Infertility treatments

Ovulation induction and timed sex – the diy fertility boost
Ovulation induction is used when you have a hormonal imbalance. It is often the first step for infertile couples. It uses fertility drugs to stimulate ovulation and the growth of eggs.

You will either be given tablets, such as Clomid, Serophene, Fertimed or Clomihexal, or fertility injections. You will then be carefully monitored, through blood tests and ultrasound, to gauge the number of eggs you produce and their maturity. Finally ovulation is triggered by an injection, so you can time intercourse with the optimum moment of ovulation.

The success rate: If you have an ovulation problem the success rate is very good. At 25% it's on a par with fertile couples. However if you have another problem, the success rate is 10%.

The upside: Fertility drugs more than doubles your chance of conception. Plus it is possible to have this treatment through your gynaecologist, although careful monitoring is important to avoid multiple pregnancies.

The down side: Headaches and hot flushes are a common side effect of Clomid tablets, and there is a risk of multiple pregnancy. This can be avoided by swapping timed intercourse for IVF.

The costs: It varies according to the drug you use. Clomid is very cheap, for example, at less than R100 a cycle, whereas the injection is R200 a shot and depending how many you need you can spend up to R5 000. Added to this is the cost of consultation and scans, R1 000 on average for each consultation.

Artificial insemination (AI)
Often used when you have mild endometriosis, failure to ovulate or there are mild abnormalities in your partner's sperm or sexual function(for example premature ejaculation).

Artificial insemination uses your partner's sperm, which is injected into the cavity of your uterus. You will have had medication to stimulate egg growth at the same time.

AI is a minor procedure done in the doctor's rooms and it's similar to having a PAP smear. You can continue life as normal afterwards, and after 14 days you can have a pregnancy test to see if it's been successful.

The success rate: This depends on why you need AI, but on average it's 15%.

The upside: It doubles your original chance of conception, firstly because of the fertility medication and secondly because of the AI procedure.

The down side:
You will get the same side effects from the fertility medication as listed above.

The costs: In addition for paying for fertility medication (see Ovulation Induction) AI costs R1 000 on average, plus fees for monitoring.

Artificial insemination using donor sperm
If there is a severe problem with the sperm of your partner, or you are a single woman wanting to have a baby, there is the option of using the sperm of a donor, which would be implanted in you via artificial insemination.

It is important that the sperm comes from a recognised donor bank. In South Africa, sperm donors remain anonymous but you will know the donor's age, physical characteristics, occupation, medical and family history, hobbies and personality. Donor sperm is also checked for diseases such as HIV and Hepatitis B.

The success rate: Slightly better than AI because the sperm is of a higher standard.

The upside: You can get pregnant.

The down side:
In the case of a couple the child would not be the genetic child of the male.

The costs: The procedure costs little more than AI, plus there are the additional costs of the donor service, which is about R400.

Invitro fertilization (IVF)
Commonly known as "test tube babies" because the eggs are removed from the body and fertilised by sperm in a laboratory.

IVF is used in cases of severe endometriosis, blocked fallopian tubes, more mature women or when there are severe problems with your partner's semen. Initially you may need medication to stimulate egg growth. The eggs are removed in a surgical theatre under sedation. The eggs are then mixed with sperm, in a dish in the laboratory, and cultured in an incubator.

About 18 hours later, the eggs are examined to see if they have been fertilised. The fertilised eggs or embryos are placed back in your uterus, three to five days after they were removed. This happens in a special procedure room and is painless. Then you wait for 14 days before you can have a pregnancy test.

Experts recommend you get on with normal life in the meantime (although it's pretty hard for most expectant, aspiring parents).

Success rate: For younger women the success rate is more than 40 percent; for women over 40, it's 20%.

The upside: You have a good chance of getting pregnant. All IVF needs is eggs, sperm and a uterus and it gives everyone a fair shot.

The down side: IVF can be a real emotional roller coaster for couples. Often the last resort for those desperate for a baby, people often start out feeling optimistic and then go through a multitude of emotions while waiting for results, which may be positive or negative.

The costs: A costly exercise, IVF will set you back between R15 000 and R25 000 a time, depending on the protocol and where you have it done.

Intra cytoplasmic sperm injection (ICSI)
Dubbed by some as 'a miracle breakthrough', ICSI has given hope to many men who were previously deemed completely sterile and now have a chance of having their own child.

Technically the same as IVF, it involves a micro-injection of a single sperm into an egg.

Success rate: The same as IVF.

The upside: As long as a man has sperm he can have his own biological child.

The down side: Like IVF, it's costly and it can fail. It can also result in a multiple pregnancy.

The costs: The same as IVF.

Egg donation

Usually used when the woman's eggs are too poor a quality for conventional IVF to succeed. In this case the eggs of a carefully screened donor would be inseminated by your partner's sperm in the lab, and the resulting embryos inserted into your womb.

Success rate: A weighty 60%.

The upside:
A woman can experience pregnancy and birth without her own eggs.

The down side:
Her child is not her genetic child, although it is that of her husband.

The costs: R35 000 for the full IVF programme, donor screening and medication.
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