According to the American Society for Reproductive Medicine, common causes of fertility issues for women include:

• Advanced age
• Polycystic ovarian syndrome
• Impaired ovulation due to disease, birth defects or abnormal hormone production
• Blocked fallopian tubes
• Inability of the uterus to hold the embryo
• Endometriosis

 

According to the American Society for Reproductive Medicine, common causes of fertility issues for men include:

• Low sperm count
• High percentage of abnormally shaped sperm
• High percentage of sperm that are not moving forward
• Ejaculation dysfunction
• Testicles that are small or a swollen scrotum

Sperm production can be affected by blocked passageways, fevers, infections or birth defects.

 

After consulting with your doctor, he or she may recommend trying a combination of fertility medications meant to stimulate or suppress certain hormones. Throughout the cycle, your doctor will likely monitor the effects of the medications and make necessary adjustments where needed. Talk with your doctor and make sure you understand your treatment plan.

The many variations of fertility medications may seem a bit overwhelming, so here are some basic facts on the drugs most commonly prescribed and why they are helpful:

• Clomiphene Citrate (commonly known as Clomid or Serophene) is a fertility pill that can boost your levels of follicle stimulating hormone (FSH). It is useful in helping women who do not ovulate regularly produce an egg every month.
• Human Menopausal Gonadotropin (hMG) will stimulate the ovaries directly by helping to mature developing follicles and trigger the release of eggs.
• Progesterone is hormone delivered by either intramuscular injection or by vaginal suppository hormone that will prepare the lining of the uterus for the arrival and implantation of an embryo.
• Gonadotropin-Releasing Hormone Agonists (GnRH agonist) such as Lupron or Synarel suppress your body’s own hormone production, thus preventing follicle development and egg release. Fertility specialists use these medications to help improve and balance your hormone level for better control of your cycle.
• Antagonists are a class of fertility drugs used for pituitary suppression if you’re preparing to undergo an IVF cycle. They can be effective in preventing a premature rise in hormone level and inducing a shorter course of ovarian stimulation.

Learn more at The 4-1-1 on Fertility Drugs.

Intrauterine Insemination (IUI) occurs when sperm is placed into a woman's uterus while she is ovulating. The woman may be given ovulation-stimulating drugs prior to the insemination. This procedure is used for couples with unexplained infertility or minimal male factor infertility, and for women with cervical mucus problems.

In Vitro Fertilization is the process of uniting the egg and the sperm in the laboratory and then transferring selected embryos into the uterus. The procedure is meticulously timed, which involves removing ripened eggs from the female's ovary, fertilizing the eggs with semen, incubating the dividing cells in a laboratory dish and then implanting the embryo back into the uterus.

Learn more at IVF.

If a couple cannot be helped through procedures such as in vitro fertilization, they may want to consider using donor eggs or embryos. Donor eggs and embryos allow an infertile woman to carry a child and give birth. You might be a candidate for donor eggs if you have any of these conditions:

• Premature ovarian failure, meaning menopause has started much earlier than usual
• Diminished ovarian reserve, meaning that the eggs that you have are of low quality
• Genetically transmitted diseases that could be passed on to your child
• A previous history of failure with IVF

Traditional Surrogate

A traditional surrogate is a woman who is artificially inseminated with the father's sperm. She then carries the baby and delivers the baby for the parents to raise. A traditional surrogate is the baby's biological mother because it was her egg that was fertilized by the father's sperm.

Gestational Surrogate

Through the process of in vitro fertilization, eggs are harvested from the mother, fertilized with sperm from the father and the resulting embryo is placed into the uterus of a gestational surrogate. She then carries the baby until birth. A gestational surrogate has no genetic ties to the child.

Learn more Tips for Parenting through Surrogacy.

A woman's fertility is largely dependent on the quality of her eggs. Some medical conditions such as cancer also limit a woman's ability to conceive. Women have the option of freezing eggs for future use. Although the woman may age, the eggs will maintain the same age as when they were frozen.

When a couple is ready to use their cryopreserved eggs, some or all of the eggs are thawed and then injected with a single sperm from the male partner to bring about fertilization. Fertilized eggs are cultured in a lab and begin to divide and develop into embryos. Generally, one or two of the best dividing embryos are transferred into the uterus. Other embryos that have grown well after fertilization but are not transferred can be cryopreserved as embryos (see below).

For more information, visit the American Society for Reproductive Medicine.

Similar to freezing eggs, embryo cryopreservation can be performed when there are more embryos than needed for a single in vitro fertilization (IVF) cycle. The extra embryos can be frozen for future IVF cycles.

When a couple is ready to use their cryopreserved embryos, some or all of the embryos are thawed so that the age of the embryos corresponds to the age of the uterine lining. The embryos are placed in the uterus around the time of ovulation and when the thickness of the lining of the uterus is optimal.

For more information, visit the American Society for Reproductive Medicine.

Cryopreserved sperm may be used at a later date to achieve pregnancy through either intrauterine insemination (IUI) or in vitro fertilization (IVF). When the sperm are thawed in the andrology lab, an embryologist analyzes the sperm count and motility. A "test thaw" may be requested by the man’s physician prior to insemination to confirm quality of the specimen. If poor sperm characteristics are identified or if very few frozen sperm samples are available, IVF may be the recommended option.

For more information on male fertility, visit the American Society for Reproductive Medicine.

For men in which other options for obtaining sperm have not been productive, testicular biopsy samples may be collected by a urologist or infertility specialist. The recovered sperm can be cryopreserved for future procedures or used immediately.

For more information on male fertility, visit the American Society for Reproductive Medicine.