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Infertility treatments

Patient Education
Last reviewed

Ovulation medicines by mouth

Medicines:

How they work:

Both help your ovaries release 1 or more eggs per cycle.

Side effects:

  • Hot flashes
  • Mood changes
  • Vision changes (call your care team)
  • Pelvic pain
  • Twins (6 to 10%)
  • Triplets (less than 1%)

Directions:

  1. Take medicine on days 3 through 7 of a menstrual cycle. Day 1 is the first day of full flow.
  2. Start ovulation predictor kits (OPK) on cycle day 11.
  3. Test 1 time each day at about the same time until positive. Do not test first morning urine.
  4. You should ovulate 24 to 36 hours after a positive kit.
  5. Check a progesterone level 6 to 8 days after a positive OPK.
  6. Check a progesterone level and call the clinic for results if you do not have a positive OPK by cycle day 22.
  7. Your dose will be changed as needed based on progesterone result.

With timed intercourse:

  • Note the day of your positive OPK.
  • Have intercourse that night and the next day.

With intrauterine insemination (IUI):

  • Note the day of your positive OPK.
  • Call the clinic to schedule IUI for the next day.

Pregnancy rates:

About 5 to 20% per cycle based on infertility diagnosis and age

Cost:

$50 to $100 for the medicines needed for each cycle. This may be more if higher dose are needed.

Combined (by mouth and injectable) ovulation induction with IUI

Medicines:

  • Clomiphene citrate (Clomid®) or letrozole (Femara®)
  • FSH (Follistim®, Bravelle®, or Gonal-F®) or HMG (Menopur® or Repronex®)
  • HCG (Ovidrel® or Novarel®)
  • Progesterone (Endometrin®, Crinone®, or Prometrium®)

How it works:

Medicines by mouth and injection stimulate your ovaries to make follicles. HCG causes your ovaries to release 1 or more eggs.

Directions:

  1. Take medicine by mouth on days 3 through 7 of a cycle. Day 1 is first day of full flow.
  2. Start injectable medicine in the evening of day 7.
  3. Return for ultrasound on cycle day 12 or as ordered by your doctor.
  4. Change medicine dose and schedule next ultrasound as ordered by your care team. Hormone blood tests may be needed.
  5. HCG will be given when follicles are of the right size based on ultrasound. You should ovulate 36 to 48 hours after HCG is taken.
  6. Your cycle may be cancelled if too many follicles develop.
  7. IUI will be scheduled 36 hours after HCG is taken.

Pregnancy rates:

About 10 to 20% per cycle based on infertility diagnosis and age

Cost:

$2,500 to $3,000 per cycle (with IUI)

Intrauterine insemination (IUI)

You will be given more details about scheduling IUI from our nurses. Keep it as a reference. IUI is done by specially trained infertility nurses.

How it works:

  1. A speculum is placed in your vagina.
  2. The cervix is cleaned with sterile saline solution.
  3. A soft, flexible, plastic tube is put through the cervix into the uterus.
  4. The sperm are slowly transferred through the tube into the uterus.
  5. Rest for 15 minutes after the insemination.

Pregnancy rates:

8 to 10% per cycle (higher when combined with fertility medicines)

Cost:

  • $850 for first IUI
  • $650 for next IUIs if needed
  • Does not include cost of medicines

In vitro fertilization (IVF)

If you decide to do IVF, you will meet with the doctors, nurses, and financial team to talk about the procedure and make plans for the future treatment cycle.

How it works:

  1. Ovaries are stimulated with injectable medicines.
  2. Eggs are removed from the ovaries during a surgical procedure.
  3. Eggs are fertilized with sperm outside the body.
  4. Fertilized eggs (embryos) are grown in culture for 3 to 5 days.
  5. Embryo(s) are transferred back to the uterus.

Pregnancy rates:

30 to 70% per cycle based on age and infertility diagnosis

Costs about:

$15,000 to $20,000