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Having trouble getting pregnant?

Allina Health OB/GYN explains infertility treatment

Dr. McNelis goes over a patient's chart with her. They are seated in a clinic exam room, next to a computer.

Michael McNelis, MD, sees patients at Allina Health clinic locations in Buffalo, Cokato and St. Michael.

Tips to avoid fertility problems

Basic good health habits can make it easier for you to become pregnant when you are ready. These tips are for both men and women:

  • Don't smoke.
  • Limit use of alcohol
  • Maintain a healthy body weight
  • Eat a diet of whole, healthy foods
  • Exercise and keep your body fit
  • Carefully control any health conditions like diabetes, high blood pressure or thyroid problems
  • Avoid sexually transmitted diseases (STDs) by practicing safe sex. If you have STD symptoms, immediately get treatment.

Allina Health clinics

Experts at these locations offer fertility assessments and infertility treatments.

Insurance and infertility treatments

Although infertility treatments are usually not covered by insurance, the initial workup is covered by some companies.

Couples should check their health plan coverage for infertility treatment.

Baby showers, a friend announcing her pregnancy, or playground full of kids are happy occasions for most. But they can be heartbreaking for a woman who wants desperately to have a baby but doesn't become pregnant.

More than 10 percent of couples have problems becoming or staying pregnant after trying for a year. The percentage is as high as 33 percent for women over 35 and increases with age.

"There is hope. Most couples are able to have a child," says Michael McNelis, MD, obstetrician / gynecologist (OB/GYN) at the Allina Health clinics. "Some are 'sub fertile,' but it's not impossible. They just need a little help, and good treatments are available."

Couples may have all kinds of fear about treatment for low fertility – pain, expense, frustration, disappointment, multiple births.

"It can be challenging. You have to be ready, body and soul," says McNelis. "But in my experience, we have been able to minimize pain, make the best decisions for a couple's preferences and finances and minimize the chance of multiples."

Treating infertility, step by step

When a couple comes to McNelis for help, his first step is an appointment with both of them.

"It's a heart-to-heart talk where I get both the medical background and personal information about the couple. It's important to be open and honest, and we talk about all medical issues, since many medical conditions like diabetes, high blood pressure and thyroid problems and medications can affect your ability to become pregnant," explains McNelis.

They talk about infertility, and McNelis answers any questions.

The next step is to determine what is causing the difficulty. Put simply, to become pregnant, you need a healthy egg, healthy sperm and a clear tract for them to get together, says McNelis.

A semen sample is taken and sent to a special lab for analysis. If there are problems with sperm count or characteristics, the man may be referred to a urologist. The woman will usually have a simple X-ray study with a liquid introduced into the uterus to determine whether the fallopian tubes are clear.

"This may cause cramping in five to 10 percent of patients, but I've never had a woman shed a tear," says McNelis. Also, a blood test will determine whether she has normal potential to produce and release an egg.

Then McNelis and the couple review the results and come up with a treatment plan that matches their situation.

Sometimes pills or shots to induce ovulation are the first step. McNelis coaches the couple on the use of ovulation predictor kits to determine the most fertile time to have intercourse.

Intrauterine insemination

McNelis, who has been successfully helping couples with fertility problems for many years, is offering a new procedure. Intrauterine insemination helps by putting the highest quality sperm directly into the uterus where they have a better chance of fertilizing an egg.

McNelis may include the intrauterine insemination treatment in the plan immediately or after several months of trying ovulation-inducing medicines alone. Intrauterine insemination is helpful when there is mild male infertility (low quality or quantity of sperm), a cervical problem or a semen allergy.

For the procedure, the sperm sample is "washed" and the best quality sperm are used. They are inserted into the uterus through a thin catheter at the optimum time in the woman's cycle, which may be induced with medicines. This puts them closer to the waiting eggs, and they don't have to pass through the cervix, which may be long or have fluids that make passage difficult.

Intrauterine insemination is done at the clinic and costs a fraction of in vitro fertilization.

"In vitro fertilization is the most effective method, but costs can be $20,000 or more. Intrauterine insemination gives many couples a good chance to become pregnant at a much lower cost," says McNelis.

When necessary, he refers patients to clinics that do in vitro fertilization.


Source: Healthy Communities Magazine, summer 2012
Reviewed by: Michael McNelis, MD, Allina Health clinics
First Published: 07/06/2012
Last Reviewed: 07/06/2012