Assisted Reproductive Technology: What, Why and How It Is Done

Did you know that 1 in 6 couples experience infertility in urban India? 

What is infertility?

“The inability to get pregnant despite unprotected intercourse for a year is termed infertility. For couples above the age of 35, this duration reduces to six months,” explains Dr. Priti Arora Dhamija, Obstetrician-Gynecologist and Fertility Expert at Sitaram Bhartia Institute of Science and Research.

“An increasing age at conception, changes in lifestyles, smoking and alcohol intake, obesity and medical conditions have contributed toward the rise in conception problems.”

Read: PCOS and Pregnancy: What Are Your Options?

Is ART the only way to get pregnant with Infertility?

Yes. You can try ‘assisted reproductive technologies’ (ART) to get pregnant.

“We see many couples get ushered into trying procedures like IUI or IVF without comprehensive counseling and evaluation.”

“At Sitaram Bhartia, we’re careful in selecting couples who would genuinely benefit from these procedures. In your very first consultation with us, we take a detailed history, ask you for how long you have been trying to conceive and any changes you have made in your routine.”

“We suggest a few tests to determine the cause behind the unsuccessful attempts to conceive.” 

“We try to understand what is important to you and accordingly help you conceive. ”

Why is assisted reproductive technology important?

Assisted Reproductive Technology helps couples overcome the hurdles they face with natural conception. 

According to the American Society of Reproductive Medicine, assisted reproductive technologies are defined as “ all treatments which include the handling of eggs, sperms and/ embryos. “

Who is eligible to try for ART?

“At our hospital, we conduct a thorough evaluation of both the male and female partners to determine their eligibility for ART,” explains Dr. Priti.

“In our practice,  we’ve seen couples conceive spontaneously, without the need for any medical intervention.”

Remember, for a pregnancy to occur, you need 

  • Healthy sperm
  • Healthy uterus
  • Atleast one open and healthy fallopian tube
  • And one ovary that releases a mature egg every cycle

ART is helpful for couples who face difficulty conceiving due to one or more of these factors. 

However, sometimes there may not be any obvious factor and yet the couple is unable to conceive. This is known as unexplained infertility and can also benefit from ART. 

Read: Reasons for Not Getting Pregnant When Everything is Normal: Your Questions, Answered

What are the different modalities (types) of assisted reproductive technology?

There are different modalities of ART including:

  • Controlled ovarian stimulation in which women are given hormonal medications that induce the ovaries to produce more eggs.
  • Egg donation, in which eggs are donated by a third party donor to a recipient so they can get pregnant using assisted reproductive techniques.
  • Egg freezing by which a woman who is keen to preserve fertility can freeze her eggs to be used at a later time.
  • ERA testing which assesses reasons behind implantation failure in a woman who has not been able to conceive in three consecutive IVF cycles.
  • Semen freezing in which the sperm is frozen to preserve the man’s fertility either before a medical treatment that may impact fertility or to be used in the future as donor sperm. 
  • Testicular Biopsy is a process through which a cut is made around the scrotum and a small sample of the tissue is removed. The biopsy is done to diagnose the cause of male infertility.
  • Testicular Sperm Aspiration (TESA) is done to retrieve the sperm or tissue from a man’s testicle. The sperm is used in IVF or IUI cycles and is usually done on the same day that the egg retrieval is done in female partners. 
  • Therapeutic Donor Insemination (TDI) wherein the sperm from a known or anonymous donor is inserted into the uterus around the time of ovulation. The sperm may have been frozen and is thawed before the process.
  • Intracytoplasmic Sperm Injection (ICSI) refers to the process through which a single sperm is manually injected into an egg for fertilization under the vision of very powerful microscopes. The difference between ICSI and IVF is that with the latter, an egg and multiple sperm are placed in a tube. The embryologists wait for the sperm to naturally merge into the egg. ICSI is useful in cases of severe male infertility or testicular derived sperms.
  • Intrauterine Insemination (IUI) is another procedure, which is nearly as popular as IVF. The difference between IUI and IVF is that the sperm is injected into the woman’s womb at the time of ovulation, hence the term “insemination”.
  • Embryo freezing by which an embryo can be frozen for use in IVF treatments at a later stage.

Is IVF an assisted reproductive technology?

IVF is the most popular type of assisted reproductive technology through which the egg is retrieved from the female and the sperm is collected from the male. The sperm and egg are fertilized outside the woman’s body in a tube in optimum conditions. 

Is surrogacy in assisted reproductive technology?

Surrogacy, in general, involves a woman carrying the pregnancy for a couple who is unable to conceive or carry a healthy pregnancy to term. The process involves the transfer of an embryo formed from the egg and sperm of the to-be parents through IVF.

Is assisted reproductive technology appropriate for you?

“You should consult a fertility expert who will guide you on the right treatment depending upon your age, medical history and conditions.”

If your fertility expert thinks ART is necessary, she will counsel you about the type of procedure, what it entails and the risks involved. 

“We counsel couples about the possibility of their child inheriting any genetic conditions and about risks such as multiple pregnancies, premature birth, low birth weight and birth defects.”  

“We also provide the full spectrum of obstetric services through our extremely well qualified obstetric team and neonatology and pediatric services through our well staffed and experienced pediatric department.”

What is the success rate of assisted reproductive technology? 

The success rate of ART varies greatly depending upon the procedure, the age, medical history and associated factors. 

Conclusion

“If you’re considering ART, you must be prepared to commit to it, financially and emotionally as it can take time and effort. “

“Carefully consider the fertility expert that you choose to partner with, as it helps to have someone who you can rely on, trust and be comfortable with as you embark on your journey toward parenthood.”

fertility-expert-sitarambhartia

Medically Reviewed by Dr. Priti Arora Dhamija

MBBS, Maulana Azad Medical College, Delhi (1999); M.D, Lady Hardinge Medical College (2004); DNB Obstetrics & Gynecology (2004); Diploma in Pelvic Endoscopy, Kiel, Germany (2014)

Dr. Priti has over 17 years of experience and is dedicated to helping couples conceive. She is best know for her optimistic, calm and compassionate approach.  

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