Immune Testing
There is great controversy about the usefulness of immune testing for infertile couples. At the present time and after considering all of the scientific data available, the American Society for Reproductive Medicine does not endorse immune testing of infertile couples.

Treatment Options

After you and your doctor have reviewed your comprehensive fertility evaluation, it is time to plan treatment. There is no simple formula to determine which treatment is best for you based solely on your test results. In order to design an ideal treatment plan, your doctor will view your test results in the context of your medical history. Several of the more common treatments available today are outlined below.

Intrauterine insemination
This technique, sometimes called artificial insemination, is the placement of sperm into the uterine cavity. The sperm is gathered from a liquid ejaculate and separated from the proteins and buffers normally present in semen. Intrauterine insemination can be performed around the time of ovulation in the normal menstrual cycle or in conjunction with medicines that stimulate the ovary.

Ovulation induction
When a woman takes fertility medicines, the goal is to cause the release of one or more eggs from her ovaries. One medication available today, clomiphene citrate, can be taken by mouth. Other medications called gonadotropins need to be given by injection just under the skin, much in the way diabetics administer insulin to themselves. Ovulation-inducing medications enhance pregnancy by making more eggs available for fertilization by sperm. These medications have helped millions of women once considered infertile bare children. There are several side effects to these medications including multiple pregnancies, i.e. twins, triplets, or even more. As mentioned above, ovulation inducing medications are often combined with intrauterine insemination therapy.

In vitro fertilization
A woman undergoing in vitro fertilization first takes ovulation-inducing medications to induce the maturation of some of her eggs. These eggs are then gathered from her ovaries by a minor surgical procedure. The eggs are combined with her husband's sperm in a special dish which is then placed in an incubator to enable fertilization. The embryos are allowed to grow for 3 to 5 days and are then painlessly placed in the woman's uterus.

Conclusion

Infertility is a common condition that is highly treatable. Couples can help themselves by first recognizing that they have a problem. Several easy tests can be done at home prior to seeing a doctor. These easy tests help reveal important information. If you believe you may be infertile, I encourage you to speak with you doctor about your fertility problem and take advantage of the marvelous advances in treatment that are presently available.

Dr. Alan Penzias is an Assistant Professor of Obstetrics, Gynecology, and Reproductive Biology at Harvard Medical School. He is the Associate Director of the Division of Reproductive Endocrinology and Infertility at Beth Israel Deaconess Medical Center in Boston, MA and is an active practitioner at Boston IVF in Waltham, MA.

Dr. Penzias received his undergraduate degree in chemistry from the University of Pennsylvania. He received his M.D. degree from the State University of New York Downstate College of Medicine in 1986. Following a residency in Obstetrics and Gynecology at Beth Israel Hospital and Harvard Medical School in Boston, MA, he completed a fellowship in reproductive endocrinology at Yale University School of Medicine.

Dr. Penzias is board certified in both Reproductive Endocrinology and Obstetrics and Gynecology. He has published more than 50 papers and textbook chapters in the field of infertility and has lectured extensively in the United States and abroad. Dr. Penzias is the President-Elect of the Boston Fertility Society and is a member of the American Society for Reproductive Medicine, the Society of Reproductive Endocrinology and Infertility, and the American College of Obstetricians and Gynecologists.