Assisted Reproductive Technologies (ART)

The term "assisted reproductive technologies" encompasses the many advanced procedures, employed by fertility specialists, that are used to help couples achieve pregnancy. ART usually applies to procedures such as in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), preimplantation genetic diagnosis (PGD), donor egg and the various procedures used to extract sperm from the male reproductive tract.

There has been an explosion of new technologies in reproductive medicine since the mid 1980's. These ART procedures, such as IVF, have enabled thousands of couples, which previously had no hope of conceiving, to create a genetically related child.

ART technologies usually involve the administration of gonadotropins like follicle stimulating hormone (FSH) in combination with luteinizing hormone (LH) to the female, which causes her ovaries to produce numerous eggs. Additional eggs are needed as not all eggs produced are genetically competent. In an IVF cycle, the eggs are removed via transvaginal ultrasound guided retrieval and exposed to sperm in a Petri dish. Once fertilization occurs, they are incubated from 3-5 days (time varies dependent upon development) until ready for embryo transfer back into the uterus.

Donor egg IVF is an ART procedure in which one woman donates her eggs to another who has diminished ovarian function. Intracytoplasmic sperm injection is an ART procedure that enables a man, who has as few as one sperm, to produce a pregnancy. In ICSI a single sperm is inserted directly into the cytoplasm of the egg prior to incubation. ICSI has been used in thousands of cases of male infertility with great success.

Preimplantation genetic diagnosis (PGD), allows the embryologist to screen for certain genetic diseases in the embryos prior to their transfer back to the mother. PGD is usually used in couples that have a high chance of transmitting a particular genetic disorder.

Some experts include intrauterine insemination (IUI) in the ART category because gonadotropins are administered and specially prepared "washed sperm" are placed inside the uterus using a sterile plastic catheter.

Advanced reproductive technologies are complex and should only be performed by physicians who have subspecialty training in reproductive endocrinology and infertility. Many of the cases of high order multiple births (>4 babies) are caused by intrauterine insemination cycles that were not properly monitored. Reproductive endocrinologists are specially trained to properly monitor women undergoing ART cycles.

 

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