What is assisted reproductive technology (ART)?
Assisted reproductive technologies are medical treatments to overcome infertility; many infertile couples will receive though ART treatments such as medications to correct ovulatory difficulties or surgery to correct anatomical problems. For some couples, the solution may require more involved medical procedures. These are several specialized treatments designed to increase the number of eggs or sperm, or bring them combine together, thus improving the likelihood of pregnancy. ART offers hope to couples who are unable to achieve pregnancy through other approaches.
The most common type of ART is in vitro fertilization; during IVF, eggs and sperm are mixed in a laboratory dish to fertilize, and some of the fertilized eggs (zygotes) are then transferred to the woman's uterus. IVF is fertilization of eggs outside the body under laboratory conditions similar to those inside the body. The procedure is performed with sedation on an outpatient basis. Under the guidance of either laparoscopy or ultrasound, a needle is used to retrieve the maturing eggs from the ovaries. Motile sperm are collected from the man's semen and washed. The sperm and eggs are then combined in culture fluid in small dishes, which are placed in a specialized incubator. This maintains an environment as close as possible to normal body conditions while fertilization occurs. Following fertilization, embryos are observed for cell division. Developing embryos are transferred to the uterus. Extra embryos may be cryopreserved (frozen).
Other types of assisted reproductive technologies include:
Intracytoplasmic sperm injection (ICSI), the injection of a single sperm into an egg. The fertilized egg is then placed in the woman's uterus or fallopian tube. Used with in vitro fertilization, ICSI is often a successful treatment for men with impaired sperm. Intracytoplasmic sperm injection (ICSI) is a technique where a single sperm is injected into the egg by piercing the shell of the egg. ICSI can result in fertilisation rates of 55 to 70% and pregnancy rates ranging from 20 to 35%. This technique can achieve pregnancies even when only a few sperm can be found in the ejaculate. The sperm are collected from the ejaculate of the man or alternatively in lower numbers from the testis from a biopsy. The female partner is given fertility drugs to help to produce a number of eggs that are then removed by surgery. The process of injecting a single sperm into an egg is then carried out.
Gamete intrafallopian transfer (GIFT), which involves collecting eggs from the ovaries, then placing them into a thin, flexible tube with the sperm. This is then injected into the woman's fallopian tubes, where fertilization takes place. Gamete intrafallopian transfer is the placement of sperm and eggs into the fallopian tube. This transfer has generally been done by laparoscopy. The average delivery rate per retrieval for GIFT in 1994 was 28.4%, compared with 21.2% for IVF. Because IVF is less invasive, programs with IVF rates close to, or exceeding, the national average for GIFT are likely.
Zygote intrafallopian transfer (ZIFT), which combines IVF and GIFT. Eggs and sperm are mixed outside of the body. The fertilized eggs (zygotes) are then returned to the fallopian tubes, through which they travel to the uterus. The placement of fertilized oocytes (ZIFT) or cleaving embryos (tubal embryo transfer or TET) into the fallopian tubes allows fertilization to be confirmed, while taking advantage of the tubal environment for part of the early development of the embryo. The success rates for these two procedures should, theoretically, be higher than that of IVF.
Embryo cryopreservation. Cryopreservation (freezing) of fertilized oocytes is a service offered to patients when, as a result of participation in an IVF procedure, more fertilized oocytes are available than our physicians recommend be transferred in the IVF cycle. If the initial IVF attempt does not result in a pregnancy these cryopreserved embryos may be used for future attempts, even after several years, eliminating the need for additional stimulation drugs, egg retrieval and fertilization.
More information on infertility
What is infertility? - Infertility is the inability to achieve and/or maintain pregnancy. Infertility may due to a variety of causes, including abnormal hormonal levels, low sperm production and scarring of the fallopian tubes.
What causes infertility in men? - The most common male infertility factors include azoospermia and oligospermia. In rare cases, infertility in men is caused by a genetic disease such as cystic fibrosis or a chromosomal abnormality.
What causes infertility in women? - The most common female infertility factor is an ovulation disorder. Other causes of female infertility include blocked fallopian tubes. Inability of the fertilized egg to implant in the uterus will lead to female infertility.
What causes infertility? - Causes of infertility include a wide range of physical as well as emotional factors. Infertility can be caused by any interruption in the usual process of fertilization, pregnancy, and birth.
How is infertility diagnosed? - In the male, sperm examination and sperm count is commonly done. In females, the basal body temperature is recorded each morning over several months to find any ovulatory disorders.
What female fertility tests are available? - Blood tests that measure the levels of various hormones. The doctor may want to measure the man's testosterone levels to see if they are high enough. Basal body temperature (BBT) can be measured at home using a special thermometer to help predict the most fertile days.
What male tertility tests are available? - A semen analysis is the most common testing procedure for determining if there is a male infertility factor. Semen analysis is the mainstay of male testing.
What treatments are available to cure infertility? - The ultimate goal of infertility treatment is a healthy pregnancy and the birth of one healthy infant. There are various treatments for infertility, depending what the problem is.
What is assisted reproductive technology (ART)? - Assisted reproductive technologies are medical treatments to overcome infertility. The most common type of ART is in vitro fertilization.
What are the treatments for female infertility? - Assisted reproductive technology (ART) combines the use of fertility drugs - hormonal therapy with artificial insemination using any of a group of techniques. Acupuncture may also be helpful.
What medicines treat female infertility? - Clomiphene triggers the release of FSH and LH, boosting egg growth and helping the ovaries release a monthly egg. Bromocriptine suppresses a hormone called prolactin. LH-RH drugs are used when the pituitary or hypothalamus gland is not producing hormones.
What are the treatments for male infertility? - Low sperm counts can be treated by collecting and concentrating healthy sperm for insemination or assisted reproductive technology (ART) treatment.
How to prevent infertility? - Most types of infertility cannot be prevented. Smoking has been linked to low sperm counts. Alcohol affects the fertility of both men and women. Excessive exercise can lead to menstrual disorders in women and affect sperm production in men.
What is in vitro fertilization (IVF)? - In vitro fertilization (IVF) is the process used to conceive a child outside the body. In vitro fertilization is a method of assisted reproduction that involves removing eggs from a woman's ovary, combining the egg with sperm in a dish and replacing the resulting embryos in the woman's uterus.
What is intrauterine insemination (IUI)? - Intrauterine insemination is a procedure in which a fine catheter is inserted through the cervix into the uterus to deposit a sperm sample directly into the uterus.
What is gamete intrafallopian transfer (GIFT)? - Gamete intrafallopian transfer (GIFT) is an infertility treatment in which eggs are removed from a woman's ovaries, and placed in one of the fallopian tubes, along with the man's sperm.
What is intracytoplasmic sperm injection (ICSI)? - Intracytoplasmic sperm injection (ICSI) is an in vitro fertilisation procedure in which a single sperm is injected directly into an egg.
What is zygote intrafallopian transfer (ZIFT)? - Zygote intrafallopian transfer (ZIFT) is technique in which a woman's egg is fertilized outside the body, then implanted in one of her fallopian tubes.