When Should You Move Up the Fertility Treatment Ladder

It’s hard to know when to move up the infertility treatment ladder from Clomid, to IUI (artificial insemination), to IVF, to IVF/ICSI, to donor egg, to surrogacy. When should you move to more advanced forms of fertility treatment/assisted reproduction? Host Dawn Davenport interviewed Dr. Jaime Knopman, Reproductive Endocrinologist with RMA of New York and Assistant Professor in the Department of Obstetrics and Gynecology at the Mount Sinai School of Medicine.

Hit the Highlights
  • Safest advice is to move from least treatment to more invasive involved infertility treatment.
  • Does infertility decline more rapidly with age or is the rate of decline even?
  • How does clomiphene citrate (Clomid) work?
  • How does letrozole work to increase the chances of pregnancy?
  • What type of patient is Clomid or letrozole most effective with?
  • How long should an infertility patient try Clomid or letrozole before moving to a different fertility treatment option?
  • Is Clomid or letrozole effective in older women?
  • What are the side effects of clomiphene citrate and letrozole?
  • What type of patient is IUI (intrauterine insemination) or artificial insemination most effective with?
  • What can a patient do to increase the odds of a pregnancy with IUI?
  • Is it possible to do a medicated (with injectable fertility medications) IUI cycle safely to avoid conception of multiples?
  • For unexplained infertility, does it make sense to go straight to IVF?
  • How many artificial insemination cycles should you try before doing in vitro fertilization?
  • What did The Fast Track and Standard Treatment (FASTT) Trial show is the best number of cycles of Clomid and IUI to use before moving to IVF?
  • Are treatments such as GIFT or ZIFT used any more?
  • Is it possible to do IVF with couples who do not want to create excess embryos? How? How to do IVF with no unused embryos remaining?
  • Is Day 3 or Day 5 best for embryo transfer with in vitro fertilization?
  • What factors should couples think about when trying to decide between donor sperm and IVF with ICSI using the partner’s sperm?
  • Is acupuncture effective at increasing pregnancy rates with IUI or IVF?
  • How effective is IUI at increasing pregnancy rates with Clomid or letrozole?
  • What does the research show on the effectiveness of egg freezing for women over the age of 35?
  • What are the risks of intracytoplasmic sperm injection (ICSI)?
  • When should you give upon your own eggs and move to donor eggs?
  • How many cycles of IVF are safe?
  • What factors to consider when deciding whether to use a surrogate if you have unexplained infertility?

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Image Credit: Davmi Pics