- How common is infertility?
- What causes infertility?
- When do I need to seek medical advice if I am unable to get pregnant?
- How is infertility diagnosed?
- How is infertility treated?
- What is the success rate of infertility treatments?
- Does health insurance covers infertility treatments?
- How much cost an IVF treatment?
- What can I do to protect my fertility?
Infertility affects one couple out of six. It concerns 10 to 15% of women between the age of 20 to 44.
One third of infertility cases can be attributed to male factors, one third to female factors, and one third to a combination of problems affecting both partners. In 10 % of cases, infertility remains unexplained.
Male infertility is most often related to abnormal sperm cells production. Female infertility factors include ovulation disorders, blocked tubes, endometriosis or a congenital uterine anomaly. Age has become one of the most common cause of female infertility in our societies as motherhood is often postponed.
An evaluation is recommended if you have been unable to conceive after one year of regular unprotected intercourse. If you are over 35, medical help is advisable already after 6 months as natural fertility and treatments success rate decrease with age.
Female evaluation includes a pelvic ultrasound, ovarian hormone levels, and imaging of the uterus and tubes. In some cases, a minor surgery (hysteroscopy, laparoscopy) might be needed to further evaluate the pelvic structures.
The baseline test for male evaluation is a semen analysis. When abnormal, additional tests might be needed (hormone levels, urological consultation, genetic tests).
Ovulation induction drugsare prescribed in case of ovulation disorder. If minor problems are found or infertility is unexplained, mild ovarian stimulation with intrauterine insemination (IUI)can be considered.
In vitro fertilization (IVF) is indicated in case of severe male factor, blocked tubes or endometriosis. It is also the treatment of choice when other treatments have failed and when time is an issue (age).
Surgical treatmentmight also be indicated in case of tubal disease, endometriosis or uterine anomalies.
With ovulation induction for ovulation disorders, the pregnancy rate is about 20% per cycle, close to the natural fertility rate. For IUI, the pregnancy rate is 10 to 15% per cycle. For IVF, the average clinical pregnancy rate reported by the Swiss National IVF Registry (FIVNAT, 2016) is 32% per cycle. My personal clinical pregnancy rate is 37%, which compares favorably to the success rate of the other swiss IVF centers.
As for spontaneous pregnancies, pregnancy rates after infertility treatments decrease with age.
In Switzerland, basic health insurance (LAMal) covers ovulation induction and 2 cycles of IUI.
Most surgical procedures are covered by health insurance, but the extend of the coverage depends on your personal insurance plan.
IVF is unfortunately not covered by LAMal, but some international health insurances do provide coverage.
IVF involves highly trained professionals and a sophisticated laboratory equipment in order to provide the best success rates. An IVF treatment costs about 7000 CHF. A frozen embryo transfer costs about 2000 CHF.
You can take an active in part by adopting a healthy life style and making the right decision at the right time!
Consider motherhood early enough
Female fertility is optimal between the age of 20 through 30, then it decreases progressively. This decrease accelerates after the age of 37. It’s the decrease in egg number and quality that explains this phenomenon. It is genetically programmed and irreversible. If you intend to have children, you better consider getting pregnant before you reach the critical age even if it means changing your career plans.
Keep a normal weight
Infertility is more common in obese women but also if you are underweight. Keep in mind that nature likes the right middle.
Avoid sexually transmitted diseases
Pelvic infections such as chlamydia or gonorrhea can go unnoticed and cause irreversible damage to the tubes. To reduce this risk, use condoms and avoid multiple sexual partners.
You’ve heard over and over again how bad smoking is for your health. But are you aware that tobacco affects also female and male fertility? Women who smoke undergo menopause one or two years earlier. Other toxics, such as marijuana, have also a negative impact on fertility.
You were looking for a good reason to quit? You’ve found it!