What is Assisted Reproductive Technology (ART)?
Assisted reproductive technology (ART) is a large group of techniques and procedures which are designed to assist infertile couples who wish to have children. This medical field exploded in the 1970s, with the development of in vitro fertilization, and it becomes increasingly advanced with each year. Although various definitions have been used, ART includes all fertility treatments in which both eggs and sperm are manipulated. In general, ART involves surgically removing eggs from a woman's ovaries, combining them with sperm in the laboratory, and returning them to the woman's body or donating them to another woman.
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In Vitro Fertilization – IVF
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In vitro fertilization (IVF) means fertilization outside of the body. IVF is the most effective ART. It is often used when a woman's Fallopian tubes are blocked or when a man produces too few sperm. Doctors treat the woman with a drug that causes the ovaries to produce multiple eggs. Once mature, the eggs are removed from the woman. A sperm sample is obtained from the father. Eggs are put in a dish in the lab along with the man's sperm for fertilization. Fertilization occurs in the laboratory when the sperm are mixed with the eggs. The fertilized eggs (zygotes) begin cell division. After 2-3 days, the zygotes are ready to be implanted into the mother's uterus. Some clinics are waiting a full 5-6 days to allow more cell division before implantation. To improve the chances that an embryo will develop into a baby, approximately 3 fertilized eggs are introduced into the uterus at one time. Often this leads to multiple births.
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Gamete Intra-fallopian Transfer – GIFT
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Gamete intrafallopian transfer (GIFT) involves transferring eggs and sperm into the woman's Fallopian tube. So fertilization occurs in the woman's body. A sperm sample is obtained from the father. Eggs are harvested from the mother. Then, both the sperm and the eggs are injected into the mother's fallopian tube in hopes that fertilization will occur naturally.
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Zygote Intra-fallopian Transfer – ZIFT
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Zygote intrafallopian transfer (ZIFT) or Tubal Embryo Transfer is similar to IVF. Fertilization occurs in the laboratory - sperm and eggs are united in the laboratory. Then the fertilized eggs (the very young embryo) are injected/transferred into the Fallopian tube instead of the uterus.
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Tubal Embryo Transfer – TET
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The main groups of patients selected for TET procedure are women who are keen to have gamete intra-Fallopian transfer (GIFT) but where there is doubt about the chance of fertilization, and women who encountered difficulties in previous embryo transfers through the cervix.
The TET procedure involves the transfer of embryos that are more advanced in development than those in ZIFT i.e. cleaved embryos. The aim is to achieve fertilization in-vitro (in the laboratory) and then replace the cleaved embryos in the Fallopian tube, the normal site for fertilization. It is suitable only for women who have at least one healthy Fallopian tube.
TET is carried out as a day-case procedure under a general anesthetic, using laparoscopy. You may experience some abdominal discomfort and pain for a few days after the procedure, but painkillers can relieve this.
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Intracytoplasmic sperm injection – ICSI
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This procedure is often used for couples in which there are serious problems with the sperm. Sometimes it is also used for older couples or for those with failed IVF attempts. In ICSI, a single sperm is injected into a mature egg. Then the embryo is transferred to the uterus or Fallopian tube.
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During ART procedures sometimes donor eggs (eggs from another woman) could be used as well as donor sperm, or previously frozen embryos. Donor eggs are sometimes used for women who have ovarian problems and cannot produce eggs. Genetic diseases could be another indication for using donor eggs and/or donor sperm - donor eggs or donor sperm is sometimes used when the woman or man has a genetic disease that can be passed on to the baby. An infertile woman or couple could also use donor embryos. These are embryos that were either created by couples in infertility treatment or were created from donor sperm and donor eggs. The donated embryo is transferred to the uterus. The child will not be genetically related to either parent.
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In Vitro Fertilization – IVF
