Assisted Reproductive Technology (ART) helps people achieve pregnancy. There are different types of ART, so it’s important to talk to your doctor and fertility specialist about which option is best for you.
For those experiencing infertility and difficulty getting pregnant, assisted reproductive technology can help. Assisted reproductive technology (ART) is an umbrella term for fertility procedures and treatments involving either eggs or embryos to aid in achieving a pregnancy. It supports those experiencing infertility, couples with genetic conditions, LGBTQ+ families , single parents by choice, and more.
What is Assisted Reproductive Technology? ART typically involves surgically removing eggs from a woman’s uterus, combining them with sperm in the lab, and transferring the embryo into the uterus for implantation. It specifically includes procedures involving eggs and embryos. ART does not include treatments where only sperm are involved or where women take medication to stimulate egg production without egg retrieval.
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Understanding infertility Infertility is diagnosed when a person is unable to get pregnant after a year or longer of unprotected sex. It’s common among both men and women. In the US, 1 in 5 women between the ages of 15 and 49 experience infertility with their first pregnancy (1 ). Causes of infertility can vary and include reproductive health conditions like polycystic ovarian syndrome (PCOS ), endometriosis , ovulatory disorders, low sperm count, or other health factors like age and obesity (2 ).
The process of getting pregnant involves several stages. Once the follicles in the ovary develop a fully mature egg, the ovary releases the egg, a process called ovulation. It travels down the fallopian tube, where it waits to be fertilized by sperm. If it’s fertilized by sperm, the egg continues to the uterus and attaches to the lining of the uterus (endometrium), an event known as implantation, and you become pregnant.
ART involves manipulating these stages of conception to increase chances of pregnancy. The most common type of ART is in-vitro fertilization (IVF), where it combines egg and sperm outside the body to create viable embryos.
Types of ART In-vitro fertilization (IVF): The most common ART procedure. IVF involves incubating the egg and sperm in a lab to create an embryo, which is then transferred into the uterus. While IVF doesn’t guarantee pregnancy, women under 35 have live birth rates of up to 55% with IVF (3 ).
There are four steps to IVF:
Superovulation: Also known as ovarian stimulation. Hormones are injected over 8 to 14 days to stimulate the ovaries to produce multiple mature eggs. Egg retrieval occurs 34 to 36 hours after the final hormone injection. Egg retrieval: A needle is inserted through the wall of the vagina into the ovaries to suction and collect eggs. Some eggs may be frozen and stored for future use if the patient wants to delay pregnancy or if fresh embryos fail to implant. Fertilization: The eggs are incubated with the sperm to form an embryo. If the sperm is not able to fertilize the egg on its own, a single sperm is injected into the egg using a needle, a process called intracytoplasmic sperm injection, or ICSI. Embryo transfer: The resulting embryo is placed back into the uterus 1 to 6 days after fertilization, using a long, thin tube. Embryo transfer is timed with the patient's ovulation cycle or medically managed with estrogen and progesterone medication to prepare the uterine lining for implantation. Intrauterine insemination (IUI): IUI is a less-invasive procedure, sometimes called artificial insemination. Sperm is inserted directly into the uterus using a long narrow tube. This method is often used for men who have low sperm count or where sperm donation is needed. While success depends on a variety of factors and the cause of the couple’s infertility, success rates can be as high as 20% (4 ).
Third party-assisted ART: This is another type of ART where patients may opt for assisted reproductive technology with third-party involvement such as donated sperm, eggs, embryos, surrogacy, or a gestational carrier to achieve pregnancy. This method may be used if other fertility treatments and traditional ART methods do not work.
Sperm donation: Donated sperm may be an option if the man does not produce sperm, produces a low quantity of sperm, is a carrier of a genetic disease, or if the woman is pursuing pregnancy without a partner. This can be used with IVF or IUI methods. Egg donation: This is an option for women who cannot produce viable eggs due to ovarian conditions, cancer treatment, or surgical removal of ovaries. The egg donor undergoes superovulation and egg retrieval. The donated egg is fertilized by chosen sperm and the embryo is implanted into the woman’s uterus. Surrogates or gestational carriers: If a woman is unable to carry a pregnancy to term, they may choose a surrogate or gestational carrier. Surrogate: A woman is inseminated with the sperm from the male. The child will be biologically related to the surrogate and the male. Gestational carrier: The embryo is not biologically related to the carrier. This is an option when a woman produces healthy eggs but is unable to carry the pregnancy. Embryo donation: Couples who have successfully completed IVF, they may choose to donate their remaining embryos. This allows the recipient to experience pregnancy and childbirth. This may be an option for women who are infertile and have been unsuccessful with IVF or at high risk of passing on genetic disorders. ART risks and considerations While ART can help assist in creating a healthy embryo, it doesn’t guarantee pregnancy. These procedures are also intensive and can cause bleeding, infection, mood swings, and other physical and emotional discomfort. IVF increases the risk of multiple births, premature delivery, miscarriage, and low birth weight.
These treatments are also expensive. A single cycle of IVF–including one egg retrieval, embryo transfers, and medications–can cost upwards of $25,000. Plus, doctors may recommend multiple rounds of IVF to increase the chance of success. Some insurance plans and employers may offer fertility benefits to reduce the costs (5 ).
>>MORE: Fertility Treatment Options, Summarized
Assisted Reproductive Technology: the bottom line Navigating infertility can be emotionally and physically challenging. Infertility is no one’s fault, and ART provides valuable options to help you build your family. Everyone’s fertility journey is unique, so it’s important to consult with your healthcare provider and fertility specialist to determine the best approach. Understanding your fertility options enables you to make informed decisions about your path to parenthood.
