Infertility treatment pdf

Your acupuncturist will tailor treatments to your condition but will generally recommend a treatment 1—3 times a week. Each session after the first one may last up to an hour—first a discussion period to update your acupuncturist followed by a 20—minute session with needles. Most patients experience little to no pain. Some might experience a mild, dull ache, pinch, or even shock sensation.

Occasionally, bruising can occur at the places where the needles are inserted. Let your acupuncturist know if you are taking aspirin or other anticoagulants blood thinners. Because qualified acupuncturists use disposable needles, the risk for infection is very, very low.

Acupuncture helps with relaxation as well, so. Infertility may also be a new focus of ongoing epidemiologic data collection systems, such as the Behavioral Risk Factors Surveillance System and the Pregnancy Risk Assessment and Monitoring System, which may provide more information on behavior and health outcomes. Information available through the revision of the birth certificate, which includes information on types of infertility treatment, needs to be evaluated and may become an important source of information on maternal and child health correlates of infertility treatment.

New data collection systems may be needed to achieve better coverage of specific population groups and issues. Ad hoc surveys may be needed to obtain qualitative and quantitative data relating to morbidity, treatment, outcomes, psychosocial impact, practice patterns, knowledge, behaviors, and attitudes.

Data from these surveys need to be analyzed to understand whether combining the information gathered in these surveys can provide a more complete picture of infertility in the United States.

Finally, appropriate mechanisms need to be put in place to maximize dissemination and utilization of surveillance data. In-depth research studies are necessary to address some of the same issues that would be desirable to evaluate at the population level using surveillance systems.

In the area of primary prevention, research into modifiable causes of infertility should be given high priority. Research is needed to elucidate the mechanisms through which specific medical conditions lead to infertility, given that detection and early treatment of these conditions may prevent infertility.

Although the causal role of sexually transmitted diseases STDs on tubal infertility is well established, and randomized trials document that chlamydia screening prevents PID, how much the chlamydia screening program has impacted infertility is unclear.

There is no information on whether interventions and programs aimed at reducing the prevalence of tobacco smoking and improving nutrition and physical activity have an impact on the prevalence of infertility. Finally, the link between infertility and chronic diseases and their treatment needs to be fully elucidated. In the area of secondary prevention, there is inadequate information on the potential risks and benefits of early detection of fertility impairment i. Whereas the benefits of early detection may arise, for example, from increasing the probability of treatment success by detecting infertility at a younger age, an individual who does not intend to have a child may experience negative psychological effects of the awareness of a diagnosis that does not immediately represent a limitation and may not necessarily predict infertility in the future.

Research is needed to evaluate the potential benefit of early detection and treatment of conditions leading to infertility, both among couples who are actively seeking a pregnancy and among individuals who may want a child in the future.

In the area of clinical outcomes research and tertiary prevention, there are few and limited economic studies assessing the cost-effectiveness of infertility treatment, the financial impact of treatment options, and the effect of insurance coverage on access to treatment and treatment outcomes. Because the promotion of elective SET may lead to a substantial reduction in the adverse effects and health care costs of ART-related multiple gestation, it is important to clarify the extent to which this practice can be proposed to patients with a variety of prognostic profiles and to identify biochemical and morphologic characteristics of oocytes and embryos that predict successful implantation and ultimately the birth of a healthy child.

This research is critically needed to provide evidence in support of recommendations for the practice of infertility treatment and minimize the frequency and severity of adverse outcomes. In the area of communication, there is very limited information on the needs and options for special populations who may seek infertility treatment or ART, such as cancer survivors, HIV-positive persons, and persons with known genetic conditions. There is essentially no information on the effect that disseminating information about fertility preservation and treatment options would have on attitudes, knowledge, and behavior among special populations.

These research themes need to be incorporated in the strategic research plans of governmental agencies and nongovernmental organizations and require a blend of basic science, clinical, and epidemiologic investigations and behavioral and social science research. A preliminary survey of current programs and policies at the national and state level reveals that there is no coordination of national and state-based surveillance efforts, that there is no national strategy for integrating infertility diagnosis and treatment in reproductive health services, including preconception care, and that insurance coverage varies greatly across states.

In addition, there are no comprehensive guidelines on what information and counseling should be provided to infertile couples on issues ranging from prevention to the risks and benefits of treatment, adoption, and child-free living. Finally, there is only limited discussion of the impact that ethical and legal issues surrounding infertility treatment may have on public health policies and programs.

There is increasing awareness by the public, media, and policy makers that infertility and its management are important problems that Americans face today; but there is no comprehensive national plan to address the problem of infertility. A national plan would offer the opportunity to strengthen existing prevention programs and propose new strategies based on an understanding of preventable risk factors, as well as the opportunity to systematically review definitions and to identify gaps in diagnosis and treatment guidelines.

