What Solo Moms-To-Be Should Know About Fertility Treatments

Illustrated by Twisha Patni
The decision to become a parent is a huge one (understatement!), and the process of becoming pregnant can feel totally mystifying and overwhelming, especially if you’re doing it on your own. Where do you start? How does it work? What do you need to know about your health and your child’s health before the baby is even born?
Solo parenting may still be stigmatized, but the truth is that a third of children in the United States are living with unmarried or solo parents, a rate that has more than doubled since 1968. And while the prospect of having a kid on your own may sound intimidating, with the right support network, including family, friends, and medical professionals who can help ease you through the process of becoming a mother, there’s absolutely no reason to panic. That’s why we tapped reproductive expert Dr. Nicole Noyes, MD, System Chief for Reproductive Endocrinology and Infertility and Director of Fertility Preservation at Northwell Health, to shed light on everything solo moms need to know before starting fertility treatments. 
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What are the options?

For women trying to get pregnant on their own, the most common fertility treatments are intrauterine insemination (IUI), a non-invasive procedure wherein donor sperm is placed in the uterus while a woman is ovulating, and in vitro fertilization (IVF), which involves removal and fertilization of a woman’s eggs via donor sperm, followed by embryo transfer into her uterus. The goal of fertility treatment is to expedite the pregnancy process, from the time a patient wants to become pregnant to the actual pregnancy, and doctors will help determine which method is best based on a variety of factors (age, medical history, and more). 
During IUI, ovulating patients will be inseminated via a small, flexible tube that reaches through the cervix to the uterus, with the goal fertilizing an egg. No anesthesia is necessary, and the non-surgical process is typically quick — under 10 minutes long. "IUI treatment is often used in combination with fertility drug administration (gonadotropins) that work to increase the number of eggs that are released in a given cycle," says Dr. Noyes, but depending on natural ovulation, IUI candidates may not need pills or hormone shots before insemination.
IVF candidates — that is, patients who have not conceived naturally or via IUI (or those over 36) — will take hormone shots every day for about 10 days, and will be monitored along the way with ultrasounds and blood tests “to see how many eggs are developing and how big they are,” Dr. Noyes explains. Once the eggs are deemed ready, they’re removed from the ovaries with a needle, and the patient is sedated so she doesn't feel the minor surgery. The procedure takes about three to five minutes. After the eggs are removed, they’re mixed or injected with sperm and cultured in an incubator for five days. Then they’re inspected under a microscope and subjected to a screening in which doctors will select the best quality embryos.
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From there, patients have options: The embryos can be frozen and implanted at a later date, or they can be used to impregnate the patient the next time she ovulates. 

How do you pick the donor sperm? 

On a personal level, solo moms may have specific qualities they want in a sperm donor — tall or a certain blood type — but medically, Dr. Noyes says the most important thing is to steer away from donor sperm that may carry diseases, and the best way to do that is to use a sperm bank. “Most banks test for genetic diseases now, so you’ll know if a donor has a risk of something like cystic fibrosis, and you can steer away from the risk,” she says. 
The era of at-home DNA tests has pretty much obliterated the concept of an anonymous donor, but whether or not you know whose sperm will be fertilizing your egg, Dr. Noyes stresses the importance of medical testing. If a male friend is donating, a sperm bank will quarantine his sperm for six months, ensure they are tested for infectious illnesses, and retest before the sperm is released. 
If you’re going the anonymous route, keep in mind that “some banks have better quality sperm than others,” Dr. Noyes says. While there’s minimum criteria donors have to meet, some banks guarantee certain higher qualities. 

When should solo moms-to-be start the fertility-treatment process?

Start your fertility-treatment process at least four months before you want to get pregnant, Dr. Noyes recommends. This will not only give you enough mental time to absorb what you’ll need to do to prepare your body for pregnancy, but also afford you time for exams on your fallopian tubes, necessary bloodwork, and a preconception consult with an obstetrician, if necessary. Again, securing sperm can also be a lengthy process. 
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This seems expensive…

“Sperm is expensive,” Dr. Noyes confirms. In fact, it can cost hundreds of dollars each time you try to get pregnant — and Dr. Noyes says it takes an average of five months with your natural cycle to become pregnant. Health insurance sometimes covers fertility treatments like ovulation monitoring and insemination, though out-of-pocket payments can start at $300 and up. At the end of the day, “it’s a lot of compromise, but the rewards are so worthwhile,” Dr. Noyes says.
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