Assisted Reproductive Technologies

What is ART?

ART is the umbrella term for a variety of medical procedures in which eggs and sperm are brought together to achieve pregnancy. The common form of ART is in vitro fertilization (IVF), which accounts for about 98% of all ART procedures in the U.S. Another form of ART is GIFT.

How does IVF work?

First, the woman takes hormonal medication to stimulate development of as many eggs as possible. (This is called ovulation induction.) The doctor monitors egg development using ultrasound and blood tests. At the appropriate time, eggs and sperm are collected from each partner (or donor) and combined in a laboratory. If the eggs are successfully fertilized in the lab, they are transferred into the woman’s uterus. Ideally, one of the fertilized eggs will implant and develop, just as in a routine pregnancy.

What is GIFT?

GIFT (gamete intrafallopian transfer) begins with the same two steps as IVF: ovulation induction and egg retrieval. The difference is that the sperm and eggs are placed directly into the fallopian tube, instead of fertilizing in the lab. If fertilization is successful, the fertilized egg travels to the uterus, just as in a natural cycle. The disadvantage of GIFT is that it must be performed under general anaesthesia. Among the reasons a patient might undergo GIFT rather than IVF are cervical problems or religious beliefs that prohibit fertilization outside the body.

When should I consider egg donation? With egg donation what are my chances for pregnancy?

Egg donation may be a good option for women who are older, who have reached menopause prematurely, who may carry a genetic disorder, or who have experienced unexplained and repeated miscarriages. IVF success rates after egg donation, even for women over age 40, are approximately the same as success rates for young women. IVF is performed in the usual manner, except that the egg donor undergoes ovulation induction and egg retrieval. The recipient is treated with oestrogen and progesterone prior to embryo transfer to prepare the uterine lining to receive an embryo.

What is intracyoplasmic sperm injection (ICSI)?

ICSI involves injecting a single sperm into an egg in the IVF laboratory. It is used in cases where the man has weak sperm or a very low sperm count. If fertilization occurs in the laboratory, the fertilized egg is transferred to the woman’s uterus using normal IVF procedures. Recent statistics show that ICSI is used in about 47% of IVF procedures in the U.S.

What is cryopreservation?

Cryopreservation, or freezing of embryos at very low temperatures, is typically done when more eggs are fertilized than are needed for a single IVF cycle. It can reduce the cost and inconvenience of future ART procedures because the first few stages (ovarian stimulation, egg retrieval) do not have to be repeated. Once a couple achieves a successful pregnancy, extra embryos can be stored for future attempts.

How successful is ART?

ART success rates have increased steadily since 1978, when the first IVF procedure was performed. For women under age 35 undergoing IVF, delivery rates compare favorably to the 20% live birth rate average couples experience for any given month. Although success rates decline as a woman ages, the chances for pregnancy have gone up for all age groups.