A Guide to Infertility Treatment Options
About one in eight couples struggle with infertility, or the inability to conceive despite having regular unprotected sex. But although this statistic is staggering, and infertility can take a huge toll on your emotional health, there's a reason to stay hopeful. Science keeps advancing, treatments get better, and more babies are being born using modern-day medicine.
In fact, according to the American Society for Reproductive Medicine (ASRM), about 85 to 90 percent of couples with infertility are treated with conventional treatment (medication or surgery). "While vital for some patients, in vitro fertilization and similar treatments account for less than 3 percent of infertility services," says the ASRM.
The best treatment for you will largely depend on the cause of infertility. Keep reading for more about common male infertility treatments and female infertility treatments. We also break down the advantages and disadvantages of each method, success rates, estimated costs, how they work, and more.
Fertility Drugs
Injected or taken in pill form, fertility drugs release hormones that induce ovulation to boost egg production and make the uterus more receptive to embryo implantation. They're often used as a female infertility treatment for women who don't ovulate regularly or have partners with very poor sperm quality. Some men may also be prescribed fertility drugs. Note that people should avoid fertility drugs if they have damaged or blocked fallopian tubes or scarring from endometriosis (these conditions usually require IVF).
Success Rates: Success rates vary, but 40 to 45 percent of women who take the pills and ovulate might get pregnant. As many as 50 percent of women who ovulate as a result of the shots get pregnant.
Pros: Fertility drugs are typically the first choice in fertility treatment because of their low cost and relative convenience.
Cons: Possible symptoms are bloating, headaches, hot flashes, and nausea. Side effects are worse with the shots, and include risk of multiple births, premature delivery, and formation of large ovarian cysts.
Costs: The cost of fertility drugs varies widely (for example, from $60 to $6,000 per cycle), depending on whether the drug is a pill or injectable. Blood tests, ultrasounds, and doctor visits might increase the price as well.
Intrauterine Insemination (IUI)
In an intrauterine insemination (IUI) procedure, specially prepared ("washed") sperm is inserted directly into the uterus through a thin, flexible catheter. If you choose this method, your doctor might recommend that you take fertility drugs to increase the chances of fertilization.
IUI is often used when men have slow-moving sperm, lower quality sperm, or a low sperm count. It can also help women who have produced antibodies to their partners' sperm or whose cervical mucus is too scant, acidic, or thick to transport the sperm to the egg. IUI can also be completed with donor sperm.
Success Rates: It depends on maternal age and the quality of sperm. In general, there's a 5 to 20 percent chance of conception per cycle, with your chances increasing each cycle.
Pros: The simple procedure can be performed in a doctor's office.
Cons: IUI can result in multiple births (twins, triplets, etc.). Women may also experience side effects from the fertility drugs.
Costs: On average, IUI costs anywhere from $300 to $1,000 per cycle, if you don't have insurance. You'll pay for more ultrasounds, donor sperm, blood work, and fertility drugs.
In Vitro Fertilization (IVF)
In vitro fertilization (IVF) involves a multi-step process in which your eggs are extracted and fertilized with sperm in a lab. The fertilized embryos are implanted into the uterus in hopes of forming a pregnancy.
IVF is often a female infertility treatment for older women, as well as those with blocked or severely damaged fallopian tubes or scarring from endometriosis. It might also be used if the man has very poor sperm quality. Couples with unexplained infertility may also turn to IVF.
Success Rates: The success of IVF depends on maternal age. If the woman is under 35 years old, most estimates say 40 to 50 percent of IVF cycles will result in pregnancy. Success rates decrease as the maternal age goes up.
To increase the odds of IVF success, some couples choose to add other assisted technologies, such as intracytoplasmic sperm injection (ICSCI). In ICSI, an embryologist selects a healthy-looking, single sperm from the male's semen and injects it directly into the egg with a microscopic needle. Once an embryo develops, it's transferred into the uterus through IVF. It's often used for low sperm count or poor sperm quality.
Pros: Couples with serious fertility problems can become parents using IVF.
Cons: Treatments are costly and physically demanding, and they require a rigorous regimen of fertility drugs before the start of each cycle.
Costs: As with any infertility treatment, IVF costs vary widely. You can generally expect to pay around $12,000 per cycle, as well as an additional $3,000 to $5,000 for fertility medications.
Getty Images. Art: Jillian Sellers.
Reproductive Surgery
Reproductive surgery can correct anatomical abnormalities, remove scarring from conditions like endometriosis, and clear blockages in either the man or the woman. While it sometimes requires a hospital stay, some surgeries can be performed on an outpatient basis.
Success Rates: The success of this infertility treatment depends largely on the condition and its severity, as well as age. Your healthcare provider can give more information about success rates for your specific type of surgery.
Pros: Besides reducing any pain or discomfort associated with the health problem, reproductive surgeries may increase the likelihood of pregnancy.
Cons: Some surgeries are more invasive than others, which can increase the risk, cost, and recovery time.
Costs: The cost depends on the surgery, the surgeon, health insurance coverage, and what's involved. Some minor procedures could be $2,000, while more invasive surgeries could cost $10,000 or more.
Donor Sperm
Couples experiencing male factor infertility might be unable to get pregnant with IUI or IVF. In some cases, they turn to donor sperm, which comes from a man other than the intended father. Men carrying genetic disorders may also choose donor sperm so they don't pass the disorder to their children. It's also commonly used by single women and same-sex couples.
