Hormone treatment using gonadotrophins is the next level of drug treatment for women with ovulatory problems. Follicle-stimulating hormone (FSH) and luteinising hormone (LH) are gonadotrophins, which are produced naturally in our bodies, and are a vital part of our reproductive cycle. The drugs using these hormones may contain just FSH alone, or FSH and LH, and are given by injection. When you are taking these drugs it is essential that you are properly monitored using ultrasound, as there is a risk of multiple births. It is also possible that the ovaries can be oversfimulated, leading to ovarian hyperstimulation syndrome (OHSS), which can pose serious health problems.
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| Female Infertility Treatments |
Bromocriptine, cabergoline and dopamine agonists
These drugs may be prescribed for women who have a disorder of the pituitary gland called hyperprotactinaemia, which causes them to produce too much prolactin. This condition an lead to irregular periods, and thus infertility. These drugs can have side effects such as nausea, sickness, headaches and dizziness.
Laparoscopic ovarian drilling
Laparoscopic ovarian drilling is sometimes offered to women with polycystic ovaries, particularly those who have not responded to clomifene citrate. It involves a general anesthetic and a laparoscopy. A tiny telescope (a laparoscope) is inserted through a small incision into the abdomen, and heat is used to burn small holes on the surface of the ovaries. This process seems to help trigger ovulation in some women.
'They go in through the belly button and they make holes all over the ovaries. It was only day surgery, and I was home in the evening. It was a little bit tender, but painless. The only discomfort you have is in your shoulder from the build up of gas, but it does go very quickly if you lie flat for a couple of hours.' Sarah, 34
Treatment for problems with fallopian tubes
There are a number of procedures that may be offered to patients who have blocked or damaged fallopian tubes to try to clear the tubes so that eggs can pass freely along them and pregnancy can occur. One of the simplest ways to try to unblock the tubes involves using a fine catheter, which is inserted through the cervix. A narrow wire is pushed through the catheter to try to clear the blockage away. The process is often successful, but does carry a risk of damaging or perforating the tube, and some women find it painful. Sometimes doctors try to clear blockages in the tubes by inserting a small balloon into the tubes and inflating it.
Tubal surgery
It may be possible to remove blockages in the tubes and scar tissue by surgery. Women who have blocked tubes are now generally offered IVF rather than surgery, as this by-passes the fallopian tubes, and has a higher chance of producing a pregnancy. If surgery is offered, it should be done laparoscopically, and the chances of success will depend on the nature and severity of the problem. Sometimes a blocked portion of tube will be cut out and the ends joined together, and scar tissue, which can glue up the reproductive organs by covering them like sticky cobwebs, can be removed.
Tubal surgery is only generally considered when both tubes are blocked. Although it will probably take longer to get pregnant with just one open tube, there is a risk that attempting to repair the blocked tube could leave scarring that might damage the clear tube. There is an increased risk of ectopic pregnancy after tubal surgery.
Uterine surgery
Some women will be offered surgery to remove fibroids or scar tissue in the womb. Many of these operations on the womb are now done using keyhole surgery where possible, rather than open surgery. To find out more, you can check out Female Infertility Treatments.
