Assisted Reproductive Technology (ART), also referred to as assisted reproduction or assisted conception, can be defined as the set of techniques and medical treatments that allow individuals and couples to start a family when it cannot be achieved naturally due to infertility problems.
Nowadays, between 12% to 18% of couples willing to create a family suffer from infertility, with 50% of the cases due to male factor infertility, and the remaining 50% caused by female infertility. It can also occur that both members of the couple are childless.
There exist another group that has no alternative but to turn to fertility treatment to have babies: single males and females, as well as same-sex couples.
Currently, the main fertility treatments available for these patients to fulfill their dreams are, on the one hand, intrauterine insemination (IUI) and in vitro fertilization (IVF), which can be combined with other options such as third-party reproduction, also known as donor-assisted reproduction, or PGD (Preimplantation Genetic Diagnosis).
The various sections of this article are assembled in the following table of contents.
Meaning of ‘Assisted Reproductive Technology’
The term Assisted Reproductive Technology, which medical abbreviation is ART, and is often referred to as medically assisted reproduction, assisted conception of fertility care, can be defined as the set of techniques and procedures that replace the natural process of conception.
The types of methods used depend on the what is causing infertility, and the type of infertility the patient suffers from. Broadly speaking, with assisted reproduction we can intervene at any point of the reproductive process, being the following the most common ones:
- Development of ovarian follicles
- Transportation of human gametes: egg and sperm cells
- Fertilization: when sperm meets the egg
- Selection of high-quality embryos
To overcome the barriers that can be found naturally in any of the processes listed above, we use fertility medications in combination with different methods, such as IUI and IVF. Moreover, there exists another method that provides even higher success rates: Intracytoplasmic Sperm Injection (ICSI).
To date, great advancements have been achieved in the field of assisted reproduction, to the point that today patients can have access to donated eggs and sperm in case they are unable to have biological children when they are at risk of transmitting a disease or because they lack gamete production function.
History of assisted human reproduction
Until late 20th Century, people who experienced trouble with fertility had to resign or turn to adoption if they wanted to become parents.
After 1978—year in which Louise Brown, the first «test-tube baby», was born—everything changed and assisted reproduction became the perfect solution for childless people.
The technique used was IVF. An egg was taken from the mother and its union with the sperm took place in a plate at the laboratory. After that, the resulting embryo was cultured until it divided into four cells, and then it was transferred back for implantation in the intended mother’s womb.
The success of the first IVF cycle led to the development of the set of techniques that are now commonly known as assisted reproduction.
At the beginning, the estimated chances of success were rather low, but they were further improved over the years, since a greater number of well-trained professionals in the field of reproductive medicine were incorporated progressively. