Fertility treatments and alternative pregnancy options
For many people, conceiving a child can be challenging. Whether you’ve started trying for a baby or you’re dealing with known fertility issues, you may feel like the path to parenthood is taking longer than expected. Fortunately, there are options that may help you build the family you’ve been hoping for. Let’s learn more and see which option may be right for you.
What is assisted conception?
If you’ve started exploring fertility treatments, you may see terms like “assisted conception” or “assisted reproduction.” This just means that a person needs medical assistance to help them conceive. The type of support needed depends on the unique situation of each person or family.1
What are fertility options if I need help getting pregnant?
If you’ve been trying to get pregnant for more than a year (or 6 months if you’re over 35), you may want to talk to your doctor about fertility testing.2 Infertility can affect both women and men. In women, it might be caused by a lack of ovulation, hormone imbalance or lifestyle factors. In men, a low sperm count or genetic condition could be contributing factors. And in some cases, there’s no known cause of infertility.3
Fertility medications
While it depends on the results of your fertility testing, one of the first options to explore when treating infertility is often fertility medication.4 It’s typically the easiest, most inexpensive option.
- How it works: Fertility drugs encourage ovulation by acting like the natural hormones in your body. These hormones are follicle-stimulating hormone (FSH) and luteinizing hormone (LH). If you need help producing more eggs or better-quality eggs, your doctor may also recommend hormone shots to stimulate egg growth.5, 6
- Costs: Common oral fertility drugs that help with ovulation range from $10 to $100 a month. Your cost will depend on your health plan’s prescription drug coverage. If hormone shots are recommended, they can cost between $1,000 to $3,500 per cycle.6
- Pros and cons: Oral medications and hormone shots tend to have good success rates. They’re also generally the most cost-effective fertility treatment options. You may experience mild, temporary side effects from certain medications, including hot flashes, breast tenderness, mood swings, headaches, bloating and nausea.5
What are medical procedures to help with getting pregnant?
If you’ve used fertility medication for a certain amount of time and haven’t conceived, your doctor may recommend moving on to the next step. This likely means trying an assisted reproduction procedure like intrauterine insemination (IUI) or in vitro fertilization (IVF).4
- How it works: During ovulation, your doctor inserts sperm (from your partner or a donor) through a tube placed directly into your uterus.7,8 Fertility drugs are sometimes used with this procedure, but they may greatly increase the chance of a multiple pregnancy (for example, twins).7
- Costs: The cost of IUI ranges from $250 to $4,000 per cycle. If donor sperm is needed, it can cost $25 to $1,500 per vial.8
- Pros and cons: IUI is a minimally invasive procedure and tends to be less costly than other procedures. However, because the timing of insemination is so important and happens within a relatively small window, it can be inconvenient. You may also need to do IUI multiple times before conceiving.7
- How it works: Your doctor gathers eggs from your ovaries through a retrieval procedure. Your eggs are then combined with your partner’s sperm (or donor sperm) in a laboratory dish. The resulting embryos are implanted in your uterus.9
- Costs: An initial IVF cycle may cost $12,000 to $15,000, plus $1,500 to $6,000 per cycle for fertility medication. Additional IVF cycles can cost $4,000 to $7,000 per cycle. Donor sperm or donor eggs, if needed, also come with extra costs.8
- Pros and cons: IVF can offer another option for conception when fertility drugs or IUI aren’t successful. IVF also offers people with blocked or damaged fallopian tubes or other conditions the chance to get pregnant. That said, IVF is expensive and the process can be demanding. You’ll also need to take fertility drugs and hormone shots during each cycle, which may cause mild side effects like hot flashes, headaches and nausea.9
- IVF is more complex. IVF is a multi-step process that involves fertility medications and medical procedures to retrieve your eggs and implant fertilized embryos in your uterus.10 IUI is simpler. It involves inserting sperm into your uterus to decrease the sperm’s travel time to the egg.11 Fertility drugs may sometimes be used with IUI to stimulate ovulation.7
- IUI costs less. Because the process is less complex, IUI tends to cost significantly less than IVF. This can be an important consideration if your insurance doesn’t cover fertility treatments. However, costs can add up if you need multiple cycles of IUI.10
- IVF has a higher success rate. While age plays a big factor in your chances of conceiving, the success rates for IVF tend to be considerably higher. For example, a woman under 35 using her own eggs has a 45% to 50% chance (or sometimes higher) of conceiving in one IVF cycle. The same woman using IUI has a 10% to 15% chance of conceiving in one IUI cycle.10
How does egg or sperm donation work?
