Notes on ART.pdf

Assisted reproductive technology treats infertility and the treatment involves both a man's sperm and a woman's egg. The procedure begins by extracting eggs from a woman's body and then fusing it with the sperm to generate embryos. This embryo is then transferred back into the woman's body.

1. Notes on ART
Dr. Rajendra Chavhan,
Assistant Professor in Zoology, M. G. College Armori, Dist-Gadchiroli

Seeking infertility treatment means learning a whole new vocabulary. You might have heard
the term assisted reproductive technology (ART) bandied about, and wondered if it applies to
you. Knowing your ART options can help you better understand your own body and weigh
various options that may help.
Assisted Reproductive Technology
What Is Assisted Reproductive Technology?
Definition – ” Assisted reproductive technology is a technology used to attain pregnancy
through the usage of procedures such as in vitro fertilization, artificial insemination and
surrogacy”
Assisted reproductive technology (ART) involves the use of medical techniques to tackle
infertility. As per the WHO (World Health Organization), infertility can be defined as the
inability to conceive after more than one year without the usage of contraception. Infertility
can be seen in both females and males. ART includes the usage of procedures such as ICSI
(intracytoplasmic sperm injection), IVF(in vitro fertilization), cryopreservation of embryos or
gametes, use of fertility medication and so on. It is referred to as fertility treatment when the
procedures are used to deal with infertility. Primarily, ART addresses infertility and
reproductive endocrinology. Also, ART plays a role in surrogacy orderings.
Assisted reproductive technology treats infertility and the treatment involves both a man’s
sperm and a woman’s egg. The procedure begins by extracting eggs from a woman’s body and
then fusing it with the sperm to generate embryos. This embryo is then transferred back into
the woman’s body. The most commonly used ART which is the most effective one is the In
Vitro fertilization or IVF which is based on this principle.
Several other times, ART techniques make use of donor eggs, donor sperms or embryos that
have been frozen previously. In some cases, techniques also involve a gestational carrier or
surrogate. A woman who conceives with an egg from a female and sperm from a male partner
is referred to as a surrogate. One of the challenges and commonly occurring complications of
ART is the occurrence of multiple pregnancies which can be minimized and prevented by
restricting the count of embryos that are being inserted into the body of a woman.
What causes Infertility?
Men and women, both could be infertile. Some of the factors or reasons for infertility are:
In Males
 Ejaculation or erectile deficiency – ejaculatiry disturbances as a result of impotence or
ejaculatory failure
 Sperm count disorder/Sperm production – includes oligospermia and azoospermia.
Some sperm cells die before reaching the egg or are malformed
 Age – one of the major causes is age. Aged males have lesser sperm count

2.  Structural abnormalities – motility or shape of sperm is affected thereby preventing
sperms from binding or even swimming towards the egg.
In Females
 Inability of the ovary to produce eggs – ovulation disorders such as PCOS
 Quality of uterine lining – such as endometriosis wherein the womb tissue invades
causing damage to the adjacent reproductive tissues
 Structure of fallopian tube – blockage in tube preventing the sperm to meet the egg
 Advanced maternal age – quality of woman’s egg decreases with age and can restrict
her ability to conceive
Types of Assisted Reproductive Technology
Some commonly used methods of ART include
1. In vitro fertilization (IVF) – one of the most common forms of ART is IVF. Here fertilization
occurs outside the body.
2. Gamete intrafallopian transfer (GIFT) – It involves the transfer of sperms and eggs into the
fallopian tube of a woman where fertilization takes place.
3. Zygote intrafallopian transfer (ZIFT) – also known as tubal embryo transfer is somewhat
similar to IVF wherein fertilization takes place outside the body. The young embryo is then
inserted into the fallopian tube and not the uterus.
4. Intracytoplasmic sperm injection (ICSI) – this technique is usually used for couples where
the male is infertile. Sometimes it is also used for those with failed IVF attempts or even for
older couples. Here the principle that is followed is that a single sperm is introduced into a
mature egg, contrary to what is seen in conventional fertilization techniques wherein the sperm
and egg is placed in a petri dish and the sperm fertilizes the egg on its own.
5. Artificial insemination – deliberate introduction of sperms into the female’s cervix or uterus
to achieve pregnancy without sexual intercourse. It can of the following types:
 Intrauterine insemination
 Intracervical insemination
 Intratubal insemination
What is Assisted Reproductive Technology?
ART is sometimes used as a catchall term for any fertility treatment, from medications to
surgery. But in the medical community, ART refers to treatments that manipulate the sperm or
the egg to make pregnancy more likely. ART works best in couples who have an issue with
sperm or who have a diagnosis that makes it difficult for the sperm to fertilize the egg. Women
who ovulate infrequently may also benefit from ART, since an ART cycle greatly increases
the odds of a successful pregnancy each cycle. ART is also a viable option in couples who have
unexplained infertility. This is because the odds of pregnancy are higher with each ART cycle,
and ART can circumvent many common but difficult-to-diagnose problems. Couples who have
tried other treatments without success, as well as people attempting to get pregnant without a
partner, may also choose ART.

