Assisted Reproductive Technology (ART) Procedures
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When conventional therapies fail to help a couple conceive, a fertility specialist may turn to assisted reproductive technology (ART). Assisted reproductive technology provides hope for many who have struggled with infertility, but is more invasive and significantly more expensive than other types of infertility treatments.
Assisted reproductive technology (ART) includes fertility treatments in which both sperm and eggs are manipulated. Assisted reproductive technology also refers to specific lab and micromanipulation techniques, such as intracytoplasmic sperm injection (ICSI) and laser hatching. These sperm and laser micromanipulation techniques are designed to enhance the effectiveness of IVF and other treatments to address a variety of infertility problems.
Some common ART procedures include:
- In Vitro Fertilization (IVF): This infertility treatment involves the harvesting and fertilization of female ova outside the body and the subsequent placement of the embryos into the uterus. Learn more about in vitro fertilization.
- Gamete Intrafallopian Transfer (GIFT): This fertility treatment is very similar to IVF, except that the harvested eggs are not fertilized in the laboratory. Instead, the ova and sperm are placed directly into the fallopian tubes, where fertilization will hopefully occur. The success rate of GIFT is approximately 30 percent.
- Zygote Intrafallopian Transfer (ZIFT): This infertility solution is similar to both IVF and GIFT. With ZIFT, the egg is fertilized with sperm in the laboratory, forming a zygote, but is not allowed to develop into an embryo. The zygote is then placed in the fallopian tubes. The success rate for ZIFT is approximately 28 percent.
- Intracytoplasmic Sperm Injection (ICSI): This increasingly popular fertility treatment involves the injection of a single sperm directly into an ovum (mature egg). Then, similar to IVF, the embryo is placed into the uterus. The success rate of ICSI ranges from 15 to 20 percent. Learn more about intracytoplasmic sperm injection.
- Laser-Assisted Hatching: For a pregnancy to result from any assisted reproductive technology procedure, the embryo must successfully implant into the uterus following the embryo transfer. Failure of the embryo to implant is one of the main reasons that some ART procedures don't result in a pregnancy. When sperm and eggs are combined in a laboratory, the zona pellucida (the shell surrounding the fertilized egg) hardens, making it more difficult for the embryo to implant. The laser micromanipulation technique called laser hatching is an additional lab technique designed to improve the efficiency of assisted reproductive technology procedures such as ICSI. Using a precision laser, an opening is made in the zona pellucida to weaken the wall of the embryo. The opening made by laser hatching helps the embryo hatch from the zona pellucida and implant correctly.
ART Candidates
Assisted reproductive technology procedures include surgically removing eggs from the ovaries, combining them with sperm in a laboratory dish, and placing them back in a woman's body. ART can benefit any couple that has experienced infertility due to the following common causes:
- Problems with the sperm such as low sperm count, low motility (movement), or abnormalities in the shape of the sperm
- Infertility experienced by women in their late 30s to 40s who are trying to conceive, an age when fertility naturally decreases
- Decline in egg quality, commonly due to age, genetic factors or unbalanced hormone levels
- Nonfunctional fallopian tubes caused by genetics, infections, or surgeries
- Endometriosis
- Unexplained fertility problems, especially for couples who have tried and failed to conceive for over a year
The first assisted reproductive technology procedure, in vitro fertilization (IVF) was developed to treat infertility due to a blockage of the fallopian tubes. Today, variations in technique have been developed that work better for infertility due to other problems.
ART Risks
Assisted reproductive technologies can help couples who have struggled with infertility achieve pregnancy. Although ART can help a couple conceive, there are multiple risks and problems associated with the procedures. The process of any ART procedure can be emotionally draining and put extensive physical and financial stress on a couple.
ART Success Rates
There is no guarantee that Assisted Reproductive Technologies will result in a pregnancy. According to a 2003 national study by the U.S. Department of Health and Human Services and the Centers for Disease Control, close to 65 percent of ART cycles using fresh, non-donor eggs failed to produce a pregnancy. Therefore, more than one ART cycle may be needed to achieve a pregnancy.
ART, or IVF, is improving rapidly, as are its success rates. According to CDC reports, between 1996 and 2005:
- The percentage of live births resulting from embryo transfers increased by 22 percent.
- The success rate for transfers of two embryos nearly tripled.
- The number of singleton births (as opposed to multiples) increased by 35 percent.
The percentage of live births increased for women in all age groups studied:
- Under 35 years of age - 29 percent increase
- Age 35 to 37 - 24 percent increase
- Age 38 to 40 - 18 percent
- Age 41 to 42 - 30 percent
- Over 42 years of age - 7 percent increase
Multiple Pregnancies
Many times, multiple embryos will be created and transferred to the uterus in order to increase the probability of a pregnancy. It is important to know that if multiple embryos are placed, they may all implant resulting in multiple pregnancies. Increased risk of premature delivery, low birth weight, and other complications are associated with multiple pregnancies.
Ectopic Pregnancy
There seems to be a slight increase in the chance of ectopic pregnancies with assistive reproduction technology procedures. In ectopic pregnancies, the embryo implants outside of the uterus, typically in the fallopian tubes, but sometimes in the abdomen, ovary, or cervix.
Locate a Fertility Clinic
DocShop can help you locate a specialist who can help you find more information about assisted reproductive technology, including ICSI and laser hatching. We encourage you to discuss cost, risks, and other possible concerns you may have involving these various infertility treatments. Locate a fertility clinic in your area today.
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