Mayo Clinic Health Manager
Get free personalized health guidance for you and your family.
Get Started
About our e-newsletters
- Free e-newsletters
- Mayo Clinic expertise
- We do not share your e-mail address
Housecall, our weekly general-interest e-newsletter, keeps you up to date on a wide variety of health topics with timely, reliable, practical information, recipes, blogs, questions and answers with Mayo Clinic experts and more. Our biweekly topic-specific e-newsletters also include blogs, questions and answers with Mayo Clinic experts, and other useful information that will help you manage your health.
Housecall Archives
Mayo Clinic Housecall
Stay up to date on the latest health information.
What you get
- Free weekly e-newsletter
- Mayo Clinic expertise
- Recipes, tools and other helpful information
- We do not share your e-mail address
Treatments and drugs
By Mayo Clinic staffHow your infertility is treated depends on the cause, your age, how long you've been infertile, and personal preferences. Although some women need just one or two therapies to restore fertility, it's possible that several different types of treatment may be needed before you're able to conceive.
Treatments can either attempt to restore fertility — by means of medication or surgery — or assist in reproduction with sophisticated techniques.
Fertility restoration: Stimulating ovulation with fertility drugs
Fertility drugs, which regulate or induce ovulation, are the main treatment for women who are infertile due to ovulation disorders. In general, they work like the natural hormones — follicle-stimulating hormone (FSH) and luteinizing hormone (LH) — to trigger ovulation.
Using fertility drugs increases your chances of getting pregnant with twins or other multiples. Oral medications carry a fairly low risk of multiples (5 percent to 8 percent), but your chances increase by about 20 percent with injectable medications. Generally, the more fetuses you're carrying, the greater the risk of premature labor, low birth weight and later developmental problems. Sometimes the amount or timing of the medications will be altered in an attempt to lower the risk of multiples.
There are several fertility drugs for abnormal LH and FSH production. These drugs include:
Clomiphene citrate (Clomid, Serophene). This drug is taken orally and stimulates ovulation in women who have PCOS or other ovulation disorders. It causes the pituitary gland to release more FSH and LH, which stimulate the growth of an ovarian follicle containing an egg. Clomiphene citrate also improves fertility in normally ovulating women, and is often used as an initial treatment for unexplained infertility.
Gonadotropins. Instead of stimulating the pituitary gland to release more hormones, these treatments increase the production of LH and FSH from other sources. Gonadotropin medications include:
- Human menopausal gonadotropin, or hMG, (Repronex). This injected medication is for women who don't ovulate on their own due to the failure of the pituitary gland to stimulate ovulation. HMG and other gonadotropins contain both FSH and LH, and directly stimulate the ovaries to ovulate.
- Follicle-stimulating hormone, or FSH, (Gonal-F, Follistim, Bravelle). FSH works by stimulating the ovaries to produce mature egg follicles.
- Human chorionic gonadotropin, or HCG, (Ovidrel, Pregnyl). Used in combination with clomiphene, hMG and FSH, this drug stimulates the follicle to release its egg (ovulate).
Metformin (Glucophage). This oral drug is used when insulin resistance is a known or suspected cause of infertility, usually in women with a diagnosis of PCOS. Metformin improves insulin resistance, normalizing ovulation.
Aromatase inhibitors (Letrozole). These drugs, also used to treat some breast cancers, may induce ovulation. However, the effect the medication has on early pregnancy isn't yet known.
Fertility restoration: Surgery
Several surgical procedures can correct problems or otherwise improve female fertility. They include:
- Tissue removal. This surgery removes endometriosis or pelvic adhesions with lasers or ablation, which can improve your chances of achieving pregnancy.
- Tubal reversal surgery (microscopic). After a woman has had her tubes cut and tied for permanent contraception, surgery may be done to reconnect them and restore fertility. Your doctor will determine whether you're a good candidate for the surgery.
- Tubal surgeries. If your fallopian tubes are blocked or filled with fluid (called hydrosalpinx), tubal surgery may improve your chances of becoming pregnant. Laparoscopic surgery is performed to remove adhesions, dilate a tube or create a new tubal opening. Tubal surgery is more successful when the blocked or narrowed part of the tube is closer to the ovary than to the uterus. Tubal blockage close to your uterus may increase your risk of ectopic pregnancy. In these and other severe cases of blockage or hydrosalpinx, removal of your tubes (salpingectomy) can improve your chances of pregnancy with in vitro fertilization.
Reproductive assistance: In vitro fertilization
This highly effective technique involves retrieving mature eggs from a woman, fertilizing them with a man's sperm in a dish in a laboratory and implanting the embryos in the uterus three to five days after fertilization. In vitro fertilization (IVF) often is recommended when both fallopian tubes are blocked. It's also widely used for a number of other conditions, such as endometriosis, unexplained infertility, cervical factor infertility and ovulation disorders. IVF increases your chances of having twins or other multiples because multiple fertilized eggs may be implanted into your uterus so that there is a greater chance that at least one will develop into a baby. IVF also requires frequent blood tests and daily hormone injections.