3. Types of Assisted Reproductive Technology
In vitro fertilization (IVF) is perhaps the most well-known form of ART, but it’s far from the
only option. Your ART options include:
In vitro fertilization
In vitro fertilization (IVF) is a relatively new technology that’s been in use for about three
decades. It’s also one of the most successful options, boasting a success rate of about 15-25%
per cycle. During an IVF cycle, a doctor retrieves eggs from the woman and then fertilize them
with sperm. The fertilized egg grows in a petri dish for several days until it becomes an embryo.
Then a doctor implants the embryo back into the woman’s uterus. To maximize the success
odds of IVF treatment, a woman usually takes fertility drugs to ensure she ovulates on a
predictable timeline and to encourage her body to produce multiple extra age. For this reason,
IVF often produces multiple embryos. This increases the likelihood of having multiple babies.
Intrauterine insemination
Intrauterine insemination fertilizes the egg inside a woman’s uterus. This is a more affordable
option than IVF, though it has a lower success rate. IUI works best for women trying to get
pregnant without a partner, for people with unexplained infertility, and when the man’s sperm
has issues traveling to the egg--often due to low mobility, but sometimes due to a chemical
mismatch between the man’s semen and the woman’s vaginal fluids. IUI requires just one
procedure, during which the sperm is implanted into the woman. Some women opt to take
fertility drugs before IUI to increase the number of eggs they produce. Fertility drugs increase
the chances of success with IUI.
Intrafallopian transfer
An intrafallopian transfer fertilizes the egg inside the woman’s fallopian tube. Intrafallopian
transfers are good options for couples with unexplained infertility, with sperm mobility issues,
or when the woman has an issue with her fallopian tube, such as a blocked tube. A gamete
intrafallopian transfer (GIT) transfers sperm and eggs into a woman’s fallopian tube, where the
sperm fertilizes the egg. Some couples prefer it because of religious or ethical beliefs dictating
that fertilization should occur inside the body. A zygote intrafallopian transfer (ZIT) is similar
to IVF. Eggs are removed from the woman’s body and fertilized in a lab setting, then
transferred into the woman’s body when they grow into embryos. But unlike with IVF, the
embryos are deposited into the fallopian tube. As with other ART options, a woman typically
takes fertility drugs prior to the cycle.

