Other Treatment

Insemination and assisted reproductive technology (ART) can improve the odds of pregnancy. They introduce the sperm to the egg in the woman's reproductive tract (insemination) or in the lab (ART).

Insemination

Insemination flushes the sperm through a thin, flexible tube directly into a woman's vagina, cervix, uterus, or fallopian tube. This puts sperm closer to the egg. And it can overcome fertility barriers such as low sperm count and cervical mucus.

Insemination can be used with donor sperm. It can be combined with other fertility treatments, such as clomiphene or hormone shots.

Assisted reproductive technology (ART)

ART is used to remove eggs from a woman's ovaries (or use donor eggs) and fertilize them with the man's sperm (or donor sperm) outside the body. One or more fertilized eggs are then transferred to the woman's uterus or fallopian tubes.

To compare ultrasound and laparoscopy for egg collection procedures, see Infertility: Using Ultrasound in ART.

ART procedures are expensive and complex. Most of the time they are used only after other treatment has failed.

Before deciding on ART treatment, consider the possible emotional and social, financial, religious, ethical and legal questions that may come up for you and your partner.

In vitro fertilization

In vitro fertilization (IVF) is the most common form of ART.

Usually, more than one embryo is put in the uterus. This increases your chances that one will develop into a baby. Because of this, IVF increases your chance of having more than one baby at a time.

• Out of 100 women who become pregnant with IVF, about 30 will have twins.⁴
• The chance of having triplets or more is higher than normal but much less than the chance of having twins. The chances of multiple births depend on how many embryos are placed in the uterus at one time.

Side effects of IVF can include bloating, weight gain, and nausea. And you risk having serious side effects such as liver and kidney problems. The embryos may not grow into babies, so the IVF may need to be repeated.

If you have several miscarriages or unsuccessful IVF attempts, talk to your doctor about genetic testing.

Other types of ART

When insemination doesn't work, your doctor may recommend ICSI (say "ICK-see"). In a lab, the doctor injects one sperm into an egg. If fertilization occurs, the doctor puts the embryo into the woman's uterus, just as in vitro fertilization (IVF).

Your doctor may also recommend ICSI when the man has had a vasectomy or has retrograde ejaculation. In retrograde ejaculation, the semen is ejaculated into the bladder instead of out through the penis. In these cases, sperm can be taken from the testicles so that they can be injected into an egg.

Another less common treatment is gamete or zygote intrafallopian transfer (GIFT or ZIFT).

• GIFT is the transfer of eggs and sperm into a fallopian tube through a small incision in the belly.
• ZIFT is the in vitro fertilization of an egg. The egg is then transferred to a fallopian tube through a small incision in the belly.

Success rates with IVF are as good as with GIFT and ZIFT or better. And IVF is less expensive. It is also less risky, because it isn't a surgical procedure.

Complementary and alternative treatments

These treatments include:

• Acupuncture, which may be effective for enhancing IVF success rates.⁵
• Dietary changes.
• Relaxation techniques.
• Mind-body medicine.

It is important to talk with your doctor before you use any complementary or alternative treatments.