Basic IVF Treatment
OVULATION INDUCTION
Oral (Clomiphene Citrate, Clomid™, Serophene™): oral tablets which function as estrogen antagonists (i.e. compete with estrogen for receptor sites). Use of this medication can lead to monthly ovulation for those women who normally do not ovulate on their own, ovulation of more than one egg for those women who do ovulate on their own, and better synchronization of the uterine lining.
Injectable (Follistim™, Gonal-F™, Repronex™, Bravelle™): highly purified preparations of follicle stimulating hormone (FSH) and/or luteinizing hormone (LH) which are taken as subcutaneous injections. These medications provide for a much more potent stimulation than the oral ovulation medications, and as such require much more frequent monitoring.
Timed Intercourse
Timed intercourse is the most basic treatment for failure to achieve pregnancy. If a basic work-up determines that your fallopian tubes are open, your ovaries are producing normal follicles, the lining of your uterus is developing adequately, and your partner's semen is normal, you may be advised to attempt pregnancy through timed intercourse. This procedure includes the use of an LH surge/ovulation prdictor testing kit to predict the time of ovulation and determine the times you and your partner will be advised to have intercourse. Timing of intercourse in this way helps to insure that sperm will be in the fallopian tube at the time the egg is released and begins to travel down to the uterus.
A more advanced form of this treatment includes the use of ultrasound to monitor the development of the follicle/egg and the lining of the uterus. Additionally, a "trigger shot" of Human Chorionic Gonadotropin (hCG; Novarel, Pregnyl) may be given to stimulate ovulation and assist in the timing of intercourse.
Intra Uterine Insemination (IUI)
Artificial insemination is a procedure performed in the office by which prepared sperm is placed into the uterus using a small catheter inserted through the cervix. Sperm can be from your partner or a donor, depending on your situation and needs, but all sperm is prepared through a series of washes that remove substances that can lead to cramping or shock. Once sperm is washed, it can remain viable for 24-48 hours.
Intrauterine insemination is often performed if you have been unsuccessful with timed intercourse, or, if it has been determined that your cervical mucus is inadequate, the sperm and mucus do not interact normally or your mucus is hostile to the sperm causing it to become nonviable. In the case of sperm-mucus incompatibility, IUI allows the sperm to bypass the cervical barrier enabling them to move into the fallopian tube and reach the egg. If a couple does not achieve pregnancy after three to six cycles, they may wish to progress to a more aggressive procedure.