4. Intracytoplasmic sperm injection
Intracytoplasmic sperm injection (ISI) removes one or more eggs from the woman’s body.
Then a mature egg is injected with a single healthy sperm. When the eggs develop normally,
they are transferred back to the woman’s body. ISI works best when there are serious sperm
issues. For example, a man with very low sperm motility or very few quality sperm might select
this option. Sometimes a man has normal sperm count and morphology, but significant DNA
damage that decreases fertility or increases the risk of an early miscarriage. ISI allows a doctor
to select the healthiest sperm and implant it in the egg. A woman typically takes fertility drugs
to boost egg production and normalize her cycle before an ISI implantation.
ART: Not the Only Option
IVF revolutionized the world of infertility. It’s received so much attention that many couples
think it’s the only or the primary option for treating issues with fertility. But assisted
reproductive technology is not the only option. In fact, many couples opt to pursue less invasive
treatments prior to trying ART. For many, the right medication or medical procedure can
greatly increase the chances of fertility. There are dozens of fertility treatments that may help,
but some of the most effective non-ART methods include:
 A procedure designed to clear blocked tubes.
 Hormones to support and encourage ovulation.
 Hormone treatments to address other issues in a woman's cycle, such as a too-short
luteal phase.
 Treating underlying medical conditions such as insulin resistance.
Fertility education can also be helpful. Some couples are not correctly timing intercourse to
maximize their chances of fertility. Others may be using lubricants that make it more difficult
for the sperm to travel to the egg. Still, others may have lifestyle risk factors, such as obesity,
smoking, or drug use, that increase the risk of miscarriage and infertility. Infertility is a complex
challenge, and it demands complex solutions. Often the best strategy is a multi-pronged
approach to medication, lifestyle changes, and a few tweaks in intercourse timing.
Your Fertility Specialist Matters
No matter what fertility treatments you choose, no matter what fertility issues you struggle
with, the right fertility specialist can make a world of difference. While a gynecologist or family
doctor can offer preliminary fertility testing, fertility experts are leaders in their field. They
know about cutting-edge research and have intimate knowledge of treatments a general
practitioner might not even know about. For the best possible chance of a quick and successful
pregnancy, a fertility specialist is your best ally. Even among fertility specialists, though,
there’s a wide range of skill levels. So ask for statistics from whomever you choose, and if
you’re not getting effective treatment, don’t be afraid to switch providers. The Center of
Reproductive Medicine, with its 5 locations in and around Houston, Texas, offers
comprehensive, compassionate, effective assisted reproductive technology and other fertility
treatment options. We’ll correctly diagnose the problem, then diligently work to treat you. We

5. know how difficult this journey can be. Our job is to make it a bit easier. To learn more, contact
us today.
What are 4 reproductive technologies?
Assisted reproductive technologies (ART).
All treatments which include the handling of eggs and/or embryos. Some examples of ART
are in vitro fertilization (IVF), gamete intrafallopian transfer (GIFT), pronuclear stage tubal
transfer (PROST), tubal embryo transfer (TET), and zygote intrafallopian transfer (ZIFT). A
general overview of 2 types of assisted reproductive treatment (ART): in-vitro fertilisation
(IVF) intracytoplasmic sperm injection (ICSI).
Assisted reproduction
Assisted reproductive technology (ART) has enabled millions of infertile couples worldwide
to have children. ART refers to manipulation of eggs, sperm and embryos outside the body in
order to achieve a pregnancy. Intrauterine insemination (IUI), which involves only the
manipulation of sperm, is considered by some but not all as type of ART.
In vitro fertilization (IVF)
IVF involves the joining of eggs and sperm in a laboratory dish and transfer of the resulting
embryos into the womb. IVF is by far the most commonly used form of ART and is practically
synonymous with the term ART. Visit our IVF page for more details.
Intracystoplasmic sperm injection (ICSI)
ICSI is a variant in IVF in which a single sperm is injected into each egg. It is done for semen
abnormalities and couples who have failed fertilization.
Donor Egg IVF
Donor egg is a variant used in couples in the which the female partner has very poor quality
eggs (often due to age) and requires eggs from a younger woman in order to have a normal
conception.
Gestational Carrier IVF
Gestational carrier is what most people think of when they think of surrogacy. IVF is done as
usual on the intended parents, but the pregnancy is implanted into the womb of a woman who
will carry the pregnancy and give birth to the child for them.
Gamete intrafallopian Transfer (GIFT)
GIFT was commonly done in the past, particularly for women who wanted to do IVF but avoid
conception outside the body. The eggs are stimulated and harvested just like in IVF, but the
eggs and sperm are placed into the fallopian tube where fertilization happens. With the
increasing success rate of IVF, GIFT is rarely done nowadays.

6. Zygote Intrafallopian Transfer (ZIFT) and Tubal Embryo Transfer (TET)
ZIFT is also similar to IVF but involves transfer of the fertilized egg (the zygote) into the
fallopian tube at the time of laparoscopy. In the past, like GIFT, ZIFT had a higher pregnancy
rate than IVF. With the advent of improved embryo transfer techniques and better laboratories,
ZIFT has also become obsolete. TET refers to the same procedure as ZIFT but with transfer
done at a later date.