specialists to select only those embryos that are potentially capable of ensuring a successful pregnancy for use in the IVF cycle.
Various techniques are relevant:
- When partners have family histories of hereditary genetic diseases
- When chromosomal mutations are present
- In cases of previous pregnancy loss and severe pregnancies in the history due to Rh conflicts
- In older reproductive age
PGT can prevent the birth of a child with severe anomalies (such as Down syndrome, Patau syndrome, etc.).
Modern medicine has enough resources for the rapid identification of infertility and its causes, as well as the resolution of existing problems. Reproductive specialists are capable of selecting the therapy scheme that best fits the particular couple. This can range from simple weight normalization and cessation of harmful habits to ovulation stimulation, artificial insemination, or surgical intervention.
We hope you now understand how and when infertility treatment occurs without IVF and when in vitro fertilization is necessary. If you have questions, ask specialists. They will inform you about the potential for conception without IVF and using assisted reproductive technologies.
We recommend consulting ALFAMEDSTAR partner doctors. They will explain whether infertility can be treated in women and men and how this occurs in specific situations. Experienced specialists will provide a comprehensive approach to the problem. If necessary, doctors utilize unique modern assisted reproductive technologies. Confident professionals will instill assurance in patients, improving overall emotional well-being and positively impacting all processes. All services are provided within one clinic, in a short timeframe, and without wait times.