For a national plan to be truly comprehensive and effective, it would have to be evidence based, consensus driven, and developed and promoted by a coalition of stakeholders. Decision makers at all levels of government need to be informed and advised about needs and priorities in the areas of surveillance, research, and health care and about evidence-based strategies for addressing infertility.

Policy to guide surveillance and research should pave the way for the development of prevention and management strategies. Systems and policies to facilitate the translation of research results into prevention programs need to be developed.

Programmatic and policy implications of surveillance and research results need to be considered and acted on as appropriate. Professional organizations need to take the lead in the development of evidence-based practice guidelines, and the health care insurance system needs to be engaged in addressing specific forms of infertility or underlying conditions that require appropriate preventive care, diagnosis, and treatment.

Once comprehensive infertility prevention and management programs are developed, efforts need to be coordinated to ensure that they reach the people who most need them. Adherence to current recommendations to prevent infertility e. Enhancement of scientific and programmatic capacity by states, territories, and tribal governments may be needed to enable health agencies to build the necessary coalitions and partnerships for translating research into public health programs, practices, and services for those who are at risk of, or suffering from, infertility.

The implementation of a national plan needs to include a strong communication and public education program, targeting policy makers, providers, and the public. Evidence-based practice guidelines on the prevention, diagnosis, and treatment of infertility and on patient counseling need to be promoted to all health care providers. Appropriate training opportunities and aid materials should be developed and marketed.

Adherence to current recommendations that help prevent infertility e. Evidence-based messages to inform the general public about the frequency, causes, signs, and consequences of infertility need to be disseminated.

The general public needs to be educated on strategies that minimize the risk of infertility. Populations at risk for infertility and poor pregnancy outcomes need to be educated on their reproductive risks and options. Discussions about infertility need to be encouraged to reduce stigma, and appropriate messages should promote attitudes and behavior that facilitate early access to infertility diagnosis and treatment.

Evidence-based recommendations on diagnostic and treatment options for couples and individuals need to be appropriately worded, made accessible, and disseminated. The dissemination of public information on the options for infertility management, including adoption and child-free living, needs to be explored.

The communication program should expedite the dissemination of new research findings to the general public. The feasibility of integrating infertility education into existing national reproductive health education programs needs to be explored. The following is a list of possible aims that a broad coalition of stakeholders should consider in developing a national plan:. Whereas public health agencies like the CDC and state and local health departments may respond to the challenges outlined above, developing a coherent national plan requires a broader range of stakeholders to set priorities and identify the resources necessary to make the plan effective.

The CDC may play a role in facilitating the development of a national action plan, but ultimately it will be a broad coalition of interests that will own and implement the plan. Collaborative partnerships enable the CDC to tap into outside knowledge and expertise, address challenging public policy issues, and reach new populations.

In the area of infertility, the potential partners of the CDC include other federal agencies, the scientific community, the health care community, insurance providers, employers, industry, advocacy groups, the general public, and of course, people who are coping with infertility. A coalition of public and private sector organizations working together needs to identify opportunities and set priorities for reducing the burden of infertility in the United States.

The development of a comprehensive plan requires a coordinated, multidisciplinary approach to address infertility, from primary prevention to treatment and support. Successful strategies to define and reach target groups such as individuals at risk of developing infertility, or infertile patients require the development and promotion of improved protocols, guidelines, and evidence-based practices, as well as rigorous evaluation of demonstration projects.

It is incumbent upon policy makers, program planners, and consumers facing infertility to ensure the translation and application of research findings and population-based implementation of best practices nationwide.

Further development of public health and clinical interventions demands a partnership between public and private entities. The CDC will strengthen its effort to address infertility by engaging other federal agencies, professional and consumer organizations, industry, and the community at large in the development of a national public health plan for the prevention, detection, and management of infertility. The findings and recommendations contained in this article can serve as a platform to stimulate discussion.

The national plan will identify public health priorities and recommend integration of existing programs and initiatives, as well as creation of new programs as deemed necessary. It will also outline plans for promoting the necessary changes in law and policies, in public health surveillance and research, and in the organization and financing of public health programs and health care systems.

As a first step, the CDC invited potential partners from the public, private, and nonprofit arenas to participate in a Public Health Symposium on Infertility held in Atlanta on September 15—16, About 60 individuals from federal agencies, organizations representing local public health agencies, professional organizations, consumer organizations and other NGOs attended the meeting.

The symposium ended with a collective intent to continue the conversation, form working groups on specific topics, and develop a draft national action plan. The National Center for Birth Defects and Developmental Disabilities studies the links between infertility treatment and birth defects in the National Birth Defects Prevention Study , infertility treatment and neurodevelopmental outcomes using registry data from Denmark , and infertility treatment and autism through the Study to Explore Early Development.

The National Center for Chronic Disease Prevention and Health Promotion maintains the National ART Surveillance System and publishes the Annual ART Success Rates Report ; maintains the Pregnancy Risk Assessment Monitoring System , which collects state-specific, population-based data on maternal attitudes and experiences before, during, and shortly after pregnancy; collaborates with state health departments in the evaluation of adverse outcomes of ART; and conducts research on the effectiveness and safety of ART and on the link between infertility and chronic disease.

