(See also Overview of Infertility Overview of Infertility Infertility is usually defined as the inability of a couple to achieve a pregnancy after repeated intercourse without contraception for 1 year. Frequent intercourse without birth control usually... read more .)
Controlled ovarian stimulation
Sometimes assisted reproductive techniques
When no explanation for infertility is identified, an approach called controlled ovarian stimulation may be used.
Controlled ovarian stimulation may make pregnancy more likely and may help women become pregnant more quickly. This treatment may result in more than one fetus.
Controlled ovarian stimulation involves the following:
Women are given a fertility drug ( clomiphene Clomiphene The ovaries do not release an egg each month, as usually occurs during a menstrual cycle. Ovulation problems can result from dysfunction of the part of the brain and the glands that control... read more ), which stimulates several eggs to mature and be released, and human chorionic gonadotropin (hCG), which stimulates ovulation, for up to three menstrual cycles.
Semen is placed directly in the uterus to bypass the mucus (intrauterine insemination) within 2 days after treatment with hCG.
If pregnancy does not result after this treatment, one of the following may be done:
Another method of controlled ovarian stimulation, which involves giving women human gonadotropins Human gonadotropins The ovaries do not release an egg each month, as usually occurs during a menstrual cycle. Ovulation problems can result from dysfunction of the part of the brain and the glands that control... read more (preparations containing hormones that stimulate the follicles of the ovaries to mature), followed by hCG to stimulate ovulation, then intrauterine insemination
Assisted reproductive techniques Assisted Reproductive Techniques Assisted reproductive techniques involve manipulating sperm and eggs or embryos in a laboratory (in vitro) with the goal of producing a pregnancy. (See also Overview of Infertility.) If treatment... read more , such as in vitro fertilization In vitro (test tube) fertilization (IVF) Assisted reproductive techniques involve manipulating sperm and eggs or embryos in a laboratory (in vitro) with the goal of producing a pregnancy. (See also Overview of Infertility.) If treatment... read more
Women have the same chance of pregnancy (about 65%) whether unsuccessful treatment with clomiphene plus hCG is followed by stimulation with gonadotropins plus hCG or immediately by in vitro fertilization. However, women become pregnant more quickly and are less likely to have a pregnancy with three or more fetuses when unsuccessful treatment with clomiphene is immediately followed by in vitro fertilization. Thus, if clomiphene plus intrauterine insemination is unsuccessful, the next step is often in vitro fertilization.
Some evidence suggests that women who are over 38 and have unexplained infertility conceive more quickly when in vitro fertilization is done before controlled ovarian stimulation is tried.