What You Need To Know About Fertility Treatments

*The Well is proud to present this content in partnership with Northwell Health Fertility.

The use of fertility treatments to get pregnant isn’t uncommon. In fact, one in four people reported that they’ve used fertility treatments or personally know someone who has. Yet many people don’t know what’s involved, the risks, the rates of success, and how (or when) to get started.

So, I reached out to Lauren Ursillo, MD, an infertility specialist at Northwell Health, to get some answers specifically for women and people assigned female at birth (AFAB).

When is it time to see a fertility specialist?

According to the U.S. Department of Health and Human Services, an estimated one in eight women have received fertility treatments. While Ursillo says that there are many reasons you might visit a fertility specialist, infertility is the most likely. “There are so many causes of infertility. It could be structural, age, an underlying disease, endometriosis, blocked tubes, or male factor,” she notes.

Women are born with a certain number of eggs, and as you age you begin to lose them. These days, many women are pushing off pregnancy until later in life, and that makes the chance of getting pregnant much lower. Ursillo says if you’re under 35 and have been trying to get pregnant for a year or more, or if you’re over 35 and have been trying for six months, it could be time to see a fertility specialist.

She adds that same sex couples and women who plan to have a baby on their own might also want to see a fertility specialist early on in their planning.

What happens during fertility treatments?

Fertility treatments are individualized depending on a variety of factors. “We’ll start with a complete workup that includes bloodwork to see if you have any hormonal imbalances and to check your ovarian reserve, as well as a uterine and tubal evaluation to make sure there aren’t any structural issues,” Ursillo explains. “We also do a semen analysis on the male partner.”

Once Ursillo meets with her patients and performs an assessment, they then discuss pursuing one of two main treatment options. The less invasive option is called ovulation induction, which involves taking a drug such as Clomid for five days to help you make more than one follicle. You will then be monitored until you’re ready to take a trigger shot, which ensures ovulation. The final step in the process is insemination or timed intercourse.

If ovulation induction doesn’t work, it might be time to consider in vitro fertilization (IVF). This type of treatment involves taking fertility drugs to produce as many eggs as possible, and then extracting eggs from the ovaries. Sperm is injected into the egg, creating an embryo. The fertilized egg is then transferred back into the uterus.

The process from start to finish can take two to three months. “The important thing to remember is that there isn’t one cookie cutter protocol. At the end of the day, it’s a numbers game trying to get that healthy egg that will turn into an embryo,” says Ursillo.

IVF with genetic testing is approximately 50% effective per cycle compared to ovulation induction, which has a 10% to 20% efficacy rate per cycle. For comparison, a standard couple that isn’t doing fertility treatments has a success rate of approximately 20% per cycle.

What are the downsides?

Fertility treatments can be pricey, so depending on your socioeconomic situation, these treatments might be out of reach. However, it’s worth checking with your insurance company to see what they cover. “Infertility is a disease, and it should be covered by insurance in the same way as diabetes and hypertension,” Ursillo adds.

There’s also a stigma attached to fertility treatments, and some women feel as though it’s their fault they can’t get pregnant. Ursillo reassures her patients, letting them know that they shouldn’t feel ashamed. “It’s my job to help them overcome that barrier and get a baby into their arms,” she says.

Another obstacle to IVF is the time commitment. While taking injections, you’ll need to see your doctor every other day for bloodwork and ultrasound to monitor your body’s response to the medication. Most women tolerate treatments well. However, nausea and bloating can occur with increased estrogen levels.

Can you improve the chances of a positive outcome?

Going to the right specialist where you feel seen and heard can make all the difference. Ursillo suggests looking online for reviews and opening up to people you trust. Chances are they—or someone they know—have gone through fertility treatments.

“Women need support, especially from their partners, family, and friends,” says Ursillo. It’s also a good idea to make sure your timing is right in terms of stress, your job, and your other commitments—stress can impact the success rates of fertility treatment.

Finally, it helps to have a healthy lifestyle that includes a well-rounded diet, regular exercise, and not smoking.

According to Ursillo, the most important thing to remember is “there are many ways to build a family, not just the traditional way.”

• Learn more about Northwell Health Fertility.
• Getting fertility treatments? Get your checklist ready.
• How much is age a factor when it comes to fertility?