assisted reproductive technologies (ART)

IVF

In vitro fertilization (IVF) is the most common procedure and has grown in demand since the first child was conceived by IVF in 1978. IVF is a multi-step process in which eggs (oocytes) are extracted from the woman’s ovary (where the eggs are produced), fertilized by sperm in a laboratory, cultured into early embryos and then transferred into the woman’s uterus. According to the Centers for Disease Control, in 2004 the live birth rate per transfer for IVF was 34%.

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ICSI

Intracytoplasmic sperm injection (ICSI) is done in combination with IVF to increase the chances of fertilization. In brief, this procedure involves injecting a single sperm into an egg using a microscope and specialized instruments. ICSI is the treatment of choice for severe male infertility and can be used for unexplained infertility. Fertilization rates for ICSI are reported to be around 70% and higher.

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GIFT

Gamete intrafallopian transfer (GIFT) was developed a few years after IVF and is sometimes used for young women who have unexplained infertility. It is not often recommended since a woman must have at least one unblocked fallopian tube for GIFT. In GIFT, eggs are retrieved from the woman’s ovaries and placed with the male sperm (obtained prior to the procedure) into a small catheter. The catheter (a flexible tube) is used to immediately deliver the eggs and sperm into the woman’s fallopian tubes where nature takes over. Unlike IVF where fertilization occurs in the laboratory, in GIFT the fertilization takes place inside the woman’s body.

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ZIFT

Zygote intrafallopian transfer (ZIFT) is essentially a blend of both GIFT and IVF. Fertilization of the eggs occurs in the laboratory and the newly fertilized eggs (zygotes) are placed into the fallopian tubes rather than into the uterus as they would in IVF. ZIFT procedures are appropriate in cases of mild to moderate male infertility where there is a question about the fertilization capacity of the sperm and where there may be antisperm antibody production. It involves two separate procedures: an egg retrieval one day followed by a laparoscopy the next day to transfer the zygotes into the tube.

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IUI

Intrauterine insemination (IUI) is used for women with unexplained infertility, inadequate cervical mucous, for antisperm antibodies and in men with mild to moderate sperm abnormalities. The procedure is fairly simple and can be done in a healthcare provider’s office around the time of ovulation. It increases the likelihood of pregnancy regardless of the infertility treatment prescribed.

IUI is performed when a woman is releasing eggs (ovulation). Sperm is collected from the man prior to the procedure and it is washed with a special solution in the laboratory. It is then injected into the uterus using a thin tube (catheter) attached to a plastic syringe. IUI is also used if sperm shows poor motility (swimming ability) or if there is an ejaculatory problem, but the effectiveness of IUI is naturally higher if sperm parameters are within the normal limits. Results depend on the age of the female partner, diagnosis and the treatments done in conjunction with IUI.

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