How do you pursue further fertility choices after completing the initial fertility evaluation?
Women and couple with unexplained infertility (no fertility factor detected) or mild male factor:
Choices are timed intercourse (if not done before), followed by ovarian stimulation and IUI for 2-3 cycles followed by IVF. IVF with single embryo transfer may be preferred in women not accepting twins or fetal reduction.
Women who do not ovulate regularly:
Choices are ovarian stimulation with oral or injection medication with IUI for 2-3 cycles followed by IVF. IVF with single embryo transfer may be preferred in women not accepting twins or fetal reduction.
Women with blocked fallopian tubes:
IVF is the best option for achieving a pregnancy. In some women laparoscopic surgery to correct the fallopian tubes can be considered.
Men with moderate to severe male factor:
IVF with ICSI yields the best chances for pregnancy.
Women with prior unsuccessful fertility treatment:
May require careful evaluation of prior treatment to improve response to stimulation, mild stimulation IVF, PGD and other interventions.
Women with markedly diminished ovarian reserve:
Can parent children through donor eggs with partner or donor sperm.
Single women interested in extending their fertility:
Using egg freezing or embryo freezing using donor sperm.
Same sex female couples:
Can parent a child through donor sperm and IUI.
Same sex male couples:
Can parent a child through using a donor oocytes and a gestational carrier.
Women desiring to extend their fertility:
Can use egg freezing or embryo freezing with partner or donor sperm. Eggs or embryos can be used years later to conceive.
Women at risk for reduced fertility:
Due to a disease or disease treatment: options are egg freezing or embryo freezing using partner or donor sperm.
Women with recurrent pregnancy loss:
May require surgery to correct the uterine cavity, ovarian stimulation and IUI or IVF with PGD.
Women desiring pregnancy with a specified sex:
For family balancing requires IVF with PGD, embryos are tested for X and Y chromosomes to determine the sex of the embryo.