Female
Infertility Treatments
By Michael Russell
Once the probable
causes of infertility have been identified, treatments can begin.
If irregular ovulation or lack of ovulation is the problem, ovulation
may be induced with medication. These medications are the well-known
fertility drugs. It is important to remember that these fertility
drugs are helpful only if the infertility is caused by a problem
with ovulation, but cannot help at all if the infertility is caused
by something else.
The most commonly used
medication to induce ovulation is called Clomid (clomiphene citrate).
Through its effect on the hypothalamus, clomiphene citrate stimulates
a release of FSH and LH from the pituitary. FSH and LH are the
hormones that act on the ovary to cause the ripening and release
of eggs. The medication is taken in the form of a pill for five
days during the month. Minor side effects include hot flashes
and lower abdominal discomfort. Clomiphene citrate substantially
increases the chances of having twins by stimulating two eggs
to ripen instead of one. It increases the chances of having triplets
and quadruplets only minimally.
In the cases when Clomid
doesn't work, a second type of fertility medication must be used.
This medication is called Pergonal (or human menopausal gonadotropin)
and must be given by injection every day until ovulation occurs.
This treatment is both costly and time-consuming and a woman must
be closely watched for any adverse side effects. By causing several
eggs to ripen at one time, the use of this medication can result
in triplets or quadruplets. Ultrasound monitoring and hormone
testing have helped lower the numbers of unwanted multiple births.
Serious side effects of Pergonal include large ovarian cysts and
massive shifts in body fluids.
Problems with the fallopian
tubes may be treated surgically. The fallopian tubes may have
been blocked as a result of a congenital abnormality, scarring
subsequent to a previous pelvic infection or to endometriosis,
or previous pelvic surgery. Sometimes the fallopian tubes themselves
are normal, but adhesions surrounding them prevent the egg and
sperm from meeting.
There is a reasonable
chance that the surgical removal of the adhesions will improve
fertility. Unfortunately, when repairing the fallopian tube requires
major reconstructive surgery (tuboplasty), the success rate is
much lower. Even when it is possible to open the fallopian tubes,
tubal function does not always return to normal and the infertility
may persist. Frequently operating microscopes, very fine instruments
and lasers are used to improve the success rate of tubal surgery.
An experimental procedure
that may eliminate the need for surgery in some cases of blocked
fallopian tubes has been adapted from a technique used to unclog
coronary arteries. A catheter carrying a small balloon is threaded
through the uterus into the blocked tube. When the balloon is
inflated, the fallopian tube is stretched and the obstructive
tissue is washed out.
Other treatments are
available for other specific causes of infertility. For example,
treatment of a genital infection may correct the infertility,
especially if the partner is treated simultaneously. Sometimes
problems with the cervical mucus may be treated by the administration
of low doses of estrogen.
Michael Russell
Your Independent guide to Infertility
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