Advanced Fertility Treatments
Review some of the most common advanced treatments and what to consider before deciding what is a good fit for you.
There are many types of treatments for families who have issues with fertility. Your reproductive endocrinologist, who is a board certified fertility specialist, can help you decide what treatment plan may be a good fit for you. Here are some advanced treatment options you may want to consider:
In Vitro Fertilization (IVF)
In Vitro Fertilization is different from intrauterine insemination (IUI) in that the sperm and egg are joined outside the body. This treatment has shown much success since it was first introduced in 1978. In 2014, the live delivery rate for a woman younger than age 35 using IVF was over 54 percent. However, the more advanced the maternal age of a woman, the lower her chance of success using IVF.
What to expect during IVF
During this type of process, a woman takes medication (usually gonadotropins), with the goal of helping to stimulate multiple follicles in both ovaries, producing multiple eggs. During this time, the woman visits the office to get blood work and ultrasounds done regularly to monitor the growth of the follicles. Before the woman ovulates, an egg retrieval is performed.
- Egg retrieval
Using a vaginal ultrasound, the doctor will insert a thin needle into the ovary, then into the follicles to retrieve the eggs. This generally takes 20 to 30 minutes.Next, an embryologist takes the eggs and joins them with the “washed” sperm in a lab dish. After fertilization, the embryos are cultured in a lab for an average of 3 to 6 days to make sure the embryos are of high quality.
- Transfer of embryos
When it’s time for this part of the procedure, the woman generally comes to the clinic with a full bladder so the lining of the uterus can be clearly visible. Using an ultrasound for guidance, the doctor will insert a catheter with the embryo(s) into the woman’s uterus.
In general, it is best to have only one embryo placed (called elective single-embryo transfer or eSET) to decrease the risk of having a multiple gestation (more than one baby at a time). This entire procedure takes about 5 minutes. *There are risks of having multiple gestations with every treatment, some riskier than others. Talk to your doctor about which treatment is right for you.
In conjunction with IVF, some families choose to freeze and store unused embryos for future use. This is called embryo cryopreservation. It is a common procedure that helps a woman preserve her chances of having a child at a later time. It is used for purposes of eSET or frozen embryo transfer (FET). Benefits include:
- The potential to grow your family at a later date with embryos created at a younger ovarian age
- Easier cycle-less appointments and more flexibility of appointment dates
- No surgery or anesthesia needed
- Less costly and more successful alternative to a fresh IVF cycle
Preimplantation genetic diagnosis (PGD)
This procedure tests the embryos for genetic abnormalities. It is commonly recommended for someone who has a genetic disorder, or who is a carrier of a genetic disorder when both partners are carriers. This is when the offspring are at risk for having a specific genetic disease such as cystic fibrosis or sickle cell disease.
Preimplantation genetic screening (PGS)
This procedure tests an embryo for chromosomal abnormalities. It does not test for specific diseases, but screens for the number of chromosomes only. PGS may be recommended in cases where a woman:
- Has had repeated miscarriages
- Is older or whose ovaries do not function well
- Has had many fertility treatments that have failed
- Wishes to select a single embryo for transfer (eSET)
Frozen embryo transfer (FET)
A frozen embryo transfer (FET) is a process that involves thawing a frozen embryo from a previous in vitro fertilization (IVF) cycle and placing it in a woman’s uterus for implantation. FET has become a popular way to save time and reduce the cost of pursuing another fresh IVF cycle.
*See the Fertility Treatment and Multiples Risk article for a more indepth discussion of multiples risk for mother and baby.
By Kristin Nelson, Contributing Writer
American Society for Reproductive Medicine. Infertility: An overview. Accessed July 20, 2017.
Society for Assisted Reproductive Technology. National summary report. Accessed July 20, 2017.
Womenshealth.gov. Infertility. Accessed July 20, 2017.
American College of Obstetricians and Gynecologists. Preterm (premature) labor and birth. Accessed July 20, 2017.
Last Updated: July 18. 2017