It also implements the National Action Plan for Cancer Survivorship: Advancing Public Health Strategies , which specifically mentions infertility as a concern of cancer survivors, and recognizes the need for fertility preservation in this group. The National Center for Environmental Health also improves the technology for laboratory testing of steroid hormones to facilitate research and clinical assessment of conditions leading to infertility, and carries out research on the impact of pesticides, hormonally active agents, and other environmental exposures on reproduction.

The NSFG is the only population-based source of information on the prevalence of infertility and receipt of infertility services other than ART. The revision of the birth certificate includes questions on infertility treatment in the risk factors section.

As of today, 19 states have incorporated these questions in their birth certificate. In addition, the Center supports prevention of gonorrhea, another important cause of PID, develops and publishes guidelines that identify the most effective STD treatments, monitors rates of these PID-causing infections, and facilitates treatment of sexual partners exposed to infection.

The National Institute of Occupational Safety and Health has developed and implements the National Occupational Research Agenda, which includes a reproductive health component and carries out specific research on workplace hazards that may have effects on reproduction, including studies on cohorts of employees exposed to specific chemicals boron, phthalates, Bisphenol-A, 1- and 2-bromopropane, methoxychlor, pesticides and studies on the reproductive health of working men and women.

The National Institute of Occupational Safety and Health also participates in the National Birth Defects Prevention Study, which studies the link between parental exposure and child outcomes. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. We also assumed that the number and distribution of term and preterm live-born infants were the same for ART and non-ART infertility treatment and applied the total medical care costs during the first 5 years of life associated with preterm and non-preterm live-born children estimated by the Institute of Medicine 40 Centers for Disease Control and Prevention.

The assisted reproductive technology success rates report. Accessed October 10, Skip directly to site content Skip directly to page options Skip directly to A-Z link.

Reproductive Health. A few days after fertilization, one or more embryos are placed in the uterus through the vagina. Healthy embryos that are not transferred may be frozen and stored. There is an increased risk of multiple pregnancy with IVF.

Several things can be done to help prevent multiple pregnancy. If test results suggest that too many eggs are developing, the shot that triggers ovulation may be delayed or not given. Your specialist also may limit the number of embryos transferred to your uterus.

Infertility treatment takes time, and it can have high costs. It takes a big commitment from both partners. Some treatments are expensive and may not be covered by insurance. This may include handling eggs and sperm or embryos. Embryo : The stage of development that starts at fertilization joining of an egg and sperm and lasts up to 8 weeks. Endometriosis : A condition in which tissue that lines the uterus is found outside of the uterus, usually on the ovaries, fallopian tubes, and other pelvic structures.

Fallopian Tubes : Tubes through which an egg travels from the ovary to the uterus. Fibroids : Growths that form in the muscle of the uterus. Fibroids usually are noncancerous. Hormones : Substances made in the body that control the function of cells or organs.

Infertility : The inability to get pregnant after 1 year of having regular sexual intercourse without the use of birth control. A menstrual cycle is defined as the first day of menstrual bleeding of one cycle to the first day of menstrual bleeding of the next cycle.

Ovarian Hyperstimulation Syndrome : A condition caused by overstimulation of the ovaries that may cause painful swelling of the ovaries and fluid in the abdomen. Ovaries: Organs in women that contain the eggs necessary to get pregnant and make important hormones, such as estrogen, progesterone, and testosterone. Pituitary Gland : A gland located near the brain that controls growth and other changes in the body. Reproductive Endocrinologist : An obstetrician—gynecologist with special training to manage disorders related to hormones of the reproductive system.

These specialists also treat infertility. Sexual Intercourse : The act of the penis of the male entering the vagina of the female. Testicles : Paired male organs that make sperm and the male sex hormone testosterone. Thyroid Gland : A butterfly-shaped gland located at the base of the neck in front of the windpipe. Ultrasound Exam : A test in which sound waves are used to examine inner parts of the body. During pregnancy, ultrasound can be used to check the fetus. Urologist : A physician who specializes in treating problems of the kidneys, bladder, and male reproductive system.

Uterus : A muscular organ in the female pelvis. During pregnancy, this organ holds and nourishes the fetus. Vagina : A tube-like structure surrounded by muscles. The vagina leads from the uterus to the outside of the body.

Copyright by the American College of Obstetricians and Gynecologists. All rights reserved. Read copyright and permissions information. This information is designed as an educational aid for the public. It offers current information and opinions related to women's health. It is not intended as a statement of the standard of care. It does not explain all of the proper treatments or methods of care. It is not a substitute for the advice of a physician. Other factors that may affect fertility include: Age Lifestyle Health conditions Sometimes no cause is found.

This is called unexplained infertility.