Infertility Treatment Options Explained

The journey to getting pregnant is different for every person. If you’re in the 17.5% of the adult population — roughly one in six worldwide — that has had problems conceiving after a year of trying, then your next step is to turn to a fertility specialist for assisted reproductive technology (ART). 

Embarking on a journey towards ART can be a daunting experience, especially for couples who have faced unique challenges such as cancer, partial hysterectomy, or who are LGBTQ+. It's important to remember that you are not alone in this journey and that each person's path toward parenthood is unique. 

Looking for fertility care is totally normal, and there's no need to feel embarrassed. Everyone has the right to make their own decisions when it comes to their reproductive health. That's why we put together a beginner's guide to the most common fertility treatments available — from medication to surgery, to IVF — to help you better understand your options.

Before we dive in, a note on language: we use the terms "woman" and “man" in this article, with "woman" defined as any person with a uterus and ovaries and "man" as any person with a penis and testes. 

What does a fertility specialist do?

It's common to start your fertility journey with your OB-GYN, but sometimes you might need to see a specialist called an REI (reproductive endocrinologist and infertility) doctor. 

REI is a subspecialty of obstetrics and gynecology that focuses specifically on hormones and fertility. These doctors are trained to be knowledgeable about hormones and everything related to fertility for both men and women. They'll help you figure out what tests and treatments will work best for you. 

It's also worth noting that consulting a fertility specialist doesn't always result in undergoing in vitro fertilization (IVF). Several treatment alternatives vary depending on your specific condition. Your specialist will guide you on the most suitable approach for you.

Your REI doctor will help get you and your partner tested to identify any potential problems that might be interfering with your fertility. 

During your medical evaluation, they'll take a close look at your previous medical history, including menstrual cycles, any past pregnancies or miscarriages, and family history. They’ll also do semen, hormone, and genetic testing to gain a thorough understanding of your situation.

As part of your check-up, your doctor will also examine your reproductive system. This is important because getting pregnant involves many different parts working together, like the ovaries, uterus, and fallopian tubes. They'll check to make sure everything is functioning properly and that there are no issues with ovulation or the lining of your uterus. It's all part of ensuring you're healthy and ready for whatever pregnancy has in store.

Treating infertility

Dealing with infertility can be a difficult and emotional journey, especially because treatment isn’t always straightforward so if you feel overwhelmed, you’re not alone! 

There are many potential causes of infertility, including ovulation issues for women and problems with sperm cells and their function for men. Age, lifestyle, and health conditions, such as reproductive organs or hormonal problems, can also play a role. 

​If you're having trouble conceiving, there are three main fertility treatments available: 

• Medication to help with ovulation 
• Surgical procedures to address any reproductive system issues (including endometriosis or blockages in the fallopian tubes) 
• Assisted conception techniques that help sperm fertilize the egg and the egg implant within the uterus, which may involve the use of donor eggs or sperm. 

Treatment will likely depend on the reason for your infertility, so your treatment plan will be tailored to your specific needs. Your doctor might offer a variety of options to help address the cause of your difficulty conceiving and support you on your path to conception (and parenthood).

Lifestyle changes

Leading a healthy lifestyle can go a long way to improving rates of conception. Your doctor might recommend any of the following lifestyle changes: 

• Stopping smoking
• Reducing and/or stopping alcohol consumption
• Staying at a healthy weight
• Eating a balanced diet
• Reducing stress as much as possible. 

Types of fertility treatments

Fertility treatments can offer a helping hand to people having trouble getting pregnant. There are several options, each designed to address different needs and causes of infertility. Some of the most common treatments include ovulation induction, where medications help stimulate egg production, and intrauterine insemination (IUI), which involves placing sperm directly into the uterus. For those who need a more advanced approach, in vitro fertilization (IVF) involves fertilizing an egg outside the body and then implanting it in the uterus. With the right treatment, many women can take steps toward having a baby. 

Fertility medications

Various hormone therapies can be used in fertility treatment, depending on the issue. Hormonal imbalances can lead to problems with ovulation, but treatment can correct it and increase the likelihood of pregnancy. 

Oral medications such as clomiphene citrate and aromatase inhibitors can be used to stimulate ovulation, and monitoring will be done during this time. If these medications aren’t effective enough, gonadotropins (administered via shots) can also be used to stimulate ovulation.

Surgical treatments 

If your doctors spot any issues with the reproductive organs with diagnostic tests, they might recommend surgery. Some common surgical procedures include: 

• Repairing blocked or damaged fallopian tubes
• Treating endometriosis by removing lesions and scar tissue
• Removing polyps or fibroids from the uterus
• Treating swollen veins in the scrotum.

Intrauterine insemination

If you're trying to conceive, intrauterine insemination may be an option for you. During this medical procedure, healthy sperm — whether from your partner or a donor — is placed directly into the uterus around the time of ovulation. Sometimes, ovulation-stimulating hormones are used to increase the chances of success. 

People opt for IUI for different reasons, like when a sperm donor is involved, when there's male factor infertility to consider, or even as a first step before trying IVF. 

