Assisted Reproductive Technology - ART
Assisted Reproduction Technology (ART)
The assisted reproductive techniques are the methods or the procedure used to conceive the baby either by artificial way or partial artificial methods. ART is useful for the infertile couples who are unable to conceive after 1 year of proper unprotected sexual intercourse. ART is widely used in today's era as infertility problems are increasing more. ART is expensive and invasive technique.
The important ART techniques
A) In vitro Fertilization (IVF) - IVF is most commonly and widely used procedure for infertility. In IVF the eggs from female ovaries are combined with the husband's sperm in the laboratory. Once the fertilization of eggs and sperm has occurred the embryo develop in 5 days . That developed embryo is placed in the female uterus where further growth occurs.
6 Steps of IVF
The five steps involved in IVF process -
1) Medication - In first step the fertility medicines are prescribed so that the large number of eggs are produced during the ovulation cycle. Even though multiple eggs are produced but not all of them are developed for fertilization. During the ovulation ultrasonography is done to monitor the egg development, to examine the ovaries and fallopian tubes. Along with this blood and urine tests are performed to monitor the hormone levels.
2) Eggs removal procedure - If the ultrasound shows the complete development of eggs then the small surgical procedure is required to remove those eggs. In this procedure, under local anesthesia , small hollow needle is passed through the vaginal area and eggs are removed from the ovaries. After the procedure female may experience lower abdominal pain and cramps which may last for a week.
3) Sperm Ejaculation- Once the eggs are taken out from the ovaries, sperms are obtained by ejaculation and fertilized with the eggs.
4) Insemination procedure - The eggs and sperms are kept in the incubator dish in the laboratory under sterilized condition where fertilization occurs.
5) Embryo transfer - Once the fertilization occurs the embryo is developed in 5 to 6 days which is then transferred to the women's womb.
6) Pregnancy - Once the embryo is transferred then women must take rest and wait for pregnancy symptoms to occur. Then blood and urine test are performed to confirm the pregnancy and Ultrasonography to monitor the proper implantation of the embryo in the uterus.
B) Intracytoplasmic sperm injection (ICSI)
It is useful in couple where IVF fails due to lack of sperms. In ICSI the single sperm is injected into the mature eggs. That fertilized egg is transferred to the uterus. Most of the IVF procedures are performed with ICSI. ICSI is also useful for testing the genetic testing of an embryo to determine the genetic disorder.
C) Tubal Embryo transfer or Zygote Intrafallopian transfer (ZIFT)
It is also similar to IVF where fertilization occurs outside the womb in the uterus and then transferred to the fallopian tubes instead of the uterus. ZIFT is advised when the fallopian tubes are open and other ART methods are not successful. The procedure is exactly same as IVF but the embryo is transferred through small opening on the abdomen instead of pelvic opening as in IVF. ZIFT has less success rate (25%) as compared to others.
The main risk involved in this procedure is having multiple babies or twins as more than one zygote is transferred into the fallopian tubes. The pregnancy may occur in the fallopian tubes itself (ectopic pregnancy) which may cause serious emergency situation and need to abort the pregnancy.
D) Gamete Intrafallopian transfer (GIFT)
This procedure involves the transfer of eggs and sperm into the uterus and fertilization occurs in fallopian tubes while in other procedures fertilization occurs in the laboratory and then the embryo is transferred.
GIFT is the useful procedure for the couples who has open fallopian tubes and cervical or ovulation problems. The procedure is same as IVF but the fertilization naturally in the tubes.
This procedure helps in the natural way of achieving the pregnancy instead of doing it outside the body or in laboratory (artificial way). But there is high risk of multiple pregnancies and ectopic pregnancy.
Gift is very rarely advised by the doctors as the success rate is very low.
Disadvantages of ART
1) Birth defects - Most of the IVF do not show birth defects but some studies show the birth defects more as compared to natural birth.
2) Genetic defects - In the ART procedures ( ZIFT , ICSI and IVF ) the DNA can be damaged which leads to genetic problems.
3) Low birth weight and pre term babies - The risk of low birth weight babies are more in IVF and ICSI. The associated health issues like cerebral palsy is also commonly seen in preterm babies.
4) Ovarian Hyperstimulation Syndrome - During ART the the hormonal medications are prescribed which causes over stimulation of ovaries. The enlargement of ovaries occur with discomfort in the abdomen, nausea and vomiting and shortness of breath. The medicines need to be stopped immediately.
Cost of ART
The cost of ART cycle depends on the procedure advised.
Usually it costs around $10,000 to $30,000 for each cycle.
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