For the one in eight U.S. couples facing infertility, pregnancy can seem like a frustrating, elusive dream. However, the outlook is brighter than ever when medical help is sought early. Infertility treatments have advanced significantly, options have expanded, and physicians have become more skilled in using them. Evaluations now begin earlier than in the past, and treatment is more proactive, especially for older women hoping to become mothers.
Key Points
"Success rates have improved significantly over the past decade," said Dr. Mousa Shamonki, a reproductive endocrinologist and director of in vitro fertilization (IVF) at the David Geffen School of Medicine at UCLA. According to the U.S. Centers for Disease Control and Prevention (CDC), more than 48,000 babies were born through assisted reproductive technology (ART) in the United States in 2003, over 2,000 more than in 2002 and 7,000 more than in 2001.
The Earlier, the Better
"Couples who cannot conceive are often told by family, 'Relax, take a vacation, and you will get pregnant,'" said Dr. Eric Surrey, an expert and former president of the Society for Assisted Reproductive Technology (SART) in Denver. This does not work for couples with underlying fertility problems, and seeking medical help early is wiser than continuing on their own. Women under 39 should seek medical help after one year of trying without success. Women over 39 should be evaluated after six months.
Treatment Options
Infertility can sometimes be treated with medication or surgical repair of the reproductive organs. Another common treatment is one to three cycles of ovarian stimulation with intrauterine insemination. Reproductive endocrinologist Dr. Guy Ringler said this involves using medication such as Clomid to stimulate the ovaries to produce more eggs, then placing sperm into the uterine cavity through a thin tube.
He said this treatment can raise the monthly pregnancy rate from about 3% to 12%–15% for women under 40 and 5%–7% for women over 40.
Donor Eggs
Donor eggs are another option for older women. Although many women are initially reluctant to use another person's eggs, the desire to have a child often leads them to accept this option. "For women over 43, donor eggs are the most realistic approach," said reproductive endocrinologist Dr. Steven J. Ory.
Transferring Fewer Embryos
Updated guidelines presented at the 2024 American Society for Reproductive Medicine (ASRM) annual meeting reaffirmed the trend toward transferring fewer embryos. The guidelines recommend that women under 35 receive no more than two embryos and consider single-embryo transfer. For older women, the recommended number also varies according to the number of days after fertilization.
Eastern Approaches
Infertility clinics nationwide are increasingly willing to consider and even adopt alternative or complementary therapies. Ringler said, "When our conventional treatments do not work, we often recommend that patients try complementary therapies." Acupuncture and traditional Chinese medicine are the most commonly tried alternatives, although acupuncture is more widely accepted by conventional reproductive endocrinologists.
The Best Way to Stimulate Egg Production
Doctors have long used Clomid to stimulate egg production. More recently, some have begun using Femara, a breast cancer medication, to induce ovulation.
Conclusion
What are the chances of taking home a baby with these newer approaches? According to CDC data, in 2003 women under 35 had a 37% live-birth rate with fresh, non-donor egg procedures. Live-birth rates declined with age. However, women of any age using donor eggs had a 50% chance of taking home a baby.
Guide | New Advances in Infertility Treatment
Knowledge | New Advances in Infertility Treatment
For the one in eight U.S. couples facing infertility, pregnancy can seem like a frustrating, elusive dream. However, the outlook is brighter than ever when medical help is sought early. Infertility treatments have advanced significantly, options have expanded, and physicians have become more skilled in using them. Evaluations now begin earlier than in the past, and treatment is more proactive, especially for older women hoping to become mothers.
Key Points
"Success rates have improved significantly over the past decade," said Dr. Mousa Shamonki, a reproductive endocrinologist and director of in vitro fertilization (IVF) at the David Geffen School of Medicine at UCLA. According to the U.S. Centers for Disease Control and Prevention (CDC), more than 48,000 babies were born through assisted reproductive technology (ART) in the United States in 2003, over 2,000 more than in 2002 and 7,000 more than in 2001.
The Earlier, the Better
"Couples who cannot conceive are often told by family, 'Relax, take a vacation, and you will get pregnant,'" said Dr. Eric Surrey, an expert and former president of the Society for Assisted Reproductive Technology (SART) in Denver. This does not work for couples with underlying fertility problems, and seeking medical help early is wiser than continuing on their own. Women under 39 should seek medical help after one year of trying without success. Women over 39 should be evaluated after six months.
Treatment Options
Infertility can sometimes be treated with medication or surgical repair of the reproductive organs. Another common treatment is one to three cycles of ovarian stimulation with intrauterine insemination. Reproductive endocrinologist Dr. Guy Ringler said this involves using medication such as Clomid to stimulate the ovaries to produce more eggs, then placing sperm into the uterine cavity through a thin tube.
He said this treatment can raise the monthly pregnancy rate from about 3% to 12%–15% for women under 40 and 5%–7% for women over 40.
Donor Eggs
Donor eggs are another option for older women. Although many women are initially reluctant to use another person's eggs, the desire to have a child often leads them to accept this option. "For women over 43, donor eggs are the most realistic approach," said reproductive endocrinologist Dr. Steven J. Ory.
Transferring Fewer Embryos
Updated guidelines presented at the 2024 American Society for Reproductive Medicine (ASRM) annual meeting reaffirmed the trend toward transferring fewer embryos. The guidelines recommend that women under 35 receive no more than two embryos and consider single-embryo transfer. For older women, the recommended number also varies according to the number of days after fertilization.
Eastern Approaches
Infertility clinics nationwide are increasingly willing to consider and even adopt alternative or complementary therapies. Ringler said, "When our conventional treatments do not work, we often recommend that patients try complementary therapies." Acupuncture and traditional Chinese medicine are the most commonly tried alternatives, although acupuncture is more widely accepted by conventional reproductive endocrinologists.
The Best Way to Stimulate Egg Production
Doctors have long used Clomid to stimulate egg production. More recently, some have begun using Femara, a breast cancer medication, to induce ovulation.
Conclusion
What are the chances of taking home a baby with these newer approaches? According to CDC data, in 2003 women under 35 had a 37% live-birth rate with fresh, non-donor egg procedures. Live-birth rates declined with age. However, women of any age using donor eggs had a 50% chance of taking home a baby.
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