Which Treatment Is Most Appropriate for You?

Understanding your available treatment options can be overwhelming. Dr. Polansky will recommend the most suitable treatment for you based on your reproductive history, the female partner’s age, the length of infertility, and the results of your fertility testing.

Your fertility tests can be done at Bay IVF. We plan fertility investigation around the three categories of infertility factors:

• Male factor infertility
• Ovulation and egg quality disorders
• Uterine and Fallopian tubes factors

   

It is important that you do not wait too long before seeing an infertility specialist. Please note that there is no distinction between having unprotected intercourse and "trying" to conceive. They both represent "exposure to conception."

The following table illustrates the recommended length of "exposure," as it relates to the female partner’s age, before consulting a Reproductive Endocrinology and Infertility (REI) specialist.

 

If you did not conceive with basic reproductive treatments (i.e., Clomid or Femara pills, intrauterine inseminations-IUI), or if these treatments are not appropriate, you will require advanced reproductive care. Most patients seeking advanced reproductive treatments will need one of the following treatments to successfully conceive:

• In Vitro Fertilization
• In Vitro Fertilization with Intracytoplasmic Sperm Injection (ICSI)
• Donor Egg IVF
• Frozen Donor Egg IVF

 

The following are some of the factors used in selecting the optimal treatment for you:

1. Length of Infertility

   If you have a history of long-standing infertility (18 months or longer of no contraception and no successful pregnancy), your probability of conceiving spontaneously or with "basic" infertility treatments has become low. You should consider treatments with a higher probability of success: In Vitro Fertilization and in some cases, Donor Egg IVF or Frozen Donor Egg IVF.

2. Impact of Female Age

   The decrease in female fertility potential is due to the loss of high-quality eggs. This age-related loss of fertility magnifies the impact of any other infertility factor present.

   As a woman ages, the remaining eggs in her ovaries also age, rendering them less capable of fertilization and of being able to develop into normal embryos. In addition, fertilization of these eggs, whether spontaneous or in a laboratory, is associated with a higher risk of miscarriages and genetic disorders. The vast majority of genetically abnormal pregnancies end very early, often resembling a normal menstrual period.

   Treatment with Clomid or Femara pills or intrauterine inseminations should not be used if the female partner is 38 years or older. At this age, the remaining reproductive time has become too valuable, and you should consider treatments with a higher probability of success (i.e., In Vitro Fertilization).

   The following table shows the impact of the female partner’s age on the selection of the most appropriate treatments based solely on the female age:

 

Female Age	Ovarian Stimulation IUI	IVF	Donor Egg IVF	Frozen Donor Egg IVF
37 and younger	Yes	Yes	Yes	Yes
38 - 43	No	Yes	Yes	Yes
44 - 48	No	No	Yes	Yes

 

3. Impact of Male Infertility

   Selection of the most appropriate treatment depends on the male partner’s reproductive history and the degree of any male infertility present. The following treatment modalities are used for couples with male factor infertility:

   • In Vitro Fertilization
   • IVF with Intracytoplasmic Sperm Injection (ICSI)

   Intrauterine insemination is not a helpful treatment for male factor infertility.