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When should I start thinking about fertility treatment?
If you’ve been trying to get pregnant for three or four months, keep trying. It may just take more time, even longer than you think it could. You may want to think about fertility treatment if:
What should I do before I get fertility treatment?
Here are some things you and your partner can do to find out if you need treatment:
When and how do I choose a fertility specialist and center?
Most couples begin by seeing an obstetrician-gynecologist or their family doctor. Because infertility is a highly technical field of medicine, talk with your health care provider about whether you should see a specialist.
Advanced medical training is needed to be a specialist. Doctors often study the fields of reproductive endocrinology for women and urology for men. Specialists are more likely than other doctors to offer a variety of treatments (see below). Here are things to think about when choosing a specialist:
What do I need to know about diagnosis and treatment?
The doctor begins by performing a physical examination, taking your medical history and, sometimes, ordering specialized tests. When a possible cause of infertility is found, the most common treatments are:
According to the American Society for Reproductive Medicine (ASRM), most infertility cases (85-90 percent) are treated with drugs or surgery. More advanced types of infertility treatment include:
Couples sometimes choose to ask another person to donate eggs, sperm or an embryo. (Embryo is the word for the human organism from conception until approximately the eighth week.) Others make an agreement with a woman to bear a child for them. These choices involve serious ethical and legal issues and should be made with care.
Are there any problems with fertility treatment for the baby or the woman?
Fertility treatment does help many women get pregnant. But it can cause certain problems.
One serious problem is that treatment can cause you to get pregnant with multiples (twins, triplets or more). Multiples are more likely to be premature (before 37 completed weeks of pregnancy). Premature babies are at risk of breathing, vision and hearing problems. Being pregnant with multiples also can cause problems for the mother. Examples are high blood pressure, preterm labor, bleeding and problems with the placenta, and diabetes.
Sometimes fertility drugs can enlarge a woman's ovaries. The woman may feel pain, bloating, nausea or vomiting. If the condition becomes severe, the woman may have to be hospitalized. Both reproductive surgery and ART may lead to bleeding, infection, or damage to organs or blood vessels.
Even one baby born after ART is more likely to have problems that a baby born without fertility treatment. These problems include being born too early or too small. Many experts are concerned that ART may be related to certain rare birth defects. More research is needed to learn about this possible risk.
Does health insurance pay for fertility treatment?
Insurance coverage for infertility treatments varies from company to company and state to state. Because treatment can be very costly, be sure to learn more about the costs and your insurance coverage while you are still thinking about treatment options.
For women having ART, how many embryos are usually transferred to the woman’s body at one time?
The number of embryos depends upon the woman’s age and her individual circumstances. March of Dimes and many fertility experts agree that it’s important to lower the chances of getting pregnant with multiples, especially three or more babies.
Medical guidelines help specialists decide how many embryos to transfer. The aim of the guidelines is to give women the best chance of getting pregnant while lowering the chances of multiples. The following recommendations are from the American Society of Reproductive Medicine:
In some circumstances, more embryos may be transferred. For instance, if a woman has had two or more failed IVF treatments, more may be used.
If a donor is contributing eggs, the age of the donor should be considered when deciding how many embryos to transfer.
For more information
These organizations provide referrals to doctors and clinics.
September 2008 (7-09)