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December 01, 2008  
EDUCATION CENTER: Diagnosis and Treatment

Clinical Overview
Definition
Diagnosis and Treatment

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  • Infertility

    Diagnosis and Treatment
    Treatment for infertility in women depends on the cause. It may include medication or surgery.

    The doctor will order a variety of diagnostic tests to determine the source of the problem. An internal examination, including a pelvic exam and Pap smear will probably be the first steps. The doctor will want to rule out cervical cancer, and may do a culture or an endometrial biopsy. A hysterosalpingogram can detect blockages in the reproductive organs.

    A first step in treating fertility is the Basal Body Temperature Test. The patient keeps track of her body temperature in order to determine the best time of the month to conceive. If this method doesn’t work, the doctor may prescribe drugs to alter the patient’s hormones.

    There are several procedures where the fertilization is done for you, in a lab. These are called assisted reproductive technologies (ART). Two of the most common are in vitro fertilization (IVF) and gamete intrafallopian transfer (GIFT). Each of these treatments can be used when the problem is the male sperm count or endometriosis, or when the cause is unknown. Both can cause multiple births.

    With IVF, the ovaries are stimulated to produce multiple follicles (follicles are the fluid-filled sacs that develop around the egg as it matures and prepares to ovulate). Eggs are gathered using a thin catheter guided into the ovaries with help of an ultrasound. The eggs are then fertilized in a laboratory and, several days later, reinserted into the uterine cavity. This process increases the chance of multiple pregnancies. With GIFT, a laparoscope is used to insert a mixture of sperm and eggs directly into the fallopian tubes. IVF is a more common procedure, but GIFT may be more successful. There is much debate over the precise success rates of these procedures; however, one estimation is that GIFT has a 28 percent success rate and IVF has an 19 percent success rate. However, GIFT requires that the woman have healthy fallopian tubes.

    Last updated: 05-Jun-07

       
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