What is assisted reproductive technology?

Assisted reproductive technology are methods of infertility treatment, which include the creation of embryos from oocytes and sperm. We will give you a clear understanding of all the related details in this article

The main definition of assisted reproductive technology ( ART ).

Facing infertility can be a devastating experience, regardless of whether it is a female or male factor infertility. But couples now have options of how to treat infertility to overcome their reproductive health issues and come closer to their dream of starting a family. And this is when ART procedures come to the rescue.

Assisted reproductive technology (ART) includes reproductive medicine and medical procedures that help combat infertility. Depending on what program you choose, ART procedures may include fertility treatment or disease control in combination with other practices to assist conception and healthy pregnancy.

Accordingly, this area includes the following possible treatment options: in-vitro fertilization, ovulation induction, artificial insemination, in vitro maturation, intracytoplasmic sperm injection, physiological intracytoplasmic sperm injection, and others.

The main goal of this field is to provide a safe and effective way to achieve the goal of becoming parents. Over the last 35 years, almost 3.7 million children have been born through assisted reproductive medicine. Therefore, you can rely on reproductive medicine as a reliable way of getting pregnant when you can't do that naturally.

Fertility treatments in assisted reproductive technology (ART)

Treatment with assisted reproductive technologies (ART) is extremely diverse. Nowadays, doctors aim to overcome even the most complex types of problems related to the human reproductive system. And luckily, reproductive medicine and infertility treatment can really help overcome the majority of fertility issues.

New types of programs and ART procedures are entering the market to help couples fight fertility. Our agency currently offers all the types available. Next, you can get acquainted with the methods and types of treatment in more detail.

1. Ovulation induction (OI)

Ovulation induction is an assisted reproductive technology and a medical type of treatment that is accompanied by taking medications to stimulate a patient's ovaries. With the stimulation, the ovaries start to work better or work in general, which enables egg production.

Usually, this type of treatment is recommended for women who do not ovulate naturally or whose ovulation is irregular. Of course, such conditions make it impossible for the woman to produce healthy eggs and become pregnant without any infertility treatments.

During this treatment, the medications are prescribed by a doctor on the first days of the menstrual cycle, from the second day. The whole process takes place under the supervision of a doctor and ultrasound monitoring of follicle growth. Depending on the particular case of the patient, two methods can be used: partial estrogen agonists or aromatase inhibitors or FSH and LH subcutaneous injections.

The percentage of pregnancy varies from 15 to 40%, depending on the situation. This type of treatment has a risk of hyperovulation and multiple pregnancies, but this risk is small if you are under the constant supervision of your doctor.

2. Artificial insemination (IUI)

Artificial insemination is a procedure of introducing a man's biological material into a woman's uterus under the supervision of a doctor. Of course, this procedure is only possible to perform when the infertility of the male partner has been ruled out.

Doctors recommend this procedure in the following cases:

- With good sperm quality but obstruction of the fallopian tubes or problems in sexual intercourse.

- The need to use donor sperm.

As for the methods used in this type of treatment, it is the stimulation of the patient's ovaries and, subsequently, in accordance with the results of stimulation, the preparation and introduction of a sperm catheter into the uterus. After the procedure, the patient remains at the hospital to lie down for up to 30 minutes.

The risks of this procedure are the same as in ovulation induction. The percentage of pregnancy is 10-20%.

3. In-vitro fertilisation (IVF)

In vitro fertilization is a more complex, but at the same time, more effective treatment plan offered to couples with complex health issues, such as poor sperm count, pelvic pathology, late fertility and significant duration of infertility.

When starting an IVF cycle, it's crucial for the couple to undergo testing, like transvaginal ultrasound, to identify the reproductive health issues each partner has and come up with the right treatment plan. Of course, it is necessary to have all the records of current health conditions and medical history before starting to take any medication.

So, the process begins with testing a woman and a man — based on their tests, the woman is prescribed medication that she will take during stimulation. On the appropriate day between the 12th and 15th day of the cycle, the date of aspiration of oocytes in the hospital is prescribed for the woman. This procedure takes up to an hour and is performed under local anesthesia. Upon completion, the patient spends from 1 to 2 hours in the ward.

The male partner takes part in the process, too. At the same time, the man provides his material (semen), which will later be introduced into the storage environment of oocytes for fertilization. From this point, we count 6 days to create a number of embryos to the state of blastocysts.

Upon their creation, the embryo can be transferred to the uterus or frozen for later use. While the fresh embryos are available for use right away, frozen embryos need to be stored and prepared for future procedures in a particular way.

