Q: Fertility treatment basics?

Posted Tuesday, September 11, 2007 4:18 PM

Q: We’ve been trying to conceive for a year, and nothing is happening. We’re determined to have a child, though. What fertility treatments are out there?

A: The good news: About two thirds of infertile couples have children after treatment. The bad news: Many insurance plans don’t cover infertility treatments. (Thirteen states, however, mandate at least some coverage, and more and more HMOs are covering part or all of it.)

There are a myriad of options, depending on the cause of the problem. For men, medication can often correct impotence and premature ejaculation, and surgery can reverse low sperm count. A procedure called electroejaculation is also available, which sounds scary but is actually just an electric stimulus that elicits ejaculation. (It's especially useful for men with spinal cord injuries who can’t otherwise ejaculate.) Another option is surgical sperm aspiration, in which sperm is harvested from the male reproductive tract. (Specifically, from the epididymis, vas deferens, or testicle – anatomy class all over again!)

For women, oral or injected fertility drugs such as Clomid, Repronex, and Gonal-F can correct ovulation disorders. Injections boost your odds of having multiples- twins or more! Some drugs stimulate the pituitary gland; others go right for the ovaries. Laparoscopic surgery can correct blockages or other problems in the fallopian tubes. Assisted hatching, which helps get the embryo implanted in the uterus, is another option. If you have endometriosis, blocked fallopian tubes or unexplained fertility, your best bet is probably in vitro fertilization (IVF). In IVF, doctors marry sperm from your husband and a mature egg from you in a lab, then deposit the fertilized egg into your uterus three to five days later.

There are complications associated with many of these treatments, so definitely do your research before signing up. In the meantime, improve your odds of conceiving by giving up smoking and drinking, getting enough zzz’s and exercise, and eating healthfully. Foods rich in folic acid (beans, leafy greens, OJ) are important for you and your husband because they increase sperm count and prevent birth defects. Don’t go overboard with the diet, though – being too skinny can throw off a menstrual cycle and make it more difficult to conceive. Good luck!