A guide to alternative infertility options

Infertility is a complex diagnosis that can have a range of causes spanning genetics, health conditions, lifestyle and so much more. As one of the most well-known fertility treatments, IVF is often seen as the first solution to infertility. However, it’s far from a one-size-fits-all treatment. In fact, research has shown that many overestimate IVF’s success rate, while underestimating the time and energy required for this invasive treatment.  

Here to help is Anna Sane, co-founder and CEO/CMO at Tilly, to offer insight into alternative treatments for infertility, IVF “add-on treatments” and how to have a constructive dialogue with your healthcare provider to ensure that you find your ideal treatment. 

Ovulation issues are the most common female factor leading to difficulties with conceiving. This can be caused by a range of underlying conditions like PCOS, hypothalamic amenorrhea, thyroid issues or POI, amongst others, which create hormonal imbalances that disrupt ovulation.

When there are ovulation issues at play, many clinics recommend ovulation stimulation, sometimes in combination with intrauterine insemination (IUI), before moving on to IVF, which is much more invasive. This treatment could be a substitute to IVF, but most clinics recommend only trying it a maximum of three times before moving on to IVF. 

Before trying medical treatments altogether, it may however also be possible to stabilise ovulation with lifestyle changes (assuming you know the underlying cause, and that this option is relevant for your condition). But lifestyle changes may require some time to set in, and it’s usually difficult to establish a fixed time frame. This leaves many people who have already been trying to conceive for a while feeling stressed, and they often prefer to turn to IVF straight away as a result.

It’s important to remember, however, that hormonal imbalances create side effects other than making conception difficult, so treating the underlying cause will likely be beneficial for your overall health in the long run. It’s frustrating that many women live with irregular cycles and unwanted side effects caused by conditions like PCOS or hypothalamic amenorrhea for years, but are not diagnosed until they want a baby, which leaves little to no time for proactivity.  

If a semen analysis shows issues with sperm quality, lifestyle changes could help to improve chances and sometimes even avoid IVF. There are, of course, cases where people should go straight to IVF, and you need to talk to your doctor about your specific case. However, men constantly produce new sperm, unlike women, who are born with a lifetime supply of eggs.

This means lifestyle adjustments can make a big impact relatively quickly, as new sperm develops in about three months. Whatever options you’re exploring, ensure they are evidence-based, and talk to your doctor about the pros and cons for your specific situation. 

Unfortunately, there are many reasons IVF might not work, and many solutions and alternatives to treat infertility, so there is no answer that is one-size-fits-all. 

To run through one scenario of hundreds, if not thousands—egg or sperm issues are common. They often stem from a lack of eggs or sperm, or very low egg or sperm quality. In these cases, using donor eggs and/or sperm is generally recommended after several failed IVF cycles. While it can seem like a simple solution, it is challenging for many prospective parents to wrap their heads around, and often requires an acceptance process. Within this context, and many others, the difficult question becomes: “When is it time to look into donated cells?” or “How many rounds of IVF should I do before I move on?”

Unfortunately, there is no straightforward answer to these questions, especially considering that very few patients will get a 0% chance of success via IVF, so theoretically, the next round could always be “the one” that succeeds—and that can weigh heavily on many prospective parents.

Ultimately, if you’re considering donor cells, it’s important to scrutinise both your statistical chance of success, as well as how long it may take, and the emotional toll that the treatment has on you. Don’t hesitate to explore these options with a therapist, and confide in your support network if you need a compassionate audience to help you work through your options. Online communities, like Tilly’s, can help you hear about others who have had similar experiences, and what worked for them, too.  

Whichever add-on treatment you’re considering, it’s important to ensure you know how to explore which option is right for you. Asking comprehensive questions is a good place to start, even if it feels tedious. To help you get started, here’s a checklist from Tilly’s app that we encourage users to turn to before their next doctor’s appointment to help them go in with the right headspace: 

Anna Sane is co-founder and CEO/CMO at Tilly (www.mytilly.co), the first AI-led fertility app offering personalised and evidence-based support for all pain points across the conception journey