Assisted Reproductive Technology

Lee Bladon 10:49 am

A.R.T.

Assisted Reproductive Technology

Assisted Reproductive Technology

Assisted Reproductive Technology (ART) refers to medical procedures or interventions that help individuals or couples to get pregnant when traditional methods have failed. ART involves the manipulation of eggs and/or sperm, often in a laboratory setting, to facilitate fertilisation, implantation, and ultimately, the development of a healthy pregnancy.

Common forms of ART include: In Vitro Fertilisation (IVF), Intracytoplasmic Sperm Injection (ICSI), Gamete Intrafallopian Transfer (GIFT), Zygote Intrafallopian Transfer (ZIFT), Donor Eggs or Sperm, Surrogacy and Embryo Cryopreservation (Freezing).

While ART has revolutionised reproductive medicine and offers hope for those with fertility issues, people are often directed down the IVF route without exploring other options. IVF can be very expensive, and according to the HFEA, it only has a 23% success rate (birth rate per cycle). Additionally, the invasive nature of examinations, tests, medications and procedures can take a heavy toll, physically and psychologically.

In Vitro Fertilisation

Assisted Reproductive Technologies for Women

Ovulation Induction

  • Objective: To stimulate the ovaries to produce multiple eggs.
  • Procedure: Fertility medications, e.g. Clomiphene (Clomid), Letrozole, or injectable gonadotropins, are used to induce ovulation, which is monitored through ultrasound and hormone level assessments.
  • Potential Issues: Multiple pregnancies. Ovarian hyperstimulation syndrome (OHSS), causing abdominal pain, bloating, and possible fluid accumulation in the abdomen and chest.

Intrauterine Insemination (IUI)

  • Objective: To facilitate the meeting of sperm and egg by placing prepared sperm directly into the uterus.
  • Procedure: Sperm is processed and concentrated before being introduced into the uterus during the woman’s fertile window.
  • Potential Issues: Low success rates.

In Vitro Fertilization (IVF)

  • Objective: Combine eggs and sperm outside the body, leading to embryo formation for implantation.
  • Procedure: Ovarian stimulation to retrieve multiple eggs, fertilisation in the laboratory, and transfer of one or more embryos into the uterus.
  • Potential Issues: Emotional and financial stress, especially when repeated cycles are involved. Multiple pregnancies. Ovarian hyperstimulation syndrome (OHSS).

Intracytoplasmic Sperm Injection (ICSI)

  • Objective: To address male infertility by directly injecting a single sperm into an egg.
  • Procedure: Used in conjunction with IVF, ICSI enhances fertilisation when there are sperm-related issues.
  • Potential Issues: Risk of genetic abnormalities.

Gamete Intrafallopian Transfer (GIFT) and Zygote Intrafallopian Transfer (ZIFT)

  • Objective: Place gametes (unfertilised eggs and sperm) or zygotes (fertilised eggs) directly into the fallopian tubes.
  • Procedure: GIFT involves transferring gametes, while ZIFT involves transferring fertilised eggs.
  • Potential Issues: Invasive surgical procedures, so carry the usual risks associated with surgery.

Egg Donation

  • Objective: The use donor eggs when a woman’s own eggs are not viable.
  • Procedure: Eggs from a donor are fertilised with sperm, and the resulting embryos are transferred to the recipient’s uterus.
  • Potential Issues: Possible emotional implications for the donor and recipients.

Surrogacy

  • Objective: Using a gestational surrogate to carry and deliver the baby.
  • Procedure: Embryos created through IVF, using the intended parents’ or donors’ eggs and sperm, are implanted in the surrogate’s uterus.
  • Potential Issues: Legal and ethical complexities.
Assisted Reproductive Technology Procedure

Assisted Reproductive Technologies for Men

Sperm Retrieval Techniques

  • Objective: To obtain sperm directly from the testicles or epididymis in cases of male infertility.
  • Procedure: Testicular Sperm Aspiration (TESA), Percutaneous Epididymal Sperm Aspiration (PESA), or Microsurgical Epididymal Sperm Aspiration (MESA).
  • Potential Issues: Can be uncomfortable.

Intracytoplasmic Sperm Injection (ICSI)

  • Objective: To address male infertility by directly injecting a single sperm into an egg.
  • Procedure: Used in conjunction with IVF, ICSI enhances fertilisation when there are sperm-related issues.
  • Potential Issues: Risk of genetic abnormalities.

Testicular Sperm Extraction (TESE)

  • Objective: To retrieve sperm directly from the testicles for use in IVF.
  • Procedure: Surgically extracting a small piece of testicular tissue to isolate viable sperm.
  • Potential Issues: Potential damage to the testicles during the extraction process.

Sperm Cryopreservation (Sperm Freezing)

  • Objective: To preserve sperm for future use, especially for individuals facing medical treatments affecting fertility or those with conditions causing infertility.
  • Procedure: Collect and freeze sperm for later use in IVF or ICSI.
  • Potential Issues: Reduced sperm viability after thawing.
Assisted Reproductive Technology Men

Assisted Reproductive Technologies for Couples

Preimplantation Genetic Testing (PGT)

  • Objective: To screen embryos for genetic abnormalities before implantation.
  • Procedure: Cells from embryos created through IVF are analysed for genetic conditions.
  • Potential Issues: False positives/negatives.

