Treatments for Infertility

Treatment list for Infertility:

The list of treatments mentioned in various sources for Infertility includes the following list. Always seek professional medical advice about any treatment or change in treatment plans.

• Vitamin A - possibly used for related vitamin A deficiency

Treatments of Infertility: Online Medical Books

16 MEDICAL BOOKS ONLINE! Review excerpts from medical books online, free, without registration, for more information about the treatments of Infertility.

Amenorrhea: Treatment
(In a Page: Signs and Symptoms)

• Imperforate hymen requires surgical correction
• Androgen insensitivity syndrome: Excise testes after puberty because of increased risk of testicular cancer
• Absent müllerian structure or presence of Y chromosome: Psychological counseling
• Ovarian failure: Consider hormone replacement therapy
• Polycystic ovarian syndrome
  –Oral contraceptives decrease ovarian androgen secretion
  –Weight reduction decreases peripheral estrogen
  –Clomiphene to enhance fertility
  –Cyclic progesterone prevents endometrial hyperplasia
• Functional hypothalamic amenorrhea
  –Weight gain and reduction in intensity of exercise
  –Consider oral contraceptives to prevent osteoporosis
  –Exogenous gonadotropins or pulsatile GnRH may be necessary

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Amenorrhea – Secondary: Treatment
(In A Page: Pediatric Signs and Symptoms)

• Correction of systemic illness, malnutrition, eating disorder, or other stress
• Hyperprolactinemia
  –Prolactinoma: Treat with dopamine agonist
  –Medication-induced: Cessation of the offending agent
• Polycystic ovary syndrome
  –Weight loss
  –Oral contraceptives
  –Antiandrogen agents such as spironolactone
  –Insulin sensitizers such as metformin
• Ovarian failure
  –Treat with estrogen-progestin replacement
• Asherman syndrome
  –Treat by surgical excision of adhesions

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Amenorrhea – Primary: Treatment
(In A Page: Pediatric Signs and Symptoms)

• Underlying chronic illnesses, malnourished states, or hypothyroidism should be treated
• Stop medications causing hyperprolactinemia (e.g., antidepressants, phenothiazines) if safe to do so
• Prolactinomas can be treated medically with a dopamine agonist
• Other pituitary tumors will need treatment according to their specific type
• Patients with ovarian insufficiency or hypogonadotropic hypogonadism need estrogen therapy for breast development, and then should cycle estrogens and progestins to establish menses

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Amenorrhea: Treatment
(Professional Guide to Diseases (Eighth Edition))

Appropriate hormone replacement re-establishes menstruation. Treatment of amenorrhea not related to hormone deficiency depends on the cause. For example, amenorrhea that results from a tumor usually requires surgery.

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Female infertility: Treatment
(Professional Guide to Diseases (Eighth Edition))

Treatment depends on identifying the underlying abnormality or dysfunction within the hypothalamic-pituitary-ovarian complex. In hyperactivity or hypoactivity of the adrenal or thyroid gland, hormone therapy is necessary; progesterone deficiency requires progesterone replacement. Anovulation necessitates treatment with clomiphene, human menopausal gonadotropins, or human chorionic gonadotropin; ovulation usually occurs several days after such administration. If mucus production decreases (an adverse effect of clomiphene), small doses of estrogen to improve the quality of cervical mucus may be given concomitantly; however, such intervention remains unproven.

Surgical restoration may correct certain anatomic causes of infertility such as fallopian tube obstruction. Surgery may also be necessary to remove tumors located within or near the hypothalamus or pituitary gland. Endometriosis requires drug therapy (danazol or medroxyprogesterone, or noncyclic administration of hormonal contraceptives), surgical removal of areas of endometriosis, or a combination of both.

Other options, often controversial and involving emotional and financial cost, include surrogate mothering, frozen embryos, or in vitro fertilization (IVF). In view of the good success rate of IVF (about 20%), IVF may be used instead of surgery in many cases.

