Five things need to happen to make a pregnancy possible:
A woman’s ovaries need to produce a high quality egg
That egg needs to be able to mature and be released into the woman’s fallopian tube
That fallopian tube needs to be open at both ends
High quality sperm needs to reach the open fallopian tube to fertilize the egg
The resulting embryo needs to be able to travel out to the uterus and implant in the wall of the uterus
If one of these steps doesn’t unfold and a woman, or couple, has trouble conceiving naturally, there are a lot of options available, but here we’ll mention the 3 most common.
Oral Medications: To start, many women will be given an oral drug like clomid or letrozol and be told to continue to have intercourse during the woman’s “fertile window.” These drugs help signal to the woman’s body to grow and release a mature egg. If someone isn’t ovulating, these drugs can help to make that happen, which is why taking these medications is sometimes referred to as “ovulation induction.”
Intrauterine Insemination or IUI: The next, more intensive, approach, is to undergo artificial insemination, which is also known as intrauterine insemination, or IUI. Basically, this entails injecting sperm directly into the uterus. If a woman takes certain fertility drugs, the costs & rates of success can vary dramatically, as you can see here in our course on the subject.
In Vitro Fertilization or IVF: Finally, the most intensive approach is in vitro fertilization or IVF. Here, eggs are surgically removed, fertilized in a laboratory, and resulting embryos are transferred back into the uterus.
As you can see in the chart below, each of these interventions carries increasingly higher odds of success, but also requires more money and a heavier burden.
In this lesson we cover high-level subjects (e.g. the basics of reproduction) and break down specific issues that pertain to African American patients namely, higher rates of infertility, inadequate referral patterns, variation in IVF success rates, tubal factor, fibroids, miscarriage, lifestyle factors and more