Tests and treatments in a fertility clinic
Finding the cause
A complete diagnosis of you and your partner is fundamental to identifying a suitable treatment strategy. You will need to undergo a number of tests to establish the cause(s) of your conception problems. Most of the tests are designed to assess four key elements for successful conception:
- To find out whether hormone production is balanced, allowing for egg and sperm development
- To establish whether the ovarian reserve is plentiful and ovulation is taking place
- That sperm is of sufficient quantity and quality
- To determine whether both male and female reproductive systems allow for fertilization
|Tests can take time. It may take two or three visits to your doctor to complete examinations over a one to six month period. Some of the tests will need to be repeated. During this time, it’s important not to become disheartened. The goal is to set a course of positive action for you and your partner to pursue.|
A step closer
The course you follow next will be different for each couple, depending on the results of tests and the kind of treatment you have already taken.
Low complexity treatments are often the first step. Depending on what causes your fertility problem you may start with:
- A surgical procedure
- Oral medicine
- Hormone treatment
If the initial treatments have not been successful you may be offered to undergo treatments with Assisted Reproductive Technologies (ART). ART is the name given to a variety of fertility treatments or procedures that include the in vitro handling of both human oocytes and sperm, or embryos, for the purpose of establishing a pregnancy.
Possible procedures (depending on the exact cause of the difficulty in conceiving):
- In Vitro Fertilization (IVF) is the most common ART treatment. Hormonal injections are given to a woman to stimulate the production and release of eggs. Eggs and sperm are united in a laboratory dish and then one or more embryos are transferred into the woman’s uterus.
- Intracyto-plasmic Sperm Injection (ICSI) is a lab procedure where a single sperm is injected into the egg cell to help fertilization. ICSI is often performed in conjunction with IVF.
- Gamete Intra-Fallopian Transfer (GIFT) following the same procedures as IVF, except fertilization occurs inside the body.
- Zygote Intra-Fallopian Transfer (ZIFT) following the same procedures as IVF, except fertilized eggs are placed in the fallopian tubes at earlier stage of embryo development.
- Microsurgical Epididymal Sperm Aspiration (MESA) or Testicular Sperm Extraction (TESE) are used to obtain sperm in case no sperm can be found in the ejaculate.
Questions you may want to ask your doctor
- How long has this clinic offered this procedure?
- Which procedure has the greatest chance of success for us?
- What are the side effects of this treatment?
- May we have an information sheet describing the treatment?
- What are our chances of having a baby if we have this treatment at this clinic?
- How long will we have to be on this treatment before stopping or trying another treatment?
- What are the risks of multiple pregnancies?
- What should we do next if this treatment does not work?
- What support or counselling is available?
- What are the costs involved with this treatment and are they reimbursed?
|The overall success rate for Assisted Reproduction Technologies (ART) is high. A Danish study from 2009 found that within five years of starting ART treatment, almost 70% of couples had succeeded in having at least one child.1 It is important to remember however that the success rate for fertility treatment is not absolute. The outcome will be different for every individual couple and clinic.|
Taking a longer view
Achieving success often takes time and multiple attempts. In a five year study conducted in Denmark, the number of successful couples doubled from 27.9% after a year of following ART treatments to 61.7% after three years. More than 40% went through 4 or more cycles during the period of the study.1
What can you do to give yourself the best chance?
Doctors will do what they can to help. Your job is to make sure you and your partner learn to cope with the fertility stress and disappointment with failed treatment cycles. There are steps you and your partner can take:
- Use the Fertility Compass to discover your coping style and learn new strategies to reduce emotional strain.
- Build a support network that works for you.
- Balance your life during treatment by creating a week-to-week planner.
1. Pinbourg A et al, Prospective longitudinal cohort study on cumulative 5-year delivery and adoption rates among 1338 couples initiating infertility treatment. Hum Reprod.2009;24: 991-999.