It’s promising to know that your struggle to conceive is not without answers. Different patients require different treatments depending on their specific problem. In some cases, for young couples who haven’t been trying for long, a piece of simple advice on the frequency and timing of sexual intercourse may sometimes suffice. But when simpler interventions are no longer working, there are different types of infertility treatments available for you today.
1. Reversing Female Infertility with Medications
Fertility Drugs & Hormone Therapies
Fertility drugs and hormones are the primary medical treatments for women who are struggling to get pregnant. These can help them ovulate and restore hormone levels. In some cases, a woman can end up releasing multiple eggs instead of one, making it more likely for pregnancy to occur. However, such medications are less effective for women with unexplained infertility and have an increased chance of multiple pregnancy eg twins.
Insulin resistance can also hurt your chances to get pregnant. It messes with your blood sugar levels causing them to spike. This affects ovulation making it hard for you to conceive. This is typically seen in women with polycystic ovarian syndrome or PCOS. So, to correct insulin resistance, your doctor may prescribe medications that will control high blood sugar levels, called antihyperglycemic agents. Although it’s not a fertility drug per se, this can help you to ovulate normally as off-label use.
Antibiotic therapy can also be part of infertility treatments. Addressing reproductive infections can prevent issues that may affect conception and pregnancy. An untreated infection can cause damage, making it difficult for you to do so. Infections can travel upwards from the vagina to the cervix, uterus, and fallopian tubes. This can lead to Pelvic Inflammatory Disease (PID) which is a painful condition that can scar and block the tubes. This can likely lead to infertility or ectopic pregnancy.
Surgical Procedures For Female Infertility
If you’ve been diagnosed with tubal or pelvic disease, surgery can be done to repair your reproductive organs. Fortunately, this can be done with minimal invasiveness, and it’s made possible through laparoscopy, also called a keyhole surgery. It uses a slender tube fitted with a light and video camera that is placed through a small cut near your belly button. Through this, the doctor can view the exterior portion of your internal reproductive organs to check for abnormal growths and blockages.
Laparoscopy can be used to remove uterine fibroids, ovarian cysts, endometriosis and other uterine abnormalities—all of which can cause infertility. If successful, laparoscopy gives you a better chance at getting pregnant either naturally or with fertility treatments.
Hysteroscopy is performed to view the internal cavity of your uterus, identify abnormalities, and perform certain corrective procedures. The doctor uses a hysteroscope which is also a slender instrument that is inserted into the vagina and further into the uterine cavity using a distending media.
Hysteroscopies can be used to repair the uterine cavity by removing polyps, fibroids, and dividing scar tissue. It can also open up blocked fallopian tubes. All these can create a healthy environment for pregnancy.
Assisted Conception for Female Infertility
Intrauterine insemination (IUI)
IUI doesn’t quite make it to the news like IVF, but this fertility treatment has been around for a while. It’s a form of artificial insemination where the processed enhanced sperm is injected directly into your uterus through a small thin tube (catheter) close to the time of ovulation. The sperm collected are the fastest moving normal ones in the lot and this may improve the rate of fertilization.
This procedure is often performed in an operating theatre or in private procedure rooms. It’s usually pain-free and you can get right back to work afterwards but will be advised to abstain from strenuous activities.
Compared to IVF, IUI is a simpler and less invasive procedure. This is considered a good first option for fertility treatment with a good success rate. But if you have had three or more unsuccessful attempts, have severely abnormal sperm parameters or if you are 35 and above, you may be advised to try IVF.
In vitro fertilisation (IVF)
In vitro fertilisation (IVF), is a type of assisted reproductive technology (ART) where the egg and sperm is fertilised outside the body. In preparation for this, you will be given fertility medications to encourage your ovaries to produce more eggs than usual.
Eggs are then harvested from your ovaries and fertilised with sperm in a laboratory. A fertilised egg (embryo) can be frozen for later use, or it can be inserted into your womb to grow and develop.
Typically, a good quality mature embryo is transferred back into your uterus each cycle in the hopes that at least one will implant itself. Sometimes more than one embryo is implanted and ends up burrowing into the uterine lining, which is why multiple pregnancies eg twins are more common in women who undergo IVF.
Egg & Sperm Donation
If you or your partner are struggling with infertility, you can receive eggs or sperm from a donor. Singapore law does not allow any commercial (buy-and-sell) arrangement for human tissue, including eggs, sperm, and embryos. However, donors are allowed and this process can be done with IVF.
Although donation is allowed, this practice is rarely used in Singapore. Generally, doctors would advise patients seeking egg donations to approach relatives or close friends first.
You will require an egg donor if:
- you are unable to produce eggs
- you have undergone many unsuccessful IVF cycles
- you are likely to pass on a genetic disorder
- you have been advised that your eggs are not medically safe to be used after a serious illness or chemotherapy
Donation requires extensive counseling to ensure that the couple fully understands the repercussions.
4. Complementary and Alternative Treatments
Beyond the scope of medicine, there are several complementary and alternative options to treat infertility. These include acupuncture, traditional herbal medicines, and manual therapies such as massage and reflexology.
While these options have the capacity to help improve your well-being, there is no evidence that they improve fertility in women. If you’re trying to get pregnant, it’s important that you discuss other alternative therapies or products you are using with your GP, OB-GYNE, or fertility doctor.
There are several types of infertility treatments for every woman who is struggling to conceive. The key is in getting a thorough assessment to know which among these treatments should be included in your individualised treatment plan. With the options available to you in Singapore today, the next step for you is to seek professional advice.
Start your journey as soon as possible. Book a non-obligatory consultation with Dr Pamela Tan today by calling 6254 2878.
Dr Pamela Tan is a board certified obstetrician and gynecologist in Singapore. She finished her undergraduate studies at the National University of Singapore and earned her post-graduate degree at the Royal College of Obstetricians and Gynaecologists in the UK. She is an accredited specialist by the Specialist Accreditation Board (Ministry of Health), and a fellow of the Academy of Medicine, Singapore. She subspecialises in colposcopy and is certified to perform Level 3 minimally invasive keyhole surgeries such as laparoscopic hysterectomy, myomectomy and cystectomy. Dr Pam also supports the natural birthing method and she strives to provide a personalised care and treatment for each patient.