Fertility treatments explained: a guide to common options

Fertility care is personal. Your team will consider test results, how long you’ve been trying, age and health history, and your preferences and values. Assessment usually includes both partners, such as hormone tests and imaging for the person trying to conceive, and a semen analysis for the partner providing sperm, so your plan reflects the full picture. Your clinicians will also weigh time sensitive factors alongside what feels right for you.

Typically, you’ll start with an assessment and a discussion of options. Ask your clinic to outline the steps and timelines in plain language and, if helpful, to send written summaries after appointments. Useful questions include: “What are the likely next steps and how long might each take?” and “How will we review progress and adjust if needed?”

Some people start with medicines that stimulate or regulate ovulation. These are prescribed and monitored by a clinician, with check ins (often blood tests and ultrasound) to see how your body responds over one or more cycles. The aim is to improve the timing and quality of ovulation so sperm and egg can meet naturally or with a simple procedure.

Ovulation supporting medicines are commonly considered when ovulation is irregular or absent (for example, in some cases of polycystic ovary syndrome). They may also be used when timing is the main concern and a less invasive option is preferred. Helpful questions are: “How many cycles do we usually try before reviewing the plan?” and “Who should I contact between visits if I have concerns?”

IUI places prepared sperm into the uterus around ovulation to increase the chance of fertilisation. It typically involves cycle tracking, a short clinic procedure, and may be repeated across several cycles. IUI is sometimes combined with medicines to support ovulation, depending on your circumstances.

IUI is often considered when there are mild sperm factors, challenges with timing or cervical mucus, when using donor sperm, or for unexplained infertility as a step before more complex treatments. You might ask: “How many IUI cycles do you usually recommend in a situation like mine?” and “What are your outcome measures and how do you calculate success rates?” If you experience unexpected or severe symptoms after a procedure, contact your clinic promptly.

IVF involves stimulating the ovaries, retrieving eggs, fertilising them in a lab, and transferring one or more embryos into the uterus. Intracytoplasmic sperm injection (ICSI) is a related method where a single sperm is injected into an egg, often used when there are significant sperm related factors. Frozen embryo transfer (FET) uses embryos from a previous IVF cycle. In some cases, genetic testing of embryos (often called PGT) may be discussed so you and your team have more information before transfer.

IVF (and ICSI/FET) is commonly considered when less invasive options haven’t led to pregnancy; when tubes are blocked or damaged; when there are notable sperm factors (often with ICSI); with some endometriosis presentations; or when embryo testing is being considered. Questions to consider: “What are the clinic’s success rates for people my age and in my situation?” “How do you reduce the chance of multiple pregnancy and monitor for side effects?” and “What support is available during the ‘two week wait’?” If you notice severe pain, swelling, breathing changes, or other worrying symptoms after stimulation or retrieval, contact your clinic urgently.

Donor pathways may use donor sperm or donor eggs, or in some cases embryo donation. In some countries, surrogacy or gestational carrier arrangements are available and involve coordinated medical and legal steps. Most programmes include counselling and consent, and legal requirements vary by country.

These options are often considered when sperm or egg quality is a limiting factor, when there’s a high risk of passing on certain genetic conditions, for single parents by choice, or for LGBTQ+ couples. Surrogacy may be discussed when carrying a pregnancy isn’t possible or advised. You could ask: “What screening, counselling, and legal processes apply here?” and “Which parts of the pathway are clinic led versus legal.”

In some cases, surgery can improve the reproductive environment. Common examples include removing uterine polyps or fibroids that distort the uterine cavity, treating endometriosis, addressing adhesions, or evaluating and treating certain tubal issues. In some situations of severe male factor infertility, procedures to retrieve sperm for use with ICSI may be discussed. Surgery isn’t always necessary and doesn’t guarantee pregnancy; your clinician will discuss likely benefits and alternatives.

Surgical approaches are usually considered when imaging or symptoms suggest a structural issue that could affect implantation or fertility. Questions to ask include: “What is the purpose of this procedure and what outcomes should we look for?” “What is the recovery time and how will this affect my timeline?” and “What follow up will I need?” If you experience unexpected or severe symptoms after a procedure, contact your clinic promptly.

Fertility preservation means freezing eggs, sperm, or embryos for possible future use. It typically involves testing, retrieval or collection, and storage arrangements. People choose preservation for many reasons, including before medical treatments that could affect fertility, or when they plan to try for a pregnancy later. The timing can be important, and your team will help plan the steps so decisions aren’t rushed.

Preservation is commonly considered ahead of treatments that may impact fertility (for example, some cancer therapies), when delaying parenthood for personal or medical reasons, or before certain gender affirming treatments. Helpful questions are: “What’s the timeline from testing to collection?” “How long are samples stored and how are they managed?” and “What are the options for future use?”

Coverage for fertility and fertility preservation treatments varies by plan; please check your Table of Benefits or contact us to confirm what’s included. This guide is for general information and does not replace medical advice. Decisions about fertility and cancer treatment are personal and should be made with your oncology and fertility teams. Availability, timelines, and success rates vary by diagnosis, age, treatment plan, and local resources. If pregnancy is not advised during treatment, use reliable contraception and ask your team when it’s safe to reconsider. Services and coverage vary by plan and country—please contact Allianz Partners Member Services for individualized guidance.