There are few things experienced as deeply as the desire to have a child.
When it’s clear the path to parenthood will not be easy, individuals and couples often turn to a reproductive endocrinologist (RE) to find out what’s going on and how it can be remedied. The RE starts with a review of health histories, diet, lifestyle, and sexual practices. (Since by the time many patients consult with an RE, they have undergone treatment with their GYN doctor, a review of those treatments can also be quite helpful.)
Then the physical evaluation begins with the least invasive testing, unless age or health issues call for additional tests at the onset. The testing can be stressful, and this is a good time to check in with a counselor who specializes in fertility. Feelings of anger, depression and anxiety are quite common among women trying to get pregnant for a long time. Counseling can also benefit the male partner undergoing evaluation of his sperm count, motility (ability of the sperm to move), and morphology (shape).
Once exam results are in, treatment may be recommended. Often, the first step is to use an ovulation-inducing drug called clomiphene citrate. If, after a few cycles there is no pregnancy, other medications (gonadotropins) to stimulate follicle development and trigger ovulation may be used. Then the eggs can be fertilized through intercourse or artificial insemination (AI), where sperm are inserted directly into a woman’s reproductive tract.
For those not yet pregnant, the next phase will probably be assisted reproductive technology (ART). ART is a term used to describe a number of treatments in which pregnancy is attempted by bringing sperm and eggs together outside the woman’s body.
Couples who pursue ART can talk with their counselor about ways to cope with the emotional ups and downs of a cycle. Counseling can also help keep relationships strong and expand networks of support.
IVF is the most common form of ART. Medication is used to stimulate the development and release of a woman’s eggs. The eggs are retrieved from the woman and placed in a Petri dish with the male’s sperm. Once some of the eggs have become fertilized, they are transferred into the woman’s uterus where one will, hopefully, continue to develop.
There are many other choices people can make as they continue the journey towards their biological child. They may choose to use donor egg, donor sperm or donor embryos. They may decide to use a gestational carrier (surrogate) to carry a child for them. Together, these methods are called “third-party reproduction.”
Making these choices takes time and deliberation. Counseling offers a safe place to explore all the issues
Fertility Treatment for Couples and Individuals
Topics Explored in Fertility Counseling
The Fertility Work-Up
Assisted Reproductive Technology (ART)
- Donor Sperm
- Donor Egg
- Donor Embryo
Pregnancy With Multiples
Pregnancy as a Single Woman
Pregnancy as a Same-Sex Couple
The Role of Complementary Care
Mind/Body Techniques to Cope With Stress
Making the Decision to Remain Child-Free
Talking With Your Child About His Beginnings