6 fertility treatment options for starting (or growing) your family (2024)

There are many options when it comes to fertility treatment, and there's likely a promising choice for you, whether you're struggling with infertility or seeking a non-traditional path to parenthood. Where to start, though?

"Navigating fertility treatments can be overwhelming," says Sasha Hakman, M.D., a double board-certified ob-gyn and reproductive endocrinologist and member of the BabyCenter Medical Advisory Board. "This is why consulting with a fertility specialist who can walk you through a personalized plan can be incredibly beneficial.”

Treatment prices can vary greatly, depending on your healthcare provider and where you live. And success rates will vary depending on your age and other fertility factors, so be sure to ask your provider for success rates and costs specific to you.

Here's an overview of your fertility treatment options:

1. Fertility medications

The most commonly used fertility drugs – clomiphene citrate (CC), letrozole, and gonadotropins – regulate your reproductive hormones and trigger the release of one or more eggs in each ovulation cycle. Most women use them for three to six months before conceiving or trying a different kind of treatment.

Fertility medications may be used alone, but they're also used during assisted reproductive technology (ART) procedures, such as intrauterine insemination (IUI) or in vitro fertilization (IVF).

Side effects and drawbacks

• Fertility drugs can increase your odds of having twins or more, and carrying multiples increases the risk of pregnancy complications.
• Clomiphene can cause hot flashes, abdominal distension and pain, nausea and vomiting, breast discomfort, mood swings and depression, headaches, abnormal vaginal bleeding, and visual disturbances (such as blurred or double vision).
• The most common side effects of letrozole are hot flashes and pain in the joints, muscles, bone, and back. Less-common side effects include headache, anxiety, confusion, and sleepiness or trouble sleeping.
• Gonadotropins can cause rash or swelling at the injection site, mood swings, breast tenderness, abdominal bloating, mild abdominal pain, and headaches.
• Some women who take gonadotropins develop a moderate or severe form of OHSS (ovarian hyperstimulation syndrome), which causes enlarged ovaries and fluid buildup in the abdomen.
• Gonadotropins slightly increase the risk of ectopic pregnancy.
• Adnexal torsion, a twisting of the ovary, is a condition that happens in less than 2% of gonadotropin cycles, but can require surgery to address.

Tell your doctor about any side effects you're experiencing, as some of them may signal a problem that needs medical attention.

Success rates

About 80% of women who take clomiphene ovulate, usually in the first three months of treatment. Of them, about half conceive. When used over six months, clomiphene results in a live birth rate of 20% to 40%.

Letrozole is especially effective in treating women with polycystic ovary syndrome (PCOS), the most common cause of infertility in women. In a study of 750 infertile women with PCOS, about 28% of those who took letrozole for up to five cycles eventually had a live birth.

The pregnancy rate for gonadotropins with timed intercourse is 15% per cycle. A 21-year study of almost 3,000 women undergoing IUI with gonadotropins found a pregnancy rate of just over 9% and a live birth rate of 7% per cycle. The cumulative pregnancy rate was almost 22%, and the cumulative live birth rate was almost 18%. Of the pregnancies, 12% were twin pregnancies.

Cost

Medication costs depend on the dosage and whether you choose a brand name or generic, but generally:

• Clomiphene pills cost about $25 to $179 a month (cycle).
• Letrozole costs about $20 per cycle.
• Gonadotropins cost from about $150 to $5,400 per cycle.

2. Surgery

Surgery can help fix genetic defects, open blocked fallopian tubes, remove fibroids, remove the tissue of endometriosis, and treat PCOS.

Laparoscopy is the procedure most often used to treat endometriosis or PCOS if you're planning a natural conception. Laparoscopy uses thin instruments and a lighted camera inserted through several small incisions in the abdomen.

Laparotomy uses a larger abdominal incision. It's rarely done, but can be used in the case of multiple large fibroids that are affecting the uterus and/or fallopian tubes.

Other minimally invasive procedures might be needed, says Dr. Hakman. The most common of these is a hysteroscopy, in which a lighted device is placed in the uterus through the cervix, and surgical instruments are used to remove any abnormalities (such as polyps or adhesions), if necessary.

Side effects and drawbacks

• You may feel discomfort in your back or shoulders after a laparoscopy.
• If you had general anesthesia, the breathing tube used during surgery may give you a sore throat for a few days. You'll also feel sleepy for a few hours and may have some nausea.
• The incisions in your abdominal area may cause discomfort for days to weeks after a laparoscopy or laparotomy.

Success rates

Success depends on the condition and the surgery used to treat it.

• Women with minimal or mild endometriosis have about a 40% chance of getting pregnant by eight to nine months after laparoscopic treatment. In one study, about 27% of patients receiving laparoscopy for endometriosis became pregnant during the first six months after the surgery, and 48% became pregnant during the first 12 months. Another 10% became pregnant in the following year, and by 38 months after the operation, the rate of pregnancy was almost 70%.
• According to one review, the live-birth rate after fallopian tube surgery ranges from 9% for women with severe tubal damage to 69% for women with mild disease.
• Women with PCOS who have ovarian "drilling" surgery (making tiny holes in the ovaries) using laparoscopy have a 50% chance of getting pregnant within one year, according to the American Society for Reproductive Medicine (ASRM).

"I conceived one month after having a laparoscopy," says BabyCenter Community member Thirtyeightandgreat in the Endometriosis support group.

Cost

Anywhere from $2,000 to $10,000 or more, depending on the type of surgery, the anesthesia used, whether the procedure is inpatient or outpatient, and your insurance coverage.

3. Intrauterine insemination (IUI)

Intrauterine insemination (IUI) involves depositing a concentrated amount of sperm from your partner or a donor directly into your uterus, using a catheter that passes through the cervix.

