There are 6 basic approaches used to treat unexplained infertility:
Do Nothing
This is the most cost effective approach to treatment. Pregnancies do occur with no treatment, but at a very low rate.
- Cost: $0/month
- Pregnancy rate: 2% /month
Clomid® (or Femara®)
These oral drugs, when used in appropriate doses, will cause a woman who normally produces a single egg each month to produce 2 or 3. This will double or triple the pregnancy rate. However, each woman will respond differently to different doses of drugs; some will grow 3 eggs on a low dose, while others will grow no more than the usual 1 egg each month on higher doses of drug. You will have an ultrasound performed during your treatment cycles so we can determine how many eggs you are growing each month. You may also be prescribed an injectable drug during the cycle to help your eggs ovulate or “drop”.
- Cost: $300/month o
- Pregnancy rate: 5%/month
Clomid® (or Femara®) plus intrauterine insemination (IUI)
Intrauterine insemination (IUI or artificial insemination) takes the best sperm produced and places it closer to the egg. Generally, most sperm do not make it from the vagina into the uterus and tubes, which is where fertilization happens. IUI helps to correct this, so that a majority of the sperm inseminated make it to the uterus and tubes. You can choose 1 or 2 inseminations in a month, 2 increases the success rate of pregnancy, but is also more expensive.
One insemination per month
- Cost: $600/month
- Pregnancy rate: 8%/month
Two inseminations per month
- Cost: $950/month
- Pregnancy rate: 10%/month
Injectable fertility drugs plus intrauterine insemination
These medications, commonly called gonadotropins, go by a variety of names such as Gonal-f®, Follistim®, Repronex®, and Bravelle®. They are very powerful drugs generally capable of producing a large number of eggs in a treatment cycle. With unexplained infertility, these drugs are used to produce more eggs than can be achieved with Clomid® or Femara®: generally 3-6 in a cycle. However, care must be taken to ensure that this is the goal that is met, and that too few or too many eggs are not produced. To do this, frequent monitoring with blood tests and ultrasound are required, as well as occasional adjustment of drug dose. These expenses, in addition to the expense of the drug, are significant, as is the time commitment and mental energy required. However, it is every effective in helping you achieve pregnancy. Two inseminations are usually used with this treatment.
- Cost: $3000/month
- Pregnancy rates: 22%/month
In vitro fertilization (IVF): Minimal Stimulation
This treatment uses injectable fertility drugs and Clomid® in low doses, only a small amount of monitoring, and little or no dose adjustment. An egg retrieval is performed to remove up to 3 mature eggs from the ovaries. The eggs are then mixed with sperm in a Petri dish, and the following day all 3 fertilized eggs are transferred into your uterus. Please see the patient information sheet for minimal stimulation IVF for more details.
- Cost: $6000/month
- Pregnancy rate: 30%/month
In vitro fertilization (IVF)
This treatment uses injectable fertility drugs to produce a large number of eggs. They are then retrieved from the ovaries, mixed with the sperm in a Petri dish and grown for 5 days in the laboratory. The best 2 embryos are then transferred into the uterus. Any embryos that are not transferred can be frozen for future family building if they are of good quality. Please see the patient information sheet for IVF for more details.
- Cost: $13,000.
- Pregnancy rate: 45%/month
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