Treatment for infertility will depend on the cause found but can include ovulation induction (clomiphene tablets), artificial insemination or assisted conception via in vitro fertilisation (IVF) or intra-cytoplasmic sperm injection (ICSI). Sometimes men require a testicular biopsy (TESE) to bypass obstructive causes such as previous vasectomy. For some couples egg or sperm donation is required. Cycle monitoring can be arranged.
Mild to moderate endometriosis, ovarian cysts or blocked Fallopian tubes are often dealt with via laparoscopic (keyhole) surgery. If very extensive, sometimes a bowel Surgeon and Urologist are required to be in attendance.
For period related issues, sometimes tablets taken at the correct times of the month are all that is required. For some, a Mirena coil (progesterone releasing) is the treatment of choice, whereas for other women endometrial ablation or hysteroscopic resection works well. Finally hysterectomy more definitively stops periods.
For PCOS, treatments will depend on the individual on where they are in life.
Fibroids can be shrunk with injections, removed hysteroscopically (if in the uterine cavity), myomectomy or via hysterectomy. They can also be shrunk via uterine artery embolisation. Management of symptomatic fibroids will depend on the individual.
The treatment of the menopause had been via the use of HRT (hormone replacement therapy) until recent data suggested increased links to breast cancer and other diseases if taken long term. Individualised specialist advice will be given to the woman on this subject.
PMT can be supported with hormones, antidepressants or psychological support.
Recurrent miscarriage management will depend of any cause found and may involve anti-coagulants. Occasionally uterine surgery may be warranted. For most, supportive care with regular ultrasound reassurance scans will be of benefit.