There are three types of fertility treatment:

1. Medicines
2. Surgery
3. Assisted Conception

The categorization is based on the procedures that are followed to effect the treatment. Depending on what is causing infertility problems, either of these procedures or a combination of them would be administered.
1. Medicines
Fertility drugs are administered as an injection or as pills. The most commonly used fertility drugs are clomiphene and gonadotropins. They regulate the reproductive hormones and induce the release of one or more eggs in each ovulation cycle. The intake of medicines to aid fertilization is recommended for a period of 3 to 6 months. If fertilization does not occur within this period, other treatments are recommended.

This is the most popular treatment for fertility as it is not that expensive and it is convenient. It is generally prescribed for women who do not ovulate regularly or those who have partners with poor sperm quality.

The success rate is around 40 to 45% for women who take pills and ovulate and around 50% for those who take injections and ovulate.

Side effects of these drugs include bloating, headaches, hot flashes, and nausea. Fertility drugs administered through injections have been known to create more severe side effects such as multiple births, premature delivery, and formation of large ovarian cysts.

2. Surgical Methods
In cases where it is required to treat genetic defects, anatomical abnormalities, remove scars, open blocked fallopian tubes, remove fibroids, remove the tissue of endometriosis, treat PCOS (polycystic ovarian syndrome), and clear blockages in either the man or the woman, surgery could be the solution.

Laparoscopy and Laparotomy are the two commonly adopted surgical procedures to treat gynecological problems that cause infertility. Laparoscopy uses thin instruments and a lighted camera inserted through several small incisions in the abdomen, whereas Laparotomy requires a larger abdominal incision.

The success rate of this method largely depends on the severity of the problem and the woman’s age. But in general, this is the best option available for women with endometriosis, fallopian tube blockage/damage or PCOS. If you want numbers, the percentage of live births in women post-surgery is 20 to 50%.
The disadvantage is that the procedure is invasive and increases risk, cost, and recovery time.

3. Assisted Conception
The assisted conception method is of four types:
• Intrauterine insemination (IUI)
• In-vitro fertilization (IVF)
• Egg and sperm donation
• Gestational surrogacy

Intrauterine insemination (IUI): This procedure involves the process of depositing a concentrated amount of high-quality sperms from a partner or donor directly into the uterus. A fine plastic tube is passed through the cervix to effect this. This procedure is done in tandem with ovulation to increase the chances of conception.

This method is suitable for women who have difficulty in having vaginal intercourse (like in the case of physical disability in either of the partners) or when any of the partners is having a sexually transmittable disease, or in cases of same-sex relationships.

If the man’s sperm and the woman’s tubes are healthy, the success rate for IUI in women under the age of 35 is around 15% in each cycle of treatment.

The side effect of this procedure is that some women may experience temporary cramps during or after IUI. Other than that, the procedure is painless.

In-vitro fertilization (IVF): During this process, the fertilization of the egg occurs outside the woman’s body. The woman is administered with fertility drugs to induce the production of more eggs than normal. The mature eggs are then removed from her ovaries and fertilized with the partner or donor’s sperm in a laboratory dish. A fertilized embryo is then put back inside the woman’s uterus.

There are several variants of this procedure such as intracytoplasmic sperm injection (ICSI), gamete intrafallopian transfer (GIFT), and Zygote Intrafallopian Transfer (ZIFT). In all these variants, fertilization takes place outside the womb, in the laboratory dish.

This method is suitable for older women or women with blocked or severely damaged fallopian tubes or scarring from endometriosis, men with very poor sperm quality, and for couples with unexplained infertility.

The success rate of this procedure varies with the age of the woman. In general, the success rate is higher for women less than 35 years of age.

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