As with fertility testing, the type of infertility treatment you receive will depend on your unique health and medical history. If youre a woman with a blocked fallopian tube, for instance, you may need surgery to remove the blockage or to repair damage before trying other fertility treatments. If youre a man who isnt producing sperm, its possible you have a blockage as well, and your doctor might recommend a procedure that retrieves viable sperm directly from the testes, or a surgery that removes the blockage.

If youre a woman under 35, treatment will likely start conservatively, said Dr. Choi. For example, your doctor may prescribe oral drugs such as clomid or letrozole, which increase the odds of pregnancy by boosting the number of eggs you release during ovulation. This approach is also common for women with certain hormonal conditions such as polycystic ovary syndrome, in which ovulation doesnt occur regularly.

Your doctor might instruct you to combine oral drugs with sex at home; or to time taking them with ovulation or with an in-office procedure called an intrauterine insemination (IUI), in which a clinician prepares a sperm sample then inserts it directly into the uterus to increase the odds of conception.

[More on intrauterine insemination.]

Women who are over 35 may also start conservatively with oral drugs or IUI, but if those measures dont work after a couple of tries, or if its clear from your medical history that they arent likely to work, Dr. Choi typically recommends moving more quickly to more aggressive treatments, such as in vitro fertilization (I.V.F.). Here, the idea is to fertilize the egg outside of the body and then put the resulting embryo back in. (To read more about I.V.F., see our guide on it here.)

Fertility treatments will also vary for people who are single, in same-sex relationships or transgender. If youre a woman whos single or in a same-sex relationship, for example, you may try IUI or I.V.F. with sperm from a donor, depending on your age and your fertility status. Women in same-sex partnerships will also need to decide which partner should carry the baby, which will depend on preference, age and health. (It is also possible for one partner to harvest eggs and the other to carry the embryo, a process sometimes called reciprocal I.V.F., shared maternity or co-maternity.)

Men who are single or in same-sex partnerships will need a surrogate to carry the embryo, whether she uses IUI, I.V.F. or some other means of conception. Men in these circumstances may also need an egg donor.

If youre transgender, your fertility treatment will depend on your individual history regarding sex reassignment surgeries, hormone treatments and so on. For example, if youve already had sex reassignment surgery, you may need donor sperm or eggs, unless you froze your own beforehand. If you only had hormone treatments, you may be able to reverse this process temporarily through new hormone treatments (under the guidance of a physician), in order to produce viable sperm or eggs.

Continue reading here:
Your Guide to Fertility and Getting Pregnant - NYT Parenting

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