Cryopreservation of Embryos, Eggs, or Sperm

  • Objective: To preserve embryos, eggs, or sperm for future use.
  • Procedure: Freezing and storing reproductive material for later use, often in cases of fertility preservation.
  • Potential Issues: Storage limitations/viability.

Assisted Hatching

  • Objective: To facilitate embryo implantation by creating a small opening in the embryo’s outer layer (zona pellucida).
  • Procedure: Performed before embryo transfer during IVF.
  • Potential Issues: As with IVF, increased risk of multiple pregnancies.

Donor Sperm or Egg Banks

  • Objective: Provide access to donor sperm or eggs for individuals or couples with fertility challenges.
  • Procedure: Selection and use of donor reproductive material in IVF or IUI.
  • Potential Issues: Limited information about the donor.

As you can see, there are a diverse range of assisted reproductive technologies that can be selected based upon your individual circumstances. The choice of treatment depends on factors such as the cause of infertility, age, and overall health of the individuals involved. Consultation with a fertility specialist is crucial to determine the most suitable approach.

Assisted Reproductive Technology Procedure

NHS or Private Fertility Clinic?

Getting IVF, ICSI or IUI on the NHS isn’t guaranteed. NHS funded fertility treatments aren’t just a postcode lottery, they are also a personal lottery. Each NHS Integrated Care Board (ICB) has its own eligibility criteria that must be met in order to qualify for NHS-funded fertility treatment, however there are some common factors that most ICBs take into account:

  • Evidence of Infertility: You need to demonstrate that you have tried to conceive naturally for at least two years (or in some cases 3 years), unless there is a medical reason why this isn’t possible.
  • Woman’s Age: The upper age limit is typically 40-42 for most ICBs, but some have stricter requirements.
  • Clinical Factors, including whether you have any underlying conditions, and the number and quality of eggs you have available (ovarian reserve).
  • Lifestyle Factors: Have you ever smoked? Your body mass index (BMI) – all ICBs have a maximum BMI limit for the woman, and some also have one for the man.
  • Fertility History: If you’ve already had IUI or IVF, even if you paid for it privately, many ICBs won’t consider you for NHS-funded treatment.
  • Family History: 76% of ICBs will only fund IVF if neither partner has any living children, although some will allow it if there are children from another partner.
  • Relationship Length: Some ICBs consider how long you’ve lived with your partner.
  • Female same-sex couples also need to go through several (up to 12) rounds of artificial insemination (such as IUI), some of which must be self-funded (@ £900-1250 per round).

Finding out whether you are eligible for NHS-funded fertility treatment is now simple, thanks to Fertility Mapper’s Eligibility Calculator. All you have to do is click the button and enter some basic information, then the online calculator does all the hard work for you.

If you aren’t eligible for NHS-funded fertility treatment, Fertility Mapper also has a webpage that helps you to find a private clinic near you. It gives each fertility clinic a score out of five, based on real customer reviews, and shows the typical costs of IVF and Egg Freezing.

Is IVF an Expensive & Emotional Gamble?

Assisted Reproductive Technologies (ART) such as In Vitro Fertilisation (IVF) and Intracytoplasmic Sperm Injection (ICSI) offer hopeful solutions to those facing fertility challenges. However, it’s important to recognise that these technologies can involve a considerable financial investment, and they often come with unforseen physical and psychological implications:

  • Financial Impact: ART procedures often involves significant costs, including medical consultations, fertility medications, laboratory fees, and the actual procedures. The financial burden can be a substantial challenge, as multiple cycles may be required to achieve a successful pregnancy. 
  • Physical Impact: Undergoing ART procedures can exert a physical toll, especially the woman. The fertility medications used to stimulate egg production may lead to side effects, and the procedures themselves involve medical interventions. Hormone fluctuations, injections, and the retrieval or implantation processes can cause physical discomfort and stress.
  • Psychological Impact: The emotional and psychological toll of ART is also significant. The anticipation, hope, and potential disappointments associated with each cycle can lead to heightened stress and anxiety. Coping with the uncertainties and pressures of fertility treatments can adversely affect your mental wellbeing, and relationships and overall quality of life.

It’s important to remember that ART isn’t the only option – other, more natural, options are available, including our own Fertility Therapies. In most cases, your body is capable of getting pregnant, it’s just out of balance for some reason. We help our clients to rebalance their entire being, and restore their reproductive system to a healthier state, which allows it to do what is was naturally designed to do.

And if you do decide to follow the ART route, Fertility Therapies can support you energetically and emotionally, and maybe even increase your chances of success?

Whatever you decide, Fertility Counselling can provide invaluable support for individuals or couples with fertility issues. The associated emotional and psychological challenges can be profound, and counselling offers a safe and supportive space to explore your feelings, hopes and fears. It can also help you to manage stress, establish coping mechanisms, and develop emotional resilience.

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