Side effects and drawbacks

• Because timing is crucial, you'll need to be available to go to the doctor's office as soon as you ovulate. Your partner will need to produce a sperm sample, unless you're using donor sperm.
• If you take fertility drugs before the procedure, you may have side effects from the medications.

Success rates

One study of more than 750 couples and more than 1,400 IUI cycles found a per-cycle pregnancy rate of 11% and a cumulative pregnancy rate of 19%.

According to ASRM, success rates can be as high as 20% per cycle, depending on whether fertility medications are used, the infertility diagnoses, and other factors.

BabyCenter Community member RainbowmomSarah went through two rounds of IUI, a lost pregnancy, and another two rounds of IUI before becoming pregnant with their 2-year-old daughter.

"It's a journey and does take time. Our journey lasted 3.5 years before getting our rainbow baby," she says in the Infertility group.

Cost

Depending on whether you use fertility drugs for the procedure, IUI cost varies from about $300 to $4,000 per cycle.

Navigating fertility treatments can be overwhelming ... consulting with a fertility specialist who can walk you through a personalized plan can be incredibly beneficial.

- Dr. Sasha Hakman, board-certified ob-gyn and reproductive endocrinologist

4. In vitro fertilization (IVF)

For in vitro fertilization (IVF), eggs are retrieved from your ovaries and then combined in a laboratory with sperm from your partner or a donor. If fertilization is successful, the resulting embryo or embryos are transferred to your uterus. IVF accounts for more than 99% of ART procedures.

Side effects and drawbacks

• You might have mild cramping and spotting after eggs are retrieved.
• There may be side effects from fertility drugs.

Success rates

According to the Society for Assisted Reproductive Technology (SART), these are the chances of live birth after IVF (as a new patient using your own eggs):

• 69% for women age 34 and younger
• 59% for women age 35 to 37
• 43% for women age 38 to 40
• 23% for women age 41 to 42
• 7% for women age 43 and older

SART has an online tool for predicting your chances of having a baby using ART.

Cost

IVF costs vary greatly, but the procedure is generally expensive. One cycle typically costs about $22,000 – but depending on what's included in your plan, it can run $30,000 or more. Since it takes an average of 2.3 cycles, the average cost of IVF for successful conception can exceed $50,000.

A "mini IVF" procedure, which uses fewer medications, ranges from $5,000 to $6,000 per cycle, plus the cost of the medication, which can run from $50 to $2,000.

5. Donor sperm, eggs, and embryos

If you're unable to get pregnant using your own eggs or a partner's sperm, you can benefit from third party-assisted ART. This includes:

• Sperm donation, which can be used with either IUI or IVF.
• Egg donation: A donor has eggs retrieved, an egg is then fertilized (using sperm from your partner or donor), and the resulting embryo is transferred to your uterus – which has been prepared with the use of medications.
• Embryo donation: A frozen embryo (usually from couples who have undergone IVF and have remaining embryos to donate) is transferred to your uterus – which, again, has been prepared with the use of medications.

Side effects and drawbacks

• Choosing the sperm, egg, or embryo donor can be a long process.
• Your risk of having twins or more is higher if you transfer multiple embryos.
• You may have side effects from the medications.

Success rates

According to SART, the monthly chance of pregnancy using sperm donation is 8% to 15%.

According to the Centers for Disease Control and Prevention, embryo transfers with donor eggs or donor embryos lead to successful, live-birth deliveries 42% to 54% of the time.

BabyCenter Community member 1teach11 was 47 when she delivered her baby boy. "I had a textbook pregnancy. I used a donor egg and donor sperm," she says in the Single Moms by Choice group.

Cost

The cost of donor sperm, eggs, and embryos varies greatly according to where you obtain them (from a friend, an infertility clinic, or a donor agency, for example).

As an average:

Donor sperm costs from $300 to about $1,600.

Donor eggs cost between about $6,700 (for anonymous donor eggs) to $20,000 per batch (usually just enough for one cycle).

Donor embryo costs range between $7,500 and $20,000.

Keep in mind there may also be charges for genetic testing, which can run $1,800 to $6,000, and for storage of the donor egg, sperm, or embryo, which can cost $350 to $1,000 a year or more.

6. Gestational surrogacy

Gestational surrogacy is when a woman undergoes IVF and carries a baby to term for you. The gestational carrier then signs away her parental rights.

Depending on how the surrogacy is done, you and/or your partner may have a biological child as a result (if your eggs and/or sperm are used).

Gay couples or single men typically use donor eggs and their own sperm. Lesbian couples often use reciprocal IVF, in which one woman donates her eggs and the other carries the baby. And some people use a donor embryo that was created using donor eggs and donor sperm.

"My best friend has offered to be our surrogate. I had cancer and am unable to conceive or carry. I'm worried and excited all together. I want this so much," says BabyCenter Community member Ane0828 in the Surrogacy group.

Side effects and drawbacks

The process can be legally complex and emotionally draining and requires a considerable amount of money, time, and patience.

Success rates

Gestational surrogacy success rates depend in part on the age of the woman providing the eggs, but gestational carriers generally have higher live birth rates using IVF than other women. (This may be because they are generally younger, have proven fertility, and usually have a single embryo transfer.)

The live birth rate for gestational carriers is 54% to 57%. Once pregnant, the success rate is very high – as much as 95%, according to some fertility clinics.

Cost

The process of surrogacy can cost as much as $200,000, according to one study. Expenses include medical fees, legal fees, surrogacy recruitment programs, and surrogate compensation. Most couples work through an agency, which charges a fee for the entire process.