Using donor eggs or sperm can expand your options when you’re trying to conceive. Sperm donors can help couples with a partner who has low or no sperm count.1 Egg donors can help a partner who has no ovaries or low-quality eggs or no eggs.12 Egg and sperm donation can also be an option for individuals who’d like to start a family on their own, or LGBTQ+ families who are same sex or have the same reproductive organs.
- How it works: Egg donation and sperm donation typically involve selecting a donor from an egg bank or sperm bank. You can also choose a donor you know. Donor sperm is used to fertilize your eggs, either through IUI or IVF. If you’re using donor eggs, they are fertilized with your partner’s sperm or donor sperm in a lab. The resulting embryo is implanted in your uterus via IVF.1
- Costs: Donor sperm ranges from $25 to $1,500 per vial, plus the costs of IUI or IVF. Donor eggs can cost $25,000 to $30,000, plus the cost of IVF.8 The cost for donor eggs is significantly higher because the process of retrieving eggs from the donor is much more complex than sperm donation.
- Pros and cons: Donor sperm and donor eggs can give you a chance at conceiving that might not otherwise be possible. However, the associated costs can be high. You’ll also want to consider how you’ll feel if you’re not genetically related to your child, and how you’ll explain that to your child in the future.12
What is surrogacy?
Surrogacy is when a woman, called a surrogate, carries and gives birth to a child for you. An egg and sperm from you and your partner (or donors) are used to create an embryo that’s implanted in the surrogate’s uterus. This is known as gestational surrogacy, meaning your surrogate has no genetic connection to your child.13
- How it works: Gestational surrogacy always requires IVF. When the baby is born, the surrogate surrenders parental rights and gives the baby to you. You’ll typically work with an attorney to complete the steps needed to secure legal parentage.13
- Costs: The entire surrogacy process can cost between $200,000 to $250,000. This includes all expenses and pay for your surrogate, plus the costs of IVF, egg and sperm donations (if needed), agency fees, legal fees and more.13
- Pros and cons: If you’ve had unsuccessful fertility treatments or you have a condition that makes pregnancy unsafe, surrogacy can give you a chance at having a biological child.14 But surrogacy is often a long, expensive and complex journey. Working with a reputable surrogacy agency and family law attorney can help guide you through the process.13
How does adoption work?
Adoption can be another path to parenthood. You’ll have the chance to expand your family while providing a child with a loving, stable home. The 3 main types of adoption are domestic adoption (within the U.S.), international adoption and adopting through foster care. You’ll want to consider your family, finances and other factors to decide if adoption could be an option for you.
Which fertility treatment or alternative pregnancy option is right for me?
It may feel encouraging to know there are many options that can help with fertility challenges. And maybe a little overwhelming too. Meeting with your doctor is often the best place to start.15 They can review your medical history and where you’re at in your family-building journey. Together, you can discuss the options that may be right for you and determine the next steps to take.
What questions should I ask my doctor about conceiving?
There are a variety of factors that can affect the conception process. Learning what may help or hurt your chances — and knowing when to get support — can help you better understand what to expect.
While age isn’t the only factor that affects your chances of conceiving, it does play a big role. Women are at peak fertility up until age 30. As you age, fertility slowly declines. For example, a woman 30 or under has a 20% chance of getting pregnant naturally each month. That declines to less than 10% by age 40. The chance of miscarriage also increases as you age.16
Healthy eating and regular, mild to moderate exercise may help improve fertility. Tobacco, alcohol and being underweight or overweight can harm both your ability to conceive and the health of your pregnancy.16 Discuss your lifestyle habits and health history with your doctor to help ensure your fertility is the best it can be.
Getting pregnant usually takes time. But if you’ve been trying for longer than a year (or 6 months if you’re over 35), it may be time for fertility testing. Your doctor can recommend what’s right for you.2
Typically, you’ll start with a physical exam, including a pelvic exam, and health history. You’ll also likely have a blood test. Additional tests and procedures may be recommended, and your doctor may suggest your partner gets tested too. Your doctor can guide you through the process and suggest the type of testing that may be right for you. 2
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