The providers at Kamm McKenzie OB/GYN are able to provide certain infertility treatments and we can refer you to great specialists for treatments we do not provide. Treatment for any of the causes of infertility discovered during your infertility evaluation [link to infertility evaluation page] will vary according to each couple’s circumstance and also provider preference.
Infertility Treatments for Different Causes
For each infertility factor, we have outlined some of the possible options for infertility treatment.
Ovulation Factor
Ovulatory assistance can be achieved with medication. Our practice provides this using clomiphene (Clomid) or letrozole (Femara). These medications help your ovaries produce at least one quality egg each month.
- It is important to note that Femara is not FDA approved for this use; however, it is commonly used in the OBGYN community for this reason and is considered safe.
- These medications do increase twin rate to 5-8%.
- We start with the lowest dose of either medication and have you take the medicine on cycle days 3 through 7 or 5 through 9. Your provider will give you instructions.
- For the first month at a particular dose, we will have you get your progesterone level checked on or about cycle day #21 in order to confirm whether or not you ovulated. Once we have you on a dose with confirmed ovulation, we encourage you to try for 3-6 months.
- If you do not conceive or if we cannot achieve ovulation with the maximum dose of the medications, we would refer you to an infertility specialist. Once there, the specialists have stronger (injectable) medications to assist with ovulation.
Tubal Factor
If after your HSG, we suspect scar tissue around the tubes to be the culprit for a blockage, then we may offer you a laparoscopy to surgically evaluate the tubes and possibly correct any blockage. Otherwise, tubal factor infertility warrants referral to an infertility specialist where in vitro fertilization (IVF) is the most common therapy.
Male Factor
If there is an abnormal semen analysis on more than one test, then you will need a referral. If there is suspicion for a medical problem that is leading to abnormal sperm, then a urology referral may be given.
Otherwise, most of the time we refer to an infertility specialist. Depending on the severity of the abnormal sperm you will likely get offered one of two treatments.
- With mild to moderate abnormalities, you will likely get offered intrauterine insemination (IUI).
- For IUI, your partner provides a fresh semen sample on your ovulation day. This sample is cleaned and the healthy sperm are then injected directly into the uterus, increasing the chance that a quality sperm finds the egg.
- For severely abnormal semen, trying donor sperm with IUI or trying IVF is sometimes the more effective choice.
Age Factor
Infertility medications are less effective with decreased ovarian function and miscarriage rates are also higher. We thus tend to refer to an infertility specialist early if we suspect this to be the cause of infertility.
Infertility treatment for age factor infertility usually starts with ovarian stimulation plus IUI and eventually to IVF. For women in their early to mid-40s or those with markedly decreased ovarian function, IVF using donor eggs is sometimes the best option.
Uterine Factor
We can usually surgically correct uterine cavity problems with a surgery called a hysteroscopy. We put a small camera through the cervix and then use surgical instruments to remove the abnormal pathology. For some more complex problems, we can refer to a specialist for the appropriate infertility treatment.
Contact Us About Infertility Treatment
We understand that infertility can be emotionally taxing for many couples. The providers at Kamm McKenzie are here to help you navigate this journey. There are good resources available right here in Raleigh to help. Please speak with your provider if necessary. Call our office at (919) 781-6200 to schedule a consult.
