Medical Ways of Having a Child: Understanding Your Fertility Options

For some couples, pregnancy may be possible without fertility treatment. A healthcare professional may provide information about the menstrual cycle, ovulation and the fertile period so that sexual intercourse can be appropriately timed.

This may be particularly relevant when there is no identified fertility problem and pregnancy has simply not yet occurred. WHO recognises fertility care as encompassing prevention, diagnosis and treatment and supports evidence-based approaches to fertility care.

Sometimes the most appropriate approach is to identify and treat an underlying medical problem affecting fertility. Depending on the diagnosis, treatment may address conditions affecting ovulation, the reproductive organs, hormones, sperm production or other factors affecting conception. Treating an underlying condition may sometimes restore the possibility of natural conception or improve the effectiveness of subsequent fertility treatment.

The cause of infertility cannot always be determined without appropriate assessment. WHO notes that infertility can arise from male, female or unexplained factors.

Some women do not ovulate regularly or do not ovulate at all. Where appropriate, a fertility specialist may prescribe medicines to stimulate or regulate ovulation.

Ovulation-induction treatment should be medically supervised because the choice and dose of medication depend on the individual's diagnosis and circumstances. Treatment may also require monitoring to reduce the risk of complications, including excessive ovarian response and multiple pregnancy.

The appropriate treatment should therefore be determined following clinical assessment rather than by using fertility medicines without professional guidance.

Some reproductive conditions can be treated surgically when surgery is medically indicated. Depending on the diagnosis, surgery may be considered for conditions affecting the fallopian tubes, uterus, ovaries or other reproductive structures. For men, certain conditions affecting the reproductive system may also be amenable to surgical treatment.

Surgery is not automatically appropriate for every fertility problem. A qualified clinician should determine whether the potential benefits outweigh the risks.

Intrauterine insemination, commonly called IUI, involves preparing sperm and placing it inside the uterus around the time of ovulation.

IUI may be considered in selected circumstances, depending on the cause of infertility and the clinical assessment. It may be performed with or without medicines that stimulate ovulation, depending on the individual situation. WHO's infertility guideline includes medically assisted reproduction among the evidence-based options that may be considered according to an individual's circumstances.

In-vitro fertilisation, commonly called IVF, is an assisted reproductive treatment in which eggs are collected from the ovaries and fertilised with sperm outside the body in a laboratory. An embryo resulting from fertilisation may subsequently be transferred into the uterus.

IVF can be considered for several causes of infertility, including some forms of tubal disease and situations where other treatments have not been successful or are not appropriate.

WHO identifies IVF and other forms of medically assisted reproduction as established components of fertility care. WHO also notes that assisted reproductive technologies have resulted in millions of births worldwide, although access remains limited in many countries.

Intracytoplasmic sperm injection, or ICSI, is a specialised laboratory procedure generally performed as part of IVF. In ICSI, a single sperm is injected directly into an egg in an attempt to achieve fertilisation.

It may be considered in selected cases, particularly where there are significant male-factor fertility problems or previous difficulties with fertilisation. The decision to use ICSI should be based on clinical assessment rather than the assumption that it is necessary for everyone undergoing IVF. The choice between conventional IVF and ICSI is a clinical decision that should be made by an appropriately qualified fertility team.

In circumstances where a person or couple cannot achieve pregnancy using sperm from the intended male partner, donor sperm may be considered where clinically, ethically and legally appropriate.

This is a specialised area of reproductive medicine requiring appropriate counselling, screening and professional oversight. The availability and regulation of donor reproduction can differ between countries and healthcare facilities. Individuals considering donor reproduction should obtain appropriate medical, ethical and legal information before proceeding.

When a woman cannot use her own eggs or when the use of donor eggs is medically considered appropriate, treatment using donated eggs may be an option in some fertility programmes.

Typically, donor eggs are fertilised with sperm and the resulting embryo is transferred to the uterus of the intended mother or, where applicable and legally permitted, a gestational carrier. The suitability of donor eggs depends on individual medical circumstances and should be assessed by a qualified fertility professional.

In some jurisdictions and fertility programmes, embryos created from donated eggs and sperm may be available for transfer to an individual or couple who cannot or choose not to use their own gametes.

However, this option involves important medical, ethical, legal and regulatory considerations. Its availability and acceptability vary between countries and fertility centres. Anyone considering this option should obtain appropriate medical and legal advice concerning the applicable regulations.

Some people may choose to preserve eggs, sperm or embryos for possible future reproductive use. Fertility preservation may be particularly relevant when a medical condition or treatment may affect future fertility, or when a person wishes to consider reproductive options at a later time.

The suitability, timing, potential benefits, limitations, risks and costs should be discussed with a qualified fertility professional.

In some countries and under specific legal and medical arrangements, a gestational carrier may carry a pregnancy on behalf of another individual or couple.

This is a complex area involving medical, ethical and legal considerations. Anyone considering this option should obtain appropriate professional and legal advice and should not assume that arrangements permitted in another country are automatically permitted or recognised in Nigeria.

There is no single fertility treatment that is suitable for everyone. Infertility can arise from male factors, female factors, combined factors or unexplained causes. WHO's 2025 guideline provides evidence-based recommendations for the prevention, diagnosis and treatment of infertility and supports a person-centred approach to fertility care.

For this reason, individuals or couples experiencing difficulty conceiving should consider consultation with a qualified medical professional rather than selecting medicines, procedures or unproven remedies based solely on advertisements, social media, testimonials or advice from unqualified persons.

The Medical and Dental Council of Nigeria (MDCN) has responsibility for professional standards and conduct in medical and dental practice in Nigeria. Its 2025 guidance on social media and responsible online conduct emphasises honesty, accuracy, transparency and evidence-based communication.

Fertility treatment can provide options, but no responsible healthcare professional should guarantee that a particular treatment will result in a pregnancy or live birth. The appropriate treatment depends on individual medical findings.

WHO also highlights that fertility care should be evidence-based, people-centred and accessible, while recognising that access to trained personnel, appropriate equipment and affordable treatment remains a challenge in many countries.

While assisted reproductive technologies such as IVF have helped millions of people have children, they are not appropriate or successful for everyone. A fertility professional should assess the individual or couple and discuss the potential benefits, limitations, risks and alternatives of available treatment options.