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Options After Fertility Treatments

Last Updated July 2022 | This article was created by familydoctor.org editorial staff and reviewed by Robert "Chuck" Rich, Jr., MD, FAAFP

Infertility can be devastating for people who want to have a baby. After being diagnosed with infertility, many people try fertility treatments. Depending on the cause of the infertility, these can include:

  • Medicines
  • Hormones
  • Surgery
  • Insemination
  • In vitro fertilization (IVF)

Sometimes treatment works and the woman can get pregnant. Other times, even after repeated attempts at treatment, she still can’t get pregnant. This can be a very difficult place to be. But if she still wants to have a baby, there are a few more options.

Path to improved health

If you have tried fertility treatments and they haven’t worked, you may feel like you are all out of options. But if you still want to have a baby, there are few more you may want to consider.

Donor sperm
In some cases, testing reveals that the infertility is caused by problems with the man’s sperm. He may not produce enough, or he may have a genetic disease. Instead of using his sperm, you can use sperm from a donor. This could be from a person you know, or you can get it from a sperm bank.

The sperm can be used with insemination (sperm are placed inside the woman’s uterus or vagina) or with IVF (an egg is fertilized outside the body then implanted in the uterus). If you use donor sperm, the baby will not share genes with the man in the relationship.

Donor eggs
Some women don’t produce healthy eggs that can be fertilized. There are many reasons this can happen. This includes genetic disease or conditions such as primary ovary insufficiency. Despite this, they are physically able to carry a baby. When this happens, they may want to use eggs that are donated by another woman. The process of collecting the eggs and fertilizing them is done the same as with IVF. The baby will not share genes with the female partner in the relationship.

Surrogate or gestational carrier
This is when another woman carries the baby for you. When you and your partner use a surrogate, sperm from the male partner is inserted into another woman. A surrogate can be used when the female partner’s eggs aren’t healthy, or when she can’t carry a baby to term. The baby will not share genes with the female partner.

A gestational carrier is a woman who carries a baby that does not share genes with her. An embryo is implanted in her uterus. The embryo may be the result of the couple’s eggs and sperm, or donor eggs or sperm may be used. A gestational carrier is used when the female partner can’t carry a pregnancy to term. The baby may or may not share genes with the partners in the relationship.

Donor embryo
Sometimes couples who have undergone IVF choose to donate any unused embryos. These frozen embryos are stored, and people who want to can adopt them. The frozen embryo is implanted in the female partner’s uterus, just like in IVF. If using a donor embryo, the baby will not share genes with the male or female partner. This is true even though the female will carry the baby.

Adoption

Some couples who have trouble with infertility decide to adopt a child. People who choose to expand their families through adoption can do so several ways:

  • Public adoption – The child is adopted through the state. These children are often in foster care.
  • Private adoption – You work with a private agency to find a baby or child to adopt. This may be a non-profit or for-profit agency.
  • Independent adoption – The adoption does not go through an agency. It is usually done through individuals who can connect a baby with a family. This could include a doctor, lawyer, or religious leader.

Things to consider

When faced with failed fertility treatments, some couples decide to stop all outside attempts to have a baby. The process of using fertility treatments can be draining physically, emotionally, and financially. Sometimes people stop trying for their own well-being. It is a deeply personal decision.

If you use a third party in your attempts to have a baby, it can introduce complicated legal and emotional issues. It is a good idea to see a lawyer. He or she can help you sort out the legal implications of your choice. A lawyer will make sure you and any donor or carrier are protected.

Questions to ask your doctor

  • If no fertility treatments have worked, what options do I have?
  • Can I use donor sperm or eggs?
  • What are the risks of using donor sperm, eggs, or embryos?
  • How much does it cost?
  • How do I find a person to be a surrogate or gestational carrier?
  • What are the legal implications of using assisted reproductive technology?
  • Do I need to get a lawyer?
  • Where do I start if I want to adopt a baby?
  • Do you think it’s healthy for me or my partner to continue to try to have a baby?

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