Beginning Fertility Treatment Options
Ovulation Induction (“Fertility Drugs”)
- Oral (Clomiphene Citrate, Clomid™, Serophene™): oral tablets which function as mixed estrogen agonists and antagonists depending on the tissue (i.e. compete with estrogen for receptor sites). Use of this medication can lead to monthly ovulation for those women who normally do not ovulate on their own, ovulation of more than one egg for those women who do ovulate on their own, and better synchronization of the uterine lining.
- Injectable (Follistim™, Gonal-F™, Repronex™, Bravelle™): highly purified preparations of follicle stimulating hormone (FSH) and/or luteinizing hormone (LH) which are taken as subcutaneous injections. These medications provide for a much more potent stimulation than the oral ovulation medications, and as such require much more frequent monitoring.
Intrauterine Insemination (IUI)
A process where sperm are isolated from the male semen ejaculate, washed, and placed into a woman's uterus using a thin flexile plastic cannula. This process is almost always used in conjunction with an ovulation induction medication.
Diagnostic or Operative Laparoscopy
A minimally invasive outpatient surgical procedure using 2-3 small holes made through the umbilicus and abdominal wall allowing passage of a telescope camera and instruments into the abdominal cavity and pelvis while the patient is under general anesthesia. This procedure is recommended for patients who may have any number of conditions that affect the uterus, fallopian tubes, or ovaries. If infertility has been longstanding for many years, or a woman has a medical history suspicious for an abnormality of the pelvis, an evaluation with laparoscopy may be warranted. Operative laparoscopy is more complex surgery used to restore a woman's pelvic anatomy in order to enhance fertility, or provide access to the pelvis in order to remove or separate the fallopian tubes from the uterus prior to proceeding with IVF, as may be indicated in some women with tubal disease that may compromise implantation of a healthy embryo.
Operative Hysteroscopy
A invasive outpatient surgical procedure performed using conscious sedation anesthesia in which a long thin camera is inserted through the vagina and cervix and into the uterus in order to correct any abnormalities of the uterine lining or cavity as detected by previous diagnostic testing. Most commonly, removal of endometrial polyps (non-cancerous small growths), fibroids, or extra tissue can be performed easily and quickly using instruments inserted through the camera.