What are the treatments for infertility ?

Infertility can be treated either medically or surgically.

Under medical treatment, the ovulation induction process is implemented for women who do not produce eggs regularly. Drugs used for the treatment are:

    Clomifene Citrate:

  • This is the first line of treatment. It induces ovulation in 80% of cases. It is started within the second and fifth day after menstruation. A starting dose of 50 mg for 5 days is administered to the patients. If required the dose and duration of treatment can be increased.
  • Gonadotropins:

  • If Clomifene Citrate fails to induce ovulation, then gonadotropins are given. The dosage of gonadotropins depends on the age of patient, cause of infertility, etc and is decided by the doctor. Gonadotropin preparations - HMG and Urinary FSH - have been available for quite some time. However, the latest and purest form of gonadotropin available is Recombinant FSH, e.g. Recagon/gonal - f. It is produced through genetic engineering and is very effective for ovulation induction. The gonadotropin hCG is given, to induce ovulation, after the follicles mature to 17 - 18 mm.
  • Bromocriptin:

  • It is administered when the prolactin level is high. It should be taken with meals, especially at bed time to avoid side effects such as nausea.
  • Thyroxin:

  • Thyroxin is given to patients with hypo-thyrodism (i.e. high TSH level, with low T3 and T4 level). It is also given to patients with high anti thyroid antibodies. It should be consumed orally, daily.
  • Metformin:

  • Some cases of polycystic ovarian disease with obesity are found to be resistant to insulin. Such cases are treated with Metformin along with other ovulation inducing drugs.

Some cases of infertility have to be treated through surgical procedures, such as:

  • Operative Laparoscopy :- In women with polycystic ovarian syndrome, at times, small holes are drilled on the surface of the ovary with laser or electrocautery. This process is called ovarian drilling and is expected to help in ovulation in the subsequent cycles.
  • Laparoscopic wedge resection of the polycystic ovaries is also done in certain cases.
  • Microsurgery can be done in cases of blocked tubes. But the success rate is not very encouraging.
  • Operative laparoscopy enables surgeons to remove tumours from uterus, ovaries and treat other defects without conducting an open surgery. This technique is known as minimally invasive surgery, as it involves minimal discomfort to the patients. Operative laparoscopy is effective in cases of adhesions, endimetriosis, pelvic tuberculosis, fibroids, ovarian tumours and cysts.
  • Operative Hystroscopy :- This procedure helps to rectify problems such as fibroids, polyps, scar tissue, uterine septum, abnormal uterine shape or other uterine problems inside the cavity.
  • Hydrotubation :- Hydrotubation: It is the injection of liquid medication or saline solutions through the cervix into the uterine cavity and fallopian tubes for therapeutic purposes.