Awareness of the different options available to treat infertility will be incomplete without an awareness of the success rates that such treatments have shown in the past. We will take a look at a few of the important and commonly used infertility treatments and their success rates.
The most prescribed fertility drugs for women include clomiphene citrate, letrozole (an aromatase inhibitor), metformin hydrochloride, gonadotrophin injections, and dopamine agonists. All of these are designed to regulate hormone levels in women and thereby trigger ovulation (the release of an egg(s)). Although such drugs have been safely used in the past, some can cause severe side-effects (e.g., ovarian hyper-stimulation syndrome (OHSS)) or even the chance of a multiple pregnancy.
By some estimates, there is a 23-40% pregnancy rate for clomiphene and 45% pregnancy rate for low-dose gonadotrophins. Letrozole was found to achieve only 18%. A study published in the New England Journal of Medicine found that the rate of becoming pregnant with multiples (twins, triplets, or more) significantly differed among the medications: The clomiphene group in the study had the fewest multiple pregnancies (5.7%), compared to those in the letrozole group (14.3%) and the gonadotropins group (13.4%).
Laparoscopy – Keyhole Surgery
This minimally invasive surgical infertility treatment involves an attempt to unblock fallopian tubes or remove scarring that is caused by endometriosis, fibroids, or ovarian cysts all in order to increase the chances of conception.
This wholly depends on the individual circumstances of the person concerned. For instance, in infertile women suffering from a disorder named endometriosis, the success rate of natural conception after laparoscopic surgery during the first year post-operation was found to be 42%, 67%, and 95% of the patients studied.
Intrauterine insemination (IUI)
IUI is a type of assisted conception wherein healthy and high quality sperm (either from a partner or a donor) is injected into the woman’s womb (uterus) via a catheter in such a way as to be placed close to the egg during the period when ovulation is occurring.
This depends on several factors such as the underlying reasons for and severity of the infertility problem, the woman’s age, and if fertility drugs are combined with the treatment. On average, the success rates from this method for women under 35 of age has been found to be 11% per IUI cycle without using fertility drugs and 13% per IUI cycle using fertility drugs. The rate goes up to over 50% in women aged less than 40 within 6 cycles of IUI. In general, combining the IUI procedure with fertility drugs greatly increases success rates.
In vitro fertilization (IVF)
IVF is one of the most commonly employed assisted reproductive methodologies that involve artificially inducing a sperm to fertilize an egg. The woman’s eggs are removed from her ovaries and then fertilized in vitro with sperm in a laboratory environment. Once an egg is fertilized, it is implanted back in the uterus.
This again depends on multiple factors such as the specifics of a patient’s infertility problem, history of miscarriages, and their age. For instance, there appears to be an inversely proportional relationship between a woman’s age and the success rate: Younger the woman, the healthier her eggs and hence the greater the chance of a pregnancy. Also, a history of prior pregnancies and births increases the chances of success. By some estimates, the percentage of cycles for women using their own eggs that result in a live birth are as follows: 32% for those under 35, 28% for those aged 35-37, 21% (aged 38-39), 14% (aged 40-42), 5% (aged 43-44), and 2% (age 45 or over). IVF success rates for women below 40 with tubal scarring or other types of pelvic-factor infertility are usually excellent, as long as there aren’t any other underlying infertility factors that complicate matters.
Intracytoplasmic sperm injection (ICSI)
ICSI is considered to be one of the most successful forms of treatment for infertile men and is used in almost half of all IVF treatments. It is a highly targeted procedure wherein just a single sperm is directly injected into the egg and the egg, once fertilized, is transferred back to the womb.
Success again depends on the specifics of the individual’s fertility problem and age. The fertilization rate for this procedure could be increased if conventional IVF methods are used, but the pregnancy rate itself with ICSI is the same as for IVF detailed above.
Donor insemination (DI)
Sperm from a donor is used to fertilize the egg via IUI or IVF treatment.
The success rate is 32% for IVF using fresh eggs and donor sperm for women under 35 years. It is 14% live birth rate per unstimulated cycle (without fertility drugs) for donor insemination.
Clearly, with a complex medical procedure such as infertility treatment, there are several factors that influence the probability of a successful outcome. Sometimes, as we have seen above, the success rate is quite low especially for women who are advanced in age. Knowledge of these success rates will help a couple or the individual involved understand the procedures in a holistic manner and prepare for it both physically and emotionally with expectations managed.