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INFERTILITY HOL-emblem1-web.GIF (3556 bytes)

Treatment

The selection of the best treatment for infertility depends on its cause. If the cause is mechanical like obstruction in the men’s ducts, the preferred solution is to go for microsurgery to repair the problem. Similarly, if the reason for the problem is due to scarred tubes in women, again surgical intervention may be preferred. There are a significant number of instances where the cause is undetermined: In other words, both partners seem to be doing OK; but they are not successful in producing kids. In instances such as these the stress may be one of the main causes of the problem. Many of the alternative solutions provided here are useful in this case. As we have discussed many causes for infertility can be caused by hormonal problems, chemical pollution, wearing tight clothes etc. In all these instances simple techniques provided in common sense remedies or in the alternative therapies are of great benefit. They also work synergistically with the conventional technique to boost the success rate. For example, reducing stress may improve the success when techniques such as artificial insemination, IUF etc. are employed. So, these work as truly integrative.

So, the first step in coming with an effective treatment is to determine the cause for the infertility. This is discussed in Investigating Fertility

Based on the determination of the cause and the partner who is responsible, the solutions are quite obvious in many cases. For example, it could be something as simple as the man's not wearing tight undershorts, or avoiding saunas and hot baths before sexual intercourse. On the other hand, it may require sophisticated manipulation of the woman's internal hormonal environment or even an operation. But sometimes the situation may not be correctable. Also, in a substantial number of cases no cause is ever discovered, even after a time- consuming and expensive evaluation. This news could be quite depressing and frustrating to a couple who desperately want a child. Here are some recently available options of which you should be aware.

Problems with Ovulation: Treatment with Clomiphene

For a woman who hasn't ovulated for a long time, clomiphene treatment is usually preferred. First, a menstrual period is induced with another drug medroxyprogesterone acetate. The woman then takes clomiphene for 5 days. Usually, she ovulates 5 to 10 days (average, 7 days) after clomiphene is stopped and has a period 14 to 16 days after ovulation.

If a woman doesn't have a period after treatment with clomiphene, she takes a pregnancy test. If she isn't pregnant, the treatment cycle is repeated with increasing doses of clomiphene until ovulation occurs or the maximum dose is reached. When the doctor determines the dose that induces ovulation, the woman takes that dose for at least six more treatment cycles. Most women who become pregnant do so by the sixth cycle in which ovulation occurs. Overall, about 75 to 80 percent of women treated with clomiphene ovulate, but only about 40 to 50 percent become pregnant. About 5 percent of pregnancies in women treated with clomiphene are multiple, primarily twins.

Prolonged use of clomiphene may increase the risk of ovarian cancer. So the treatment cycles should be limited.

Side effects of clomiphene include hot flashes, abdominal swelling, breast tenderness, nausea, vision problems, and headaches. About 5 percent of women treated with clomiphene develop ovarian hyperstimulation syndrome, in which the ovaries become greatly enlarged and a large amount of fluid shifts from the bloodstream to the abdominal cavity. To try to prevent this disorder, the doctor prescribes the lowest effective dose and withholds clomiphene if the ovaries enlarge.

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