In vitro fertilization (IVF) has given thousands of women who struggle with infertility the opportunity to become pregnant.
Infertility is a common problem. Approximately 12% of U.S. women age 15 to 44 have trouble conceiving or carrying a pregnancy to term. Unfortunately, many patients think—or are led to believe—that IVF is their only chance to have a baby. This is not always true.
Though IVF can be effective, it can cost upwards of $30,000. IVF can also be emotionally draining. Some couples go through multiple rounds to become pregnant, and some experience miscarriage during the process.
Depending on your circumstances, less invasive, less expensive fertility treatment options than IVF might work for you. The road to discovering your options starts with a visit to your women's health care provider.
When to See a Doctor
If you've been trying to conceive for a year with no results, consider making an appointment with your women's health care provider to evaluate your options. Women who are 35 or older should see a doctor after six months because pregnancy rates decline as women age.
If you have known reproductive problems such as endometriosis or polycystic ovary syndrome (PCOS), talk with your doctor before you start trying to become pregnant. The doctor can help you avoid therapies that might not work for your condition.
Being patient is tough when you're excited to get pregnant. But remember, it can take young, healthy couples with no fertility problems 12 to 18 months to conceive.
Infertility Options Beyond IVF
Assess Your Sexual Activity
Before testing or treatment, your doctor may ask about your sexual habits. We ask so we can make recommendations and improve your chances of getting pregnant.
It’s not uncommon for patients to tell me they only have sex once during their menstrual cycle. However, that one time might happen on the day you're likeliest to conceive, even if you've charted your ovulation—the release of eggs from the ovaries.
You’re most likely to get pregnant if you have sex within a day or two of ovulation. This is typically 14 days after the first day of your period, if your cycle is about 28 days long. But the body does not always follow an exact schedule. Having sex every other or every two days throughout the month will give you the best chance of getting pregnant.
Knowing this, try to avoid scheduling sex around your cycle. Do what is comfortable, fun, and natural for you and your partner to avoid creating unnecessary stress.
Evaluation & Testing
There are many reasons that you may be having trouble getting pregnant or staying pregnant. The three main factors are:
- Ovulation disorders: Some women may not ovulate regularly, and this can affect when and how eggs are released from the ovaries.
- Semen issues: This could include low sperm count or decreased sperm mobility.
- Structural abnormalities: Polyps, scar tissue, or excess tissue in the uterus, cervix, or fallopian tubes may block a fertilized egg from implanting in the uterus.
Testing for fertility problems can include a semen analysis, blood tests to measure hormone levels, or imaging such as X-ray or ultrasound. In approximately two-thirds of patients, we can identify what might be the cause of infertility problems.
Even if a specific cause is not found, we can eliminate certain issues and begin discussing treatment options. We typically recommend the least invasive, least expensive options first.
Stimulating Ovulation or Sperm Count
If ovulation is a known or possible issue, ovulation induction (OI) can be a good starting point. OI uses medications to increase ovulation. One common drug we use is Clomid, which costs as little as $10 per cycle.
In addition to or instead of medication, your doctor may suggest an injection of human chorionic gonadotropin (hCG). This hormone triggers your ovaries to release an egg. Injections can cost $500 or more because the treatment requires ultrasound monitoring and bloodwork. For men, vitamins such as vitamins C and D and dietary supplements such as L-carnitine may help with sperm count and mobility.
Intrauterine Insemination (IUI)
The next step in infertility treatment may be intrauterine insemination (IUI). This procedure gives the sperm a bit of a head start by placing it inside the uterus to increase the chance of fertilization.
IUI is often used in conjunction with fertility medications or if the cause of infertility is unknown. IUI may be used if the man has low sperm count or decreased sperm mobility. It is also helpful if the woman has endometriosis or scar tissue that blocks sperm from entering the uterus. While some insurance companies cover IUI, many do not. IUI can cost $300 or more depending on the bloodwork and medication needed.
Correcting Structural Abnormalities
Polyps, small fibroids and scar tissue can be treated with minimally invasive surgery. The doctor will insert a small camera called a hysteroscope, through the cervix and into the uterus. Through the hysteroscope, the doctor will insert small devices to perform the surgery. Endometriosis or large fibroids may require more extensive surgery.
Using Assisted Reproductive Technology (ART)
If less invasive treatments are not working or you have a condition such as damaged fallopian tubes, IVF may be appropriate. During IVF, a doctor collects eggs from a woman’s ovaries and fertilizes them with sperm in a lab. The fertilized egg is then transferred to the uterus. The process takes about four weeks and can cost between $10,000 and $15,000.
I encourage patients interested in IVF to take time to research potential providers. Along with differences in prices, pregnancy rates also can differ between providers. Your OB/GYN can refer you to an ART doctor with experience in your unique situation.
Final Thoughts
The journey to pregnancy can be challenging, especially when it seems like everyone around you is getting pregnant or pressuring you. Pregnancy is possible for many patients, and your OB/GYN can help you navigate effective, affordable fertility options.
Above all, you want to feel comfortable with your doctor. It can be emotionally exhausting to deal with infertility, but having a doctor you trust that can guide you through the options that are available for your unique situation can help.
Ready to discuss fertility options? Call 505-272-2245 for an appointment today.