Assisted reproductive technology

Assisted reproductive technology (ART) is a general term referring to methods used to achieve pregnancy by artificial or partially artificial means. It includes taking medications to induce ovulation, or in vitro fertilization among other techniques.

ART treatments are relatively new and have been around for only around three decades. About 9% of children born of ART have a major birth defect It is still unclear how much of this difference may be due to the underlying health issues that made ART necessary. There is also evidence that they have higher rates of genetic mutation than children conceived naturally. This is most apparent in children born after IntraCytoplasmic Sperm Injection (ICSI) treatment, where a single sperm is injected directly into an egg. ICSI uses a random sperm, avoiding the natural selection process, where any sperm that can't reach the egg dies. After ICSI around 7% of children born have a severe genetic defect as opposed to less than 4% conceived spontaneously.

ART Procedures

- Transvaginal Ovum Retrieval – This is the process whereby a small needle is inserted through the back of the vagina and guided via ultrasound into the ovarian follicles to collect the fluid that contains the eggs.
- Assisted Hatching – performed shortly before the embryo is transferred to the uterus. A small opening is made in the outer layer surrounding the egg in order to help the embryo hatch out and aid in the implantation process of the growing embryo.
- Intracytoplasmic Sperm Injection (ICSI) – beneficial in the case of male factor infertility where sperm counts are very low or failed fertilization occurred with previous IVF attempt(s). The ICSI procedure involves a single sperm carefully injected into the center of an egg using a microneedle.
- Gamete intrafallopian transfer (GIFT) – a mixture of sperm and eggs is placed directly into a woman’s fallopian tubes using laparoscopy following a travsvaginal ovum retrieval.
- Zygote intrafallopian transfer (ZIFT) - egg cells are removed from the woman's ovaries and fertilized in the laboratory; the resulting zygote is then placed into the fallopian tube
- Autologous Endometrial Coculture – possible treatment for patients who have failed previous IVF attempts or who have poor embryo quality. The patient’s fertilized eggs are placed on top of a layer of cells from the patient’s own uterine lining, creating a more natural environment for embryo development.
- Preimplantation Genetic Diagnosis (PGD) – PGD involves the use of Fluorescent In Situ Hybridization (FISH) or Polymerase Chain Reaction (PCR) DNA amplification to help identify genetically abnormal embryos and improve healthy outcomes.
- Egg Donor – a resource for women with no eggs due to surgery, chemotherapy, or genetic causes; or with poor egg quality, previously unsuccessful IVF cycles or advanced maternal age. In the egg donor process, eggs are retrieved from a donor’s ovaries, fertilized in the laboratory with the sperm from the recipient’s partner, and the resulting healthy embryos are returned to the recipient’s uterus.
- Therapeutic Donor Insemination – used in situations where no sperm is available.
- Gestational Carrier and Surrogacy – an option when a patient’s medical condition prevents safe pregnancy or when a patient has ovaries but no uterus due to congenital absence or previous surgical removal.
- SSR (Surgical sperm retrieval) - The reproductive urologist may obtain sperm from the vas deferens, epididymis or directly from the testis in a short outpatient procedure.

See also

• birth control
• Malthusian catastrophe

External links

*"How To Get Pregnant" author Dr. Sherman J. Silber, M.D.explains Assisted Reproductive Technology