Infertility treatments: what to try first and when to see a specialist

Struggling to get pregnant is frustrating and confusing. You want straight answers: what tests to run, which treatments actually work, how much it costs, and how risky it is. This page gives practical steps so you can plan your next move without wasting time or money.

Common medical and procedural options

Start with basic testing: semen analysis for him, blood work (AMH, FSH, day-3 hormones) and ovulation checks for her, and a uterine fallopian tube check (HSG). Many couples find a fix after testing points to a simple problem.

Fertility medications are often the first active step. Letrozole or clomiphene help stimulate ovulation and are cheap and widely used. If those don’t work, injectable gonadotropins boost egg production but carry higher cost and monitoring needs.

IUI (intrauterine insemination) places prepared sperm into the uterus around ovulation. It’s less invasive and cheaper than IVF and makes sense for mild male factor issues, unexplained infertility, or when using donor sperm.

IVF (in vitro fertilization) is the most effective option when tubes are blocked, sperm quality is poor, or other treatments fail. IVF involves ovarian stimulation, egg retrieval, fertilization in the lab, and embryo transfer. ICSI (injecting a single sperm into an egg) is used when sperm issues are severe.

If IVF fails or genetic issues exist, donor eggs, donor sperm, or a gestational carrier are options. Adoption and foster-to-adopt routes are also valid for many families and deserve consideration early in planning.

What to expect: costs, success rates, and choosing a clinic

Costs vary a lot. IUI often runs from a few hundred to about $1,000 per cycle. IVF typically ranges from $7,000 to $20,000+ per cycle depending on testing, medications, and lab work. Add-ons like genetic testing or donor gametes raise the price.

Success depends mainly on age and diagnosis. Approximate IVF live birth rates per cycle: under 35 about 40–50%, 35–37 about 30–40%, 38–40 about 20–30%, and lower after 40. Clinics report different numbers, so compare clinics’ published outcomes not marketing claims.

Risks include multiple pregnancy (from transferring multiple embryos or using fertility drugs), ovarian hyperstimulation syndrome (OHSS) with stimulatory meds, and rare procedure-related complications. Ask the clinic how they manage these risks.

Choose a clinic that publishes clear success data, offers transparent pricing, and has board-certified staff. Ask about lab quality, embryo freezing methods, and patient support services. If insurance coverage is possible, get pre-authorization before starting treatment.

Practical prep: stop smoking, aim for a healthy BMI, control chronic conditions, start prenatal folic acid, and track cycles for a month before testing. See a fertility specialist after 12 months of trying if you’re under 35, or after 6 months if you’re 35 or older—or sooner if you know there’s a problem.

If you want, I can help you compare treatment steps, estimate costs for your area, or prepare a list of questions to take to a clinic visit.