IVF is an effective solution for disease control and conception in case of a couple's infertility. Success rates of this procedure depend on the patient's age, but our company, according to statistics, has a successful pregnancy rate of approximately 65%.

4. In Vitro Maturation (IVM)

In vitro maturation is a treatment program that is recommended for women with low ovarian follicles reserve. For them, a separate stimulation plan is developed with minimum or no medication. During this procedure, the process of egg retrieval takes place.

The doctor constantly monitors the growth of follicles at the beginning of the menstrual cycle. When the follicles grow to approximately 10 millimeters, the patient is scheduled to aspirate oocytes under local anesthesia. The oocytes are then placed in a special environment and cultured until fully mature.

At the stage of maturation, embryologists perform the procedure of fertilization and further cultivation of embryos.

5. Intra-Cytoplasmic Sperm Injection (ICSI)

ICSI is an ART procedure that is part of the in vitro fertilization program. This part begins when oocytes and sperm combine to form embryos. ICSI fertilizes 50% to 80% of eggs.

The procedure has two methods:

- introduction of the entire amount of sperm biomaterial into the environment where the oocytes are located.

- selecting one specific spermatozoid to be introduced into the middle of a particular oocyte using a micropipette.

This type of fertilization significantly increases the chances of success of the program. As soon as the procedure is completed, the process of culturing embryos begins.

6. Physiological intracytoplasmic sperm injection (PICSI)

Physiological intracytoplasmic sperm injection is a method of fertilizing an oocyte with sperm, which is recommended in cases of unsuccessful attempts at ICSI in vitro fertilization, poor quality of embryos, their poor cultivation (excluding cases of low oocyte quality) or after several miscarriages. However, this procedure can't be performed in case of severe male factor infertility of the partner.

Before the male partner sperm is introduced into the oocyte during this procedure, it is placed in a special environment with hyaluronan hydrogel. Under these conditions, every single sperm shows how mature it is, allowing the specialist to select the best ones for the procedure. The embryologist selects the most mature sperm and only then inserts them into the oocyte with special devices.

This procedure has no risks and is a separate stage before ICSI fertilization.

7. Preimplantation Genetic Screening ( PGS )

PGS and PGD are available to all patients undergoing IVF programs. These are two types of genetic testing of the embryo before it is transferred to the uterus, particularly for a certain number of chromosomes and to identify possible pathological diseases.

Preimplantation genetic diagnosis and testing is usually performed on days 3-6 of embryo cultivation and gives us the opportunity to learn its gender for the ability to balance the family. In addition, the screening helps to reduce chances of pregnancy complications.

Speaking about the statistics of the success of programs with PGS testing, without any hesitation, we can add 20-25% of success in accordance with the implantation of embryos in the uterus, which results in a positive pregnancy.

8. Other technologies

Besides those listed, there are some other ART procedures and their extensions.

For example, when signing up for an IVF procedure, you can choose to use egg donation or sperm donation. When using donor's eggs, fresh donor embryos or the donated frozen embryos are fertilized with donor sperm or your partner's semen sample. After the embryo transfer to your uterus, you undergo the same further process as you would in a standard cycle.

In case there are any remaining embryos after the egg retrieval, you can preserve them. The frozen embryos can be used for the next cycles and pregnancies with an embryo transfer. Donated frozen embryos result in successful pregnancies similarly to how fresh or the patient's own embryos do when it is possible to use them.

As for the other available procedures, you can have embryos transferred to the fallopian tube, which is closer to conceiving naturally. This includes such procedures as gamete intrafallopian transfer, zygote intrafallopian transfer and pronuclear stage tubal transfer. These therapies can be performed with frozen embryos, too.

Then, a surrogate or gestational carrier can be requested to bear your baby. During surrogacy, the patient should still visit the doctor for disease control.

Final word on what is assisted reproductive techniques

Without a doubt, it should be noted that assisted reproductive technologies, with all fertility treatments that are part of this industry, are an important step in medicine. Each year, assisted reproductive technology clinics conduct approximately 30,000 ART cycles for couples who need disease control and help them achieve their most cherished goal of becoming a parent. There is no risk of birth defects.

Our company is no exception — we are happy to help and provide the best treatment plan to anyone who needs it. Our coordinators are always happy to assist you, so in case of questions, please contact us via email: info@ifg-ivf.com.

M.D., IVF specialist, gynecologist, reproductive endocrinologist, expert of ultrasound diagnostics.


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