Medicine or hormone treatments are often the first steps in fertility treatment. They're also used for in vitro fertilization (IVF) and other assisted reproductive technologies. Medicines include: 

• Clomiphene and letrozole. These stimulate the release of hormones that help with ovulation. 

• Gonadotropins. These hormone shots stimulate the ovaries to produce mature eggs. 

• Treatment for polycystic ovary syndrome (PCOS). If you're not ovulating because of PCOS, your doctor might recommend a drug such as metformin along with clomiphene. 

• Gonadotropin-releasing hormone (GnRH). It increases production of hormones needed to produce eggs and sperm. 

• Bromocriptine and cabergoline. These lower prolactin levels. High prolactin levels can prevent ovulation and sperm production. 

• GnRH analogue. This is used for IVF. 

Infertility treatment is a success if it results in the birth of a healthy baby. Many things affect your chances of conceiving and carrying a healthy pregnancy, with or without treatment. Major ones include: 

Your age and how long you've been trying to conceive: Your age (and the age of your egg supply) has a big impact on your chances of getting pregnant and having a healthy baby. From your mid-30s into your 40s, your chance of pregnancy with your own eggs decreases, and your risk of miscarriage increases. 

The cause of infertility: 

• Ovulation problems (except those related to age) are the most successfully treated cause of infertility. But problems with the fallopian tubes can be harder to treat. 

• The success of treating other causes depends on the type of problem and how severe it is. 

Some people complete many cycles of infertility treatment before they conceive or decide that treatment has failed. Before you start treatment, talk to your doctor and decide how much time and money you are willing to spend. 

For some people with fertility problems, a structural problem can be treated with surgery. Treatment can increase the chances of natural conception.

When thinking about surgery, ask your doctor questions about the procedure. For example, how many times has the surgeon done the procedure? What are the chances of treatment success? How long will it take to recover? 

Surgery may include: 

• Fallopian tube procedures. This includes sterilization reversal. 

• Laparoscopic surgery. This may help treat endometriosis. 

• Myomectomy. This may help treat uterine fibroids. 

• Laparoscopic ovarian drilling. This may be used when weight loss and medicine haven't stimulated ovulation in people who have polycystic ovary syndrome (PCOS). 

• Varicocele repair. This is used to cut or bypass an enlarged vein in the scrotum. 

• Vasectomy reversal. This reconnects the tubes (vas deferens) that were cut during a vasectomy. 

If you have severely blocked fallopian tubes, your doctor may recommend that you skip surgery and have in vitro fertilization (IVF). You might also choose IVF first if you are older than 34 (for any type of blockage) or if you want to get pregnant as soon as possible, at any age. You may be able to get pregnant sooner if you choose IVF than if you have surgery. 

Sometimes infertility is related to lifestyle or other health conditions. To help protect your fertility: 

• Avoid using tobacco (cigarettes) and marijuana. 

• Avoid exposure to harmful chemicals. 

• Avoid excessive alcohol use. 

• Limit sex partners and use condoms to reduce the risk of getting a sexually transmitted infection (STI). Untreated STIs can damage the reproductive system and cause infertility. If you think you may have an STI, get treatment right away to reduce the risk of damage. 

• Stay at a body weight that's close to the ideal for your height. It will reduce the chance of hormone imbalances. 

If you have been diagnosed with cancer and hope to have children in the future, talk to your doctor about your options to help preserve fertility. 

Complementary medicine may help you stay well and cope with infertility. Complementary medicine for fertility includes: 

• Acupuncture. 

• Dietary changes. 

• Relaxation techniques. 

• Mind-body medicine. 

Talk with your doctor about any complementary health practice that you would like to try or are already using. Your doctor can help you manage your health better if they know about all of your health practices. 

For your first fertility questions and testing, you can see: 

• A family medicine physician. 

• An internist. 

• A nurse practitioner (NP). 

For complete fertility testing, see an obstetrician/gynecologist with special training and experience in fertility problems. This doctor may be called a reproductive endocrinologist or fertility specialist. When looking for a specialist, ask what percentage of a doctor's practice is fertility treatment. Also ask if the doctor has training in reproductive endocrinology.