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1) About
If you and your partner are struggling
with conception, you may be interested in trying some procedures to help
increase your chances of pregnancy. A large percentage of couples face
difficulties when it comes to getting pregnant, but many have found
success with Assisted Reproductive Technology. ART involves a number of
different procedures to help address fertility problems and increase the
likelihood of pregnancy. Be sure to speak with your reproductive
endocrinologist about ART procedures that may be right for you.
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2)
What is Assisted Reproductive Technology ?
Although various definitions have been used for ART, the definition used
by CDC is based on the 1992 Fertility Clinic Success Rate and
Certification Act that requires CDC to publish the annual ART Success
Rates Report. According to this definition, ART includes all fertility
treatments in which both eggs and sperm are handled. In general, ART
procedures involve 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. They do NOT include
treatments in which only sperm are handled (i.e., intrauterine—or
artificial—insemination) or procedures in which a woman takes medicine
only to stimulate egg production without the intention of having eggs
retrieved.
ART has been used in the United States since 1981 to help women become
pregnant, most commonly through the transfer of fertilized human eggs
into a woman’s
uterus (in vitro fertilization). However, deciding
whether to undergo this expensive and time-consuming treatment can be
difficult. According to CDC’s 2007 ART Success Rates Report, 142,435 ART
cycles were performed at 430 reporting clinics in the United States
during 2006, resulting in 43,412 live births (deliveries of one or more
living infants) and 57,569 infants. Although the use of ART is still
relatively rare as compared to the potential demand, its use has doubled
over the past decade. Today, over 1% of all infants born in the United
States every year are conceived using ART.
ART can alleviate the burden of infertility on individuals and families,
but it can also present challenges to public health, as evidenced by the
high rates of multiple delivery,
preterm delivery, and low birth-weight
delivery experienced with ART.1 Monitoring the efficacy and safety of
technologies that affect reproduction, such as contraception and ART,
has become an important public health activity.
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3)
Who Can Benefit from Assisted Reproductive Technology ?
ART procedures aren't designed to help everyone conceive. Because they
are emotionally and physically draining, they are often used only when
other, simpler treatments have failed. ART procedures can benefit both
male factor and female factor infertility. In particular, it is often
used when couples are facing:
tubal factor infertility
ovulation problems
ejaculatory dysfunction
unexplained infertility
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4)
Who Shouldn't Pursue Assisted Reproductive Therapy ?
Those who choose to participate in ART procedures need to meet specific
criteria. In particular, women must have:
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5)
Types of Assisted Reproductive Therapies
There are numerous types of ART procedures. Your reproductive
endocrinologist can help to determine which procedure is best suited to
you.
IVF (In Vitro Fertilization)
IVF is one of the more commonly performed ART procedures. It involves
the extraction of multiple eggs from a your ovaries. These eggs are then
fertilized using a sample of sperm from your partner that has been
washed and prepared. Once the eggs have been fertilized they are
implanted in to your uterus.
ICSI (Intracytoplasmic Sperm Injection)
ICSI is a highly advanced procedure, which allows reproductive
specialists to isolate one sperm from your partner with which to
fertilize one of your eggs. Once fertilization has taken place, the
embryo is allowed to develop for a few days and is then implanted into
your uterus at the appropriate time of your cycle.
GIFT (Gamete Intrafallopian Transfer)
GIFT is often used as an alternative to the IVF procedure. Eggs and
sperm are collected from you and your partner. These are then mixed in
tiny plastic cylinders, similar to straws, and the mixture is inserted
into your fallopian tubes. Fertilization takes place inside of your
fallopian tubes, instead of outside of your body.
ZIFT (Zygote Intrafallopian Transfer)
ZIFT is very similar to GIFT, however, fertilization takes place before
the egg is placed inside of your fallopian tubes. A sample of sperm is
mixed with your harvested eggs. Once fertilization has taken place
(creating a zygote) the fertilized egg is implanted surgically into your
fallopian tubes.
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6)
Preparing for Assisted Reproductive Technology
Before you can begin ART procedures, your reproductive endocrinologist
will likely administer fertility drugs. These fertility drugs will help
to induce ovulation, allowing more eggs to be released during your
monthly cycles. Common fertility drugs used to induce ovulation include:
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7)
Success Rates of Assisted Reproductive Therapy
The success rates of ART procedures vary depending upon your health,
fertility issues, and the specific procedure that your choose to
undergo. Success rates for popular ART procedure are as follow:
IVF (In Vitro Fertilization) : Success
rates for IVF treatment procedures are generally between 25% and 35% per
treatment cycle.
ICSI: Success rates for ICSI treatment is
generally 20% per cycle.
GIFT: GIFT success rates are typically
high, with a 24% live birth rate per cycle.
ZIFT: ZIFT success rates are slightly
higher than those produced by GIFT. ZIFT is associated with a live birth
rate of 29%..
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