The success rates for IUI range from 5-15% per try, but it's important to keep in mind that the success rates for IUI can vary greatly depending on several factors. Your doctor will help you understand those factors and support you through the process.

It’s generally more affordable than other fertility treatments (such as IVF) but you might have to pay anywhere from $300 to $1,000 without insurance. 

Assisted reproductive technology

Assisted reproductive technology (ART) refers to all fertility treatments in which both eggs and sperm are handled, IVF.

In vitro fertilization

IVF is probably the most well-known treatment for infertility. IVF is used for various reasons, such as when surgery isn’t an option, or when a donor sperm or egg is needed. It's also useful when the root cause of infertility cannot be identified. 

The procedure involves combining sperm with the egg in a lab (that’s the “in vitro” part), followed by transferring the fertilized egg (also known as an embryo) to the uterus. 

Each of these steps involves a complex series of procedures, including collecting the egg, fertilizing it with the sperm, and transferring the embryo. It's essential to have frequent doctor visits throughout the process, and it may take more than one cycle of IVF to succeed. Success rates for IVF can range anywhere between 12% and 70% and generally decrease as you get older. 

Unfortunately, IVF can also be pretty costly — anywhere between $12,000 to $25,000 per cycle — and most insurance plans don’t cover fertility treatments like IVF.

Egg freezing

Egg freezing, also known as "oocyte cryopreservation", is becoming a more and more popular solution. Although it’s not technically infertility treatment, many people turn to it to preserve their fertility so they can try to start a family in the future. 

Egg freezing involves removing eggs from the ovaries, freezing them, and using them later for IVF. Medications are administered to stimulate egg production and once the eggs are mature, they are retrieved. If you choose to freeze your eggs before the age of 35, there is a high chance of having a successful pregnancy (around 80-85%) using IVF.

Fertility naturally declines with age — regardless of your gender — so your chances of conceiving decline as the number and quality of eggs decrease. Egg freezing could be an option if you:  

• Have a medical condition or need treatment that will affect your fertility, such as cancer, PCOS, or endometriosis.
• You’re worried about your fertility declining but you’re not ready to have children yet (known as "elective egg freezing").
• You're transitioning from female to male and you want to preserve your fertility before you start hormone therapy or have reconstructive surgery. 

The vaginal microbiome and ART

As you can see, there are a lot of variables that go into female infertility overall and ART specifically. But you might be wondering, does the vaginal microbiome play a role in all of this? Yes, it might. However, research is still being done.  

An imbalance in the vaginal microbiome can increase inflammation and the risk of infection in the reproductive tract, creating a less hospitable environment for conception. On the other hand, a microbiome dominated by protective bacteria, such as Lactobacillus crispatus, has been associated with improved fertility, successful implantation, and improved pregnancy outcomes.

A recent meta-analysis of 17 studies, which included 3,543 patients, found that vaginal dysbiosis in IVF couples was associated both with early pregnancy loss as well as a reduction in clinical pregnancy rate. Additionally, the protective microbe Lactobacillus seems to be beneficial for ART success.

One study found that a Lactobacillus-dominant vaginal microbiome was associated with successful ART overall, while another study went even further to say that Lactobacillus-dominant vaginal microbiomes were associated with successful first rounds of IVF.

Though research is still ongoing, several studies have found a link between a healthy vaginal microbiome with improved fertility outcomes, including higher rates of implantation and improved outcomes in IVF and IUI. Whether you're preparing to undergo fertility treatment or are just starting your fertility journey, you can now receive personalized fertility-related insights with Evvy's Vaginal Health Test.

FAQ

What is the best treatment for infertility?

The best infertility treatment depends on your unique situation, and the good news is that there are several options to help you on your journey to parenthood. If you have irregular ovulation, medications like Clomid or letrozole can help stimulate egg production. If sperm needs a little help reaching the egg, intrauterine insemination might be a good choice. For more complex cases, in vitro fertilization is often the most effective, as it allows fertilization to happen in a lab before the embryo is placed in the uterus. Every person’s path is different, so working with a fertility specialist can help you find the right treatment for you.

What reduces the chances of getting pregnant?

Several factors can make getting pregnant more difficult, but understanding them can help you take control of your fertility. Age plays a big role, as egg quality and quantity naturally decline over time, especially after 35. Hormonal imbalances, irregular ovulation, and conditions like PCOS or endometriosis can also make conception harder. Lifestyle choices, such as smoking, excessive alcohol, poor diet, or high stress levels, may negatively affect fertility. Even factors like being significantly underweight or overweight can throw off your cycle. If you're struggling to conceive, talking to a doctor can help identify any issues and guide you toward the best steps forward.

What is the best fertility drug to get pregnant?

The best fertility drug depends on your specific needs, but there are a few commonly used options that can help. Clomid (clomiphene citrate) is often the first choice for women who have irregular ovulation because it stimulates the ovaries to release an egg. Letrozole is another option, especially for women with PCOS, as it can improve ovulation while having fewer side effects. For more advanced cases, injectable hormones called gonadotropins may be used to boost egg production. Since every woman’s body is different, working with a doctor can help determine the right medication to support your fertility journey.