Assisted reproductive technology (ART) is the use of clinical and laboratory methods for the purpose of reproduction. The clinical practice of ART is governed under the American Society of Reproductive Medicine (ASRM) guidelines.
Ethical Issues of ART
The ASRM offers guidelines regarding several issues of assisted reproductive technology, such as:
Preimplantation genetic diagnosis (PGD)
Posthumous use of gametes
Purpose of ART
Approximately 10-13% of couples who are reproductive age are affected by infertility. Doctors define infertility as the inability to conceive a child after a year of unprotected intercourse. Our fertility center uses assisted reproductive technology and state of the art equipment to help you achieve pregnancy.
In Vitro Fertilization (IVF)
In vitro fertilization is the most commonly used form of ART. This technique involves combining the man’s sperm and the woman’s eggs in a laboratory setting, so fertilization can occur. Once the eggs and sperm combine, embryos develop, and they can be placed inside the recipient woman’s uterus.
Intracytoplasmic Sperm Injection (ICSI)
Often used along with IVF, intracytoplasmic sperm injection is done when problems with sperm exist. The ICSI procedure involves inserting a single sperm into a mature egg. The embryologist uses small instruments to do this procedure, and he/she chooses the best, hardiest sperm for fertilization. When combined with IVF, this procedure greatly increases pregnancy rates.
If a woman has poor quality eggs, or ovulation does not produce an egg, donation of eggs is an option. With this procedure, another woman donates an egg, which is combined with the sperm from the intended father for fertilization. After an embryo develops in the laboratory setting, the embryo is placed inside the intended mother’s uterus.
If a man suffers fertility problems related to slow moving sperm, inactive sperm, or a low sperm count, donor sperm can be used. The intended mother’s egg is combined with the donor’s sperm, and the resulting embryo is implanted inside the woman’s uterus. Recipient couples can choose donor sperm based on certain characteristics.
Gamete Intrafallopian Transfer (GIFT)
So fertilization can occur naturally in the woman’s fallopian tubes, GIFT allows the sperm and egg to be combined in the laboratory setting. Before the embryo develops, the egg is placed back into the woman’s body. GIFT has a success rate of approximately 30%.
Zygote Intrafallopian Transfer (ZIFT)
With zygote intrafallopain transfer, the eggs and sperm are combined in the laboratory setting. The fertilization occurs outside the woman’s body, but the resulting zygote is placed in the fallopian tube so it can naturally implant into the uterus.
Eggs can be stored using a process called cryopreservation. When excessive eggs are removed from the woman’s body, during GIFT or IVF, they can be frozen until the couple requires them for another cycle. Also, donor eggs are often frozen. The egg does not age, and when it is thawed, it is in the exact same condition as when it was first preserved.
An embryo is protected by a soft outer layer called the zona pellucida. When the embryo cannot break out of this layer to implant in the soft lining of the uterus, assisted hatching is an option. Laser manipulation is a technique to make a small opening in the layer to weaken it, which allows the embryo to break free and implant naturally.
Surrogates and Gestational Carriers
Some women are not able to carry a baby to term. Many women do not produce quality eggs for pregnancy either. For these women, surrogates and gestational carriers are an option. With a gestational carrier, the intended mother contributes the egg, and the carrier only carries the baby to term. With a surrogate, the intended father’s sperm and the surrogate’s egg is combined using IVF, and the surrogate carries the baby.