Success Rate: Using donor sperm, the success rate of conception depends largely on the type of procedure (IUI or IVF), the quality of the eggs and sperm, and more. According to RESOLVE: The National Infertility Association, success rates while using donor sperm vary between 60 and 80 percent, but pregnancy may take many cycles.
Pros: Donor sperm enables infertile men, carriers of genetic disorders, and single or same-sex couples to have a child.
Cons: Some men may be uncomfortable with a donor who has no genetic relationship to them.
Costs: Sperm might cost between $700 and $1000 per vial. Factors that may affect the price include a donor consultation or photo match, shipping, storage, and more. You also need to factor in the cost of infertility treatment, such as IUI or IVF.
Donor Eggs
Donor eggs are obtained from the ovaries of another woman. They're usually fertilized by sperm from the recipient's partner, and resulting embryos are transferred into the recipient's uterus. Couples usually decide on donor eggs for the following reasons: the woman's ovaries are damaged or prematurely failing, she has undergone chemotherapy and/or radiation, she carries genetic disorders that she doesn't want to pass along, or she's an older woman with poor egg quality.
Success Rates: When undergoing IVF with fresh donor eggs, around 50 percent of women will give birth. The number drops for frozen eggs.
Pros: Donor eggs enable older women and those with ovarian problems to become mothers.
Cons: The procedure is expensive, the recipient must take a rigorous drug regimen with many potential side effects, and some women with no genetic link to the donor eggs may be uncomfortable using them.
Costs: Using donor eggs generally cost between $15,000 to $30,000, which includes IVF and compensation for the donor.
Donor Embryos
Some couples undergoing IVF become pregnant and no longer need unused fertilized eggs. They can donate these embryos to other infertile couples; this is called embryo adoption. The adopted embryo is transferred into the recipient through IVF.
Success Rates: The live birth rate is about 30 to 50 percent, depending on how many embryos are implanted and whether they are fresh or frozen.
Pros: Embryo adoption enables infertile couples to have a childbearing experience.
Cons: This infertility treatment requires medical screenings, a rigorous fertility drug regimen, and lots of legalities. It can also be difficult and expensive to adopt embryos.
Costs: According to the Embryo Adoption Awareness Center, using donor embryos can cost $7,500 to $19,500.
RELATED: What is Embryo Adoption?
Surrogacy
With this infertility treatment, one woman (called a surrogate) carries a baby for someone else. The surrogate becomes pregnant by IUI using the father's sperm or through IVF with the couple's embryo. Donor eggs and sperm may also be used.
Surrogacy is best for women who can't carry a baby because of disease, hysterectomy, or infertility. In rare instances, both partners are infertile, and surrogacy with donor sperm and/or eggs provides a solution.
Success Rates: Surrogacy success depends on the quality of the eggs and sperm being used. On average, though, live birth rates range from 5 to 30 percent per cycle. Additional cycles increase the likelihood of birth.
Pros: Couples with untreatable fertility issues (for example, the woman may not have a uterus, or she has a disease that makes it risky to carry a pregnancy to term) can become parents.
Cons: Costs are prohibitive. Couples may feel removed from the pregnancy and have to deal with an array of state surrogacy laws and legal contracts.
Costs: Pregnancy with a surrogate might cost between $90,000 and $150,000 (or even more). Various factors come into play, including IUI or IVF, fees to the surrogate agency, and compensation for the surrogate mom.
Gamete Intrafallopian Transfer (GIFT)
With gamete intrafallopian transfer (GIFT), eggs are collected, mixed with sperm in a petri dish, then placed directly inside the fallopian tube where fertilization can occur. Couples may choose GIFT if the woman has at least one functioning fallopian tube and/or the man has a low sperm count or sperm with poor motility. It's also an alternative for couples who have a moral or religious objection to IVF (or fertilization that takes place outside of the woman's body), as well as those with unexplained infertility.
Success rate: About 25 to 35 percent of GIFT cycles will result in pregnancy. Younger, healthier women generally have a higher success rate.
Pros: This infertility treatment allows fertilization to occur in a natural environment.
Cons: There's no immediate verification that fertilization has occurred. GIFT is also more complicated than IVF because a laparoscope is used to insert the egg and sperm mix into the tubes. If more than one egg is used, there's a higher-than-normal risk of a multiple birth.
Costs: GIFT costs around $15,000 to $25,000 per cycle. Naturally, the price is affected by insurance, medications, and more.
Zygote Intrafallopian Transfer (ZIFT)
Zygote intrafallopian transfer (ZIFT) is similar to IVF because sperm and egg are fertilized outside of the body. However, the embryo is inserted into the fallopian tube instead of the uterus. ZIFT is usually used when the couple has unexplained infertility—or when the man has a low sperm count, the woman has at least one tube open, and/or there are ovulation problems.
Success rate: As with most assisted reproductive techniques, the success rate depends on age and health. Based on various studies, it ranges from 25 percent to 45 percent per cycle.
Pros: Fertilization of the egg/sperm mixture, now called a zygote, can be confirmed before it's placed into the fallopian tube (which doesn't happen with GIFT). As a result, fewer eggs may be used, which lowers the risk of a multiple birth.
Cons: Because a laparoscope is necessary, ZIFT is considered invasive surgery, which increases risks and costs compared to IVF. Most patients can go home the same day though.
Costs: ZIFT will generally set you back around $15,000 to $25,000 per cycle.
RELATED: How Do I Know I'm Fertile?
