Fertility treatments aren’t as invasive as you may think

Posted on 31 January 2020

Many people who can’t get pregnant immediately think of IVF. But in 80% of cases, fertility treatment is a lot simpler, and easier, than you think. We take you through this progressive process that helps your body stimulate a natural, beautiful process.

Infertility is common yet frequently misunderstood. Up to 15% of South African couples experience fertility issues, according to 2011 data collected by Statistics SA. Many of those face their diagnosis with trepidation, imagining a long, arduous and invasive treatment process ahead.

But treatment for infertility is often easier than you think, says Dr Kasturi Moodley, an obstetrician at Mediclinic Pietermaritzburg and the managing director of  The Midlands Fertility Health Centre – the first of its kind to be established in the area.

“Becoming pregnant should, in ideal circumstances, be a natural and hassle-free process,” she says. “And most of the couples we see think the same way. They never imagine that this should be difficult. They start trying, and nothing happens. So they speak to their gynaecologist, and their doctors will say, ‘You’re perfectly healthy, keep trying’. It’s only months or years later, after they’ve had a protracted period with no success, that they come to us.”

Most of the work involved in treating infertility – or overcoming the common reproductive health issues that lead to periods of infertility – is done in the testing stage. This is where infertility specialists can get a detailed understanding of what is causing your infertility, and determine a course of action.

“Early diagnosis is key,” says Dr Moodley. “Many cases are caused by relatively minor complications that can be corrected fairly quickly and with a minimally invasive approach. But we have to pick up the problem early in order to succeed in rectifying the issue.”

When you see an infertility specialist, they will look for hormonal imbalances, examine the fallopian tubes for obstructions and analyse the quality of the male partner’s sperm. You can expect to undergo a blood test, to gauge your body’s levels of follicle-stimulating hormone (FSH), which triggers the ovaries to prepare an egg for release each month. Then, a hysterosalpingogram (HSG), or “tubogram”, will give your doctor an even closer look, with a series of X-rays of the fallopian tubes and uterus, taken after a liquid dye is injected into the cervix.

These are not standard tests that would be performed by your gynaecologist, says Dr Moodley. “Most hormonal and biomechanical factors we take into account will not be detected in the course of an ordinary examination.”

One common cause of infertility is a blockage in the fallopian tube, she explains: every month, you may produce an egg in the left fallopian tube, or in the right, at random. “If there is an obstruction, it won’t be seen on a standard ultrasound, and you could be ovulating, yet not fall pregnant for months or years.”

Another common issue? The man in your life. Fertility specialists will also examine his sperm and conduct a series of surveys to determine if it is healthy enough to travel to the egg effectively.

Dr Moodley says this is part and parcel of creating optimal conditions for what should always be a natural process, and the remedies she uses are surprisingly non-invasive. “Hormone imbalances can be adjusted through medication and changes in diet. If there are issues with the quality of the sperm sample, we can usually rectify that through changes in diet and lifestyle. If we find a blockage in the fallopian tube, we can subtly position the sperm to meet the egg on the other side.”

Failing these steps, Dr Moodley says, she may prescribe a course of intrauterine insemination (IUI) treatment. This is another minimally invasive technique that facilitates the body’s normal functioning. IUI works by helping the ovary’s follicles to grow and release a mature egg, through medication and monitoring by ultrasound.

Fertility treatment becomes more complicated with age. The longer a couple waits before seeking specialist help, the more complex – and difficult – treatment can be. “Stress is the enemy of pregnancy,” Dr Moodley says. “We are here to ensure this process is as stress free as possible.”