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Male infertility: Treatment
(Professional Guide to Diseases (Eighth Edition))

When anatomic dysfunction or infection causes infertility, treatment consists of correcting the underlying problem. A varicocele requires surgical repair or removal. For patients with sexual dysfunction, treatment includes education, counseling or therapy (on sexual techniques, coital frequency, and reproductive physiology), and proper nutrition with vitamin supplements. Decreased follicle-stimulating hormone levels may respond to vitamin B therapy; decreased LH levels, to human chorionic gonadotropin (hCG) therapy. Normal or elevated LH level requires low dosages of testosterone. Decreased testosterone levels, decreased semen motility, and volume disturbances may respond to hCG.

A patient with oligospermia who has a normal history and physical examination, normal hormonal assays, and no signs of systemic disease requires emotional support and counseling, adequate nutrition, multivitamins, and selective therapeutic agents, such as clomiphene, hCG, and low dosages of testosterone. Obvious alternatives to such treatment are adoption and artificial insemination.

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Amenorrhea: Patient counseling
(Professional Guide to Signs & Symptoms (Fifth Edition))

After diagnosis, answer the patient’s questions about the type of treatment that will be provided and its expected outcome. Because amenorrhea can cause severe emotional distress, provide emotional support. Be sure to encourage the patient to discuss her fears and, if necessary, refer her for psychological counseling.

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Infertility, female: Treatment
(Handbook of Diseases)

Effective treatment depends on identifying the underlying abnormality.

Functional infertility

With hyperactivity or hypoactivity of the adrenal or thyroid gland, hormone therapy is necessary; a progesterone deficiency requires progesterone replacement. Anovulation necessitates treatment with clomiphene, human menopausal gonadotropins, or human chorionic gonadotropin; ovulation usually occurs several days after such treatment.

If mucus production decreases (an adverse effect of clomiphene), small doses of estrogen may be given to improve the quality of cervical mucus.

Anatomic infertility

Surgical restoration may correct certain anatomic causes of infertility such as fallopian tube obstruction. Surgery may also be necessary to remove tumors located in or near the hypothalamus or pituitary gland. Endometriosis requires drug therapy (danazol or medroxyprogesterone, or noncyclic administration of hormonal contraceptives), surgical removal of areas of endometriosis, or both.

Other options, typically controversial and involving emotional and financial cost, include surrogate mothering, frozen embryos, zygote intrafallopian transfer, in vitro fertilization, and artificial insemination.

READ BOOK EXCERPT ONLINE »

Infertility, male: Treatment
(Handbook of Diseases)

When anatomic dysfunction or infection causes infertility, treatment consists of correcting the underlying problem. A varicocele requires surgical repair or removal.

For patients with sexual dysfunction, treatment includes education, counseling or therapy (on sexual techniques, coital frequency, and reproductive physiology), and proper nutrition with vitamin supplements.

Decreased follicle-stimulating hormone levels may respond to vitamin B therapy; decreased LH levels may respond to chorionic gonadotropin therapy. A normal or elevated LH level requires low dosages of testosterone. Decreased testosterone levels, decreased semen motility, and volume disturbances may respond to chorionic gonadotropin.

Patients with oligospermia who have a normal history and physical examination, normal hormonal assay results, and no signs of systemic disease require emotional support and counseling, adequate nutrition, multivitamins, and selective therapeutic agents, such as clomiphene, chorionic gonadotropin, and low dosages of testosterone. Obvious alternatives to such treatment are adoption and artificial insemination.

READ BOOK EXCERPT ONLINE »

Amenorrhea: Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)

After diagnosis, answer the patient’s questions about the type of treatment that will be provided and its expected outcome. Because amenorrhea can cause severe emotional distress, provide emotional support. Be sure to encourage the patient to discuss her fears and, if necessary, refer her for psychological counseling.

