Drug Treatments
Clomiphene (Clomid/Serophene)
Clomiphene is the most popular fertility drug prescribed in the United States. While its exact mechanism of action is unknown, clomiphene causes a 50% increase in FSH levels which stimulates follicles to grow and release eggs. The conception rate per treatment cycle is about 5%, however if conception isn't accomplished within 6 cycles, couples may be advised to try an alternate method of treatment to avoid the risk of ovarian cancer.
FSH for Clomiphene-resistant Polycystic Ovarian Syndrome
This treatment is an alternate to the above treatment in those who are unresponsive to clomiphene after 6 months. FSH is given by injection with quite a high success rate; pregnancy rates of 25% after three cycles.
Pulsatile Gn-RH
The absence of the hypothalamic hormone gonadotropin-releasing hormone factor (Gn-RH) results in a deficiency in the stimulation of FSH and LH release. Women with this condition are given pulses of Gn-RH through intravenous injections which are meant to mimic the normal secretions of Gn-RH. Pregnancy rates of up to 15% can be achieved with this treatment.
Bromocriptine
In hyperprolactinemia, high prolactin levels suppress Gn-RH which results in the failure of ovulation. Bromocriptine is given to suppress prolactin production and allow for restoration of ovarian function. With bromocriptine treatment, ovulation rates can be as high as 75%. This treatment is not associated with miscarriages, premature births, fetal malformations or multiple pregnancies.
Surgical Treatments
Tuboplasty
A tuboplasty, also known as a salpingoplasty, is carried out on scarred and narrowed fallopian tubes to allow for eggs to pass through and continue on to the uterus. A tiny balloon-tipped catheter is placed in the blocked tube and inflated to open the tube and re-create the passageway.
Fimbrioplasty
The finger-like extensions of the fallopian tubes, known as fimbriae, can sometimes fuse together and block the passage of eggs to the uterus. Microsurgical techniques are used to peel back the fimbriae and restore movement of the ova.
Surgery for Polycystic Ovarian Syndrome
The methods involved in treating this syndrome involve damaging the ovary to stimulate ovulation either by cutting out or drilling holes in portions of the ovary. Surgery is restricted to those cases that are resistant to clomiphene therapy.
Surgery to Reverse Sterilization
Approximately 3/100 women sterilized through tubular clipping or such techniques regrets the operation and asks for it to be reversed. Rejoining of the severed ends of the fallopian tubes can produce pregnancy rates as high as 92%, however the success depends largely on the expertise of the physician and the hospital. Those sterilized with clips have the highest chance of successfully reversing their infertile status.
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