In vitro fertilization (IVF) may be the first thing that comes to mind when you think of fertility treatment. But not every couple who is trying to get pregnant needs IVF to achieve their goal of having a baby. At the Fertility & Reproductive Medicine Center, we offer several less-invasive—and more cost-effective—treatments you can try before IVF.
Non-IVF Fertility Therapies: Treatments We Offer
Medical therapies include ovulation-stimulating drugs that can help you ovulate more regularly. More powerful doses can stimulate your ovaries to produce and release several mature eggs at once to increase your odds of getting pregnant. You can use over-the-counter ovulation predictor kits along with any of these medications to help time sexual intercourse or intrauterine insemination (IUI) and maximize your chance of conception.
Intrauterine Insemination (IUI) Treatment
An IUI is a medical procedure that places the sperm directly into the uterus. The sperm does not have to travel up the vagina and through the cervix to reach the uterus. The advantage of IUI is that it puts a much larger number of sperm into the uterus than would occur with intercourse. IUI may be useful if the male partner has a low sperm count.
Ovulation Stimulating Medications
The ovulation-stimulating medications we often prescribe include:
- Clomiphene citrate (Clomid®): If you have an ovulation disorder or unexplained infertility, clomiphene citrate is often the first intervention your doctor will recommend. Taken orally, Clomid® helps induce ovulation by tricking the pituitary gland into producing more follicle-stimulating hormone (FSH) and luteinizing hormone (LH). These 2 hormones then stimulate the ovaries to produce and release more eggs.
- Letrozole (Femara®): We often recommend this medication first to women who have polycystic ovary syndrome (PCOS). Femara® works by temporarily stopping the conversion of androgens to estrogens. The brain then responds by increasing secretion of FSH, which induces ovulation.
- Metformin: For women who show signs of insulin resistance or glucose intolerance, this diabetes medication may help induce ovulation. Although this medication is not used frequently, your doctor may recommend metformin if other oral ovulation-inducing medications have not helped you.
- Gonadotropins: These medications are identical to natural follicle-stimulating hormone (FSH) and are sometimes combined with luteinizing hormone (LH). Given by injection, these hormones stimulate the growth and release of multiple eggs. Your doctor may recommend injectable gonadotropins if oral medications have not worked or if multiple follicles need to be developed as part of IVF treatment.
Risks of Ovulation-Stimulating Medications
While these medications can significantly increase your chances of getting pregnant, they are not without their potential downsides, like most medical treatments. If you decide to use fertility medications, we will monitor you closely to help prevent problems. Possible risks include:
- Conceiving multiples: Because these medications stimulate the ovaries to produce and release more than one egg per cycle, there is an increased risk of conceiving twins, triplets or more.
- Ovarian hyperstimulation syndrome (OHSS): Some women using injectable fertility medications to stimulate egg production may experience swollen, painful ovaries, abdominal pain, bloating, weight gain and other symptoms of OHSS. Usually these symptoms go away within a week or so, but some cases may be more severe.
- Lack of results: It’s usually recommended that you try any of these drug treatments for up to three cycles. If you haven’t become pregnant, our fertility experts can help you decide if it’s time to move on to other options.
To make an appointment with a Washington University fertility and reproductive medicine specialist at the Women and Infants Center, call 855.925.0631.