READ BOOK EXCERPT ONLINE »

Amenorrhea: Nursing considerations
(Nursing: Interpreting Signs and Symptoms)

▪ In patients with secondary amenorrhea, physical and pelvic examinations must rule out pregnancy before diagnostic testing begins.

▪ Prepare the patient for tests, such as progestin withdrawal, serum hormone and thyroid function studies, and endometrial biopsy.

Patient teaching

▪ Explain to the patient all tests and procedures.

▪ Explain the underlying disorder and treatment plan.

▪ Encourage the patient to discuss her fears and, if necessary, refer her for psychological counseling.

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Medications used to treat Infertility:

Note:You must always seek professional medical advice about any treatment or change in treatment plans.

Some of the different medications used in the treatment of Infertility include:

• Bromocriptine
• Parlodel
• Apo-Bromocriptine
• PMS-Bromocriptine
• Serocryptin

Medical news summaries about treatments for Infertility:

The following medical news items are relevant to treatment of Infertility:

• Lupus treatment shows promising results
• Lupus treatment shows promising results for SLE sufferers
• PCOS may be improved by the diet drug Xenical
• Period pain (see Dysmenorrhea)
• Uterine fibroids linked to failed fertility

Discussion of treatments for Infertility:

Infertility: NWHIC (Excerpt)

Depending on what the tests turn up, different treatments are recommended. Eighty to 90 percent of infertility cases are treated with drugs or surgery.

Therapy with the fertility drug Clomid or with a more potent hormone stimulator--Pergonal, Metrodin, Humegon, or Fertinex--is often recommended for women with ovulation problems. The benefits of each drug and the side effects, which can be minor or serious but rare, should be discussed with the doctor. Multiple births occur in 10 to 20 percent of births resulting from fertility drug use.

Other drugs, used under very limited circumstances, include Parlodel (bromocriptine mesylate), for women with elevated levels of a hormone called prolactin, and a hormone pump that releases gonadotropins necessary for ovulation.

If drugs aren't the answer, surgery may be. Because major surgery is involved, operations to repair damage to the woman's ovaries, fallopian tubes, or uterus are recommended only if there is a good chance of restoring fertility. (Source: excerpt from Infertility: NWHIC)

Infertility: NWHIC (Excerpt)

New, more complex assisted reproductive technologies, or ART, procedures, including in vitro fertilization (IVF), have been available since the birth 18 years ago of Louise Brown, the world's first "test tube baby." IVF makes it possible to combine sperm and eggs in a laboratory for a baby that is genetically related to one or both partners. IVF is often used when a woman's fallopian tubes are blocked. First, medication is given to stimulate the ovaries to produce multiple eggs. Once mature, the eggs are suctioned from the ovaries (1) and placed in a laboratory culture dish with the man's sperm for fertilization (2). The dish is then placed in an incubator (3). About two days later, three to five embryos are transferred to the woman's uterus (4). If the woman does not become pregnant, she may try again in the next cycle. (Source: excerpt from Infertility: NWHIC)

Infertility: NWHIC (Excerpt)

Gamete intrafallopian transfer, or GIFT: Similar to IVF, but used when the woman has at least one normal fallopian tube. Three to five eggs are placed in the fallopian tube, along with the man's sperm, for fertilization inside the woman's body.

Zygote intrafallopian transfer, or ZIFT (also called tubal embryo transfer): A hybrid of IVF and GIFT. The eggs retrieved from the woman's ovaries are fertilized in the lab and replaced in the fallopian tubes rather than the uterus.

Donor egg IVF: For women who, for example, have impaired ovaries or carry a genetic disease that can be transferred to the offspring. Eggs are donated by another healthy woman and fertilized in the lab with the male partner's sperm before being transferred to the female partner's uterus.

Frozen embryos: Excess embryos are frozen, to be thawed in the future if the woman doesn't get pregnant on the first cycle or wants another baby in the future. (Source: excerpt from Infertility: NWHIC)

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