Approximately 12-13% of Canadians experience infertility, and although a variety of causes may be to blame, there are few absolutes when it comes to solutions. Intended parents have a variety of options to explore beyond IVF to treat infertility or to build their families.

Understanding Three Basic Sources of Infertility

Intended parents who face infertility may attribute it to one of several causes. According to Dr. Roger Lobo of the American Society for Reproductive Medicine, two causes are most often to blame: problems with ovulation and structural problems. The third cause has no clear answer.

1. “Up to a third of female infertility cases are due to ovulation problems,” says Dr. Lobo, who also states that ovulation problems may be caused by normal aging, eating disorders, polycystic ovarian syndrome (PCOS), or excessive stress and exercise. All of these can have a negative impact on hormones and can cause anovulation, or, the absence of ovulation.
2. Structural problems are, according to Dr. Lobo, the second leading cause of female infertility, and these problems typically affect the fallopian tubes or uterus, which “can interfere with the transporting and implantation of a fertilized egg.” In some cases, structural problems are congenital, which means that the problem has existed since birth. In other cases, women may have fibroids (benign tumors) growing in the walls of their uterus, blocked fallopian tubes, or scar tissue from infections.
3. A third category of infertility has been termed “unexplained infertility.”Resolve.org reports that “approximately one in five couples will experience unexplained infertility despite completing a full infertility work-up.” This area can be particularly frustrating and even devastating for intended parents because, without a firm explanation for infertility, finding an effective treatment may be more fraught with anxiety, guilt, and emotion.

Advances in Reproductive Medicine Create Other Options

Thanks to continued advances in reproductive medicine, intended parents have a variety of treatment options to explore. For example, a common treatment for women with irregular or absent ovulation is called “ovulation induction,” or OI. With this treatment, oral medications “stimulate egg development and release,” and some research suggests this treatment may be effective for intended parents with unexplained infertility. For patients with structural problems, surgery may be advisable to unblock fallopian tubes, remove fibroid tumors, or diagnose and/or remove mild to moderate endometriosis.

Intrauterine insemination (IUI) is another option intended parents may consider. With this treatment, the intended father’s sperm (or sperm from donor if necessary) is prepared and then placed directly in the intended mother’s uterus. IUI is typically timed with ovulation, and can be coordinated with a “natural” cycle or with OI.

Beyond these treatments, more intended parents are treating infertility with Traditional Chinese Medicine, which refers to a “range of medicine practices which have been used in China for over five thousand years. Among them, acupuncture and Chinese herbs are the most powerful therapies to treat health problems.” Studies are showing a positive impact on the outcomes of infertility treatment when intended parents combine the two approaches; for example, acupuncture treatment on the day of IVF or IUI has been shown to improve the success rate of the procedure.

Third Party Reproduction

Also thanks to advances in reproductive medicine, third party reproduction—the process by which intended parents add to their family with help from an egg or sperm donor or from a surrogate—is a growing area. Hand-in-hand with fertility specialists who will help you understand the causes, treatments, and complications of infertility, a fertility lawyer will help you understand the legal landscape if you are creating your family through third party reproduction. The right fertility lawyer will help you understand the legal rights and obligations of all parties involved, will draft and negotiate donor and surrogacy agreements, and will obtain a declaration of parentage on your behalf when your family has been created through surrogacy. A fertility lawyer can also provide you with guidance and support throughout the entire process. As a fertility lawyer, I see my role as your legal partner on the journey of life.

What has your infertility experience been? Use the comments to share your story; let us know what treatments you have found to be effective, if there are support groups who have helped you through the emotional process of expanding your family, or if you simply have a question.