Question: How is infertility treated? I have heard about IVF, but what are GIFTs and all the other funny terms? What do they do for infertile men?
In the male, hormone supplements, storage and concentration of sperm (artificial insemination by husband—AIH), or fertilization by donor sperm (artificial insemination by donor—AID) can be tried. In the woman, fertility drugs can be used to promote ovulation (eg. clomiphene), other drugs may be used to treat endometriosis, or antibiotics may be needed to treat infections. If there is an anatomical abnormality, it may be correctable by surgery.
As a last resort, a very small number of couples may be considered suitable for IVF (in-vitro fertilization or ‘test-tube babies’), or GIFT (gamete intra-Fallopian transfer). GIFT involves giving ovulation-stimulating (egg-producing) hormones to an infertile woman, then harvesting an egg directly from her ovary using a laparoscope, and transferring this unfertilized egg along with sperm from her partner, directly into her Fallopian tube. This is done by using a very fine instrument that passes through her cervix and uterus to the internal opening of a Fallopian tube. If necessary the sperm or egg may be donated by another man or woman.
Most infertility treatment is carried out in private clinics and hospitals, and Medicare benefits for these procedures are restricted. Centers in every Australian capital and many major provincial centers now perform both IVF and GIFT. Australia is one of the leading countries in the world with this technology.
The treatment of infertility has progressed by leaps and bounds over the past few years, and the techniques used are at the leading edge of medical technology. New procedures are constantly being introduced and then discarded in favor of yet another improvement, so that it is difficult for even GPs to keep up. Gynecologists who specialize in this area are the best source of information.

Question: How do doctors investigate couples who are infertile?
Doctors start their investigations by checking the couple’s sexual habits. A woman is only fertile for four to six days a month, and if sex is infrequent, it is quite easy to miss these days. The first step in specific testing is a sperm analysis in the man. The sperm from an ejaculation is collected in a sterile container and must be examined in a laboratory within two hours. The number of sperm, their shape and their activity are all checked to ensure that they are adequate to fertilize the woman’s egg. If these tests are normal, it is not usually necessary to perform any further tests on the man.
In a woman, the first step is a temperature chart. This involves marking on a graph the woman’s temperature immediately upon waking every morning, the days of the period or other bleeding, and the days when intercourse has occurred. From this and a blood test, a doctor can often see problems with ovulation. There is normally a rise in temperature for the second half of the cycle after the egg has been released from the ovary.
After these simple tests, investigations become more complex. It is necessary to exclude any blockage in the tubes leading from the ovary to the womb, and to assess the woman’s hormonal and biochemical function by a series of blood tests. A careful gynecological examination is performed, and this may be followed by special X-rays or ultrasound scans that outline the uterus (womb) and tubes. The final stage of investigation is an operation called a laparoscopy, in which a small tube is poked through a cut in the lower part of the abdomen. To prevent scarring, the navel is often used for this purpose. Through this tube the doctor can directly examine the female reproductive organs to detect any problems.
Please be assured that although these investigations may not sound very nice, you should suffer no more than discomfort and some indignity, as appropriate anesthetics are given for the more invasive procedures.