|What Is Assisted Reproductive Technology?
Assisted reproductive technology (ART) is an umbrella term to describe high tech surgical procedures to help infertile couples conceive. A baby born via ART is sometimes referred to as a test tube baby. According to the Center for Disease Control and Prevention (CDC), the definition of ART includes all fertility treatments in which both sperm and eggs are handled. In general ART procedures involve removing eggs surgically from a woman's ovaries and combining them with sperm in the laboratory and then returning them to the woman's body, or donating them to another woman. They do NOT include treatments where only sperm is handled such as artificial insemination, or the use of fertility drugs to stimulate egg production without the intention of having the eggs surgically removed. ART has been used since 1981 in the United States, most commonly in vitro fertilization (IVF). Deciding whether to undergo one of these expensive treatments can be difficult. It may be possible to start with less invasive fertility treatments (such as IUI or fertility drugs) and gradually move up to ART if these fail.
• 1 percent of all babies born in the U.S. are conceived using ART.
• In 2010, over 47,000 babies were born using ART.
• About 30 percent of ART deliveries are twin deliveries (see also, how common are twins?).
• The risk of triplets (or more babies) is less than 5 percent.
What Are The Methods Of Assisted Reproductive Technology?
The most common methods of ART include:-
In Vitro Fertilization (IVF)
IVF means fertilization outside of the body. The woman is treated with fertility drugs to stimulate her ovaries to produce more than one egg. Once the eggs mature they are surgically removed. Then they are put in a lab dish and combined with the man's sperm. After a period of 3 to 5 days, the fertilized eggs are removed and the healthiest embryos are implanted in the woman's womb. IVF procedure is most often used where the man produces too little sperm or where the fallopian tubes are blocked.
If the woman's eggs are not of good quality, egg donation may be considered. This is where the eggs of another woman (donor) are harvested and used in an IVF procedure.
If the man's sperm is not of good quality, sperm donation may be considered. This is where the sperm from another man (sperm donor) is used for artificial insemination. Donor sperm can also be used with IVF treatments, although this is less common. This sperm can be bought from a sperm bank. Sperm banks are licensed by the state where they are located and have stringent requirements for donors. In some cases, men choose to bank their own sperm for future possible ART treatments (known as sperm banking or semen cryobanking). Typically it is used by men undergoing cancer treatment who are concerned about future infertility.
Zygote Intrafallopian Transfer (ZIFT)
Also called tubal embryo transfer, this process is similar to IVF. Fertilization occurs in a lab dish, but the embryo is transferred to the fallopian tube instead of the uterus. As studies report no significant difference in success rates between ZIFT and IVF, clinics usually perform IVF because it is less expensive and does not require laparoscopy and general anesthesia. Only 1 percent of all ART procedures are ZIFT.
Gamete Intrafallopian Transfer (GIFT)
This involves transferring sperm and eggs into the woman's fallopian tube. Fertilization occurs inside the woman's body. ZIFT is an advancement on GIFT. Few fertility clinics offer GIFT as an option.
Intracytoplasmic Sperm Injection (ICSI Procedure)
With IVF, sperm is combined with harvested eggs in a lab dish where it is allowed to naturally fertilize the eggs. If the sperm is not of good quality, and doctors don't think it's up to the job of fertilization, ICSI can be employed. This is where a single sperm is injected into an egg (read about extracting sperm for IVF). The resulting embryo is then transferred to the uterus or womb. ICSI is also offered to older couples where previous IVF cycles have failed.
Donor Cytoplasm (Bioengineered Babies)
Highly advanced form of ART. Cytoplasm is the inner part (yolk) of an egg - any defects here compromise the baby forming process. With donor cytoplasm, a woman donates the cytoplasm of her eggs to another woman. Using ICSI technique, the sperm from the husband and donated cytoplasm are injected into the wife's eggs. The advantage is that the couple can have children using both their sperm and egg. The disadvantage is that the pregnancy rate is not as high as with egg donation. This procedure is currently banned in the U.S. and Britain until further studies are available.
An infertile couple may also be offered donor embryos. These are often 'extra' embryos created by other couples during IVF that are not needed; or they are created from donor eggs and sperm. The donated embryo is implanted in the womb. It will not be genetically related to either parent. Brokers match unwanted embryos with prospective parents through the internet or via organizations dedicated to the process. In essence you are adopting a child, the only difference being you experience a pregnancy.
Who Are Candidates For ART?
ART candidates who use their own eggs should:
• Be under 44 years of age.
• Display no sign of premature menopause.
• Have a normal, healthy uterus (womb).
• Have at least one accessible ovary from which eggs can be taken.
• All ART candidates should be in good general health and have no medical conditions that would pose a threat to their health or that of their child.
An accessible ovary and menopause status are irrelevant for women planning to use donor eggs. Donor egg recipients should be under 50 years of age and have a normal womb.
What Are The Success Rates?
Of all ART procedures, IVF has the highest success rates. According to the Society of Assisted Reproductive Technologies (SART), in 2008, 34 percent of all IVF cycles resulted in a live birth. See IVF success rates for more details.
Does It Raise The Risk Of Birth Defects?
There is no evidence to suggest an increase in birth defects in children conceived by IVF (compared to those who conceive naturally). As ICSI is a relatively new technique (first performed in 1992), long-term health and fertility of children conceived by ICSI is not yet available.
How Long Does Assisted Reproductive Technology Take?
The entire process takes 5 to 6 weeks, 2 of those weeks will involve intensive visits to your fertility clinic.
How Much Does It Cost?
The cost depends on which type of ART is selected and how many attempts are needed before a successful pregnancy occurs. For example, an average cost for one IVF cycle is between $12,000 and $17,000. And the average cost of one IVF cycle combined with egg donation is between $25,000 and $30,000. More importantly the average cost of a live birth by ART procedure is $55,000. This is because it typically takes 3 attempts (cycles) to produce a baby. Only about 16 percent of health insurance companies routinely cover these costs, making it well beyond the reach of most American couples who are not insured.
What is the cost of egg donation?
What is the cost of IVF?
Does Insurance Cover ART?
No, in most states, most insurance plans do not cover ART (although some insurance policies may cover part of the therapy).
What Is Egg Freezing?
Egg freezing, technically called oocyte cryopreservation or egg banking, is where a woman's eggs are removed, frozen and stored. When she is ready to become pregnant the eggs are thawed, fertilized and transferred to the womb as embryos. It is aimed at three types of women:
1. Those undergoing cancer treatments like radiotherapy and chemotherapy which are toxic for eggs.
2. Women having ART but who object for ethical reasons to freezing complete embryos.
3. Women who want to preserve their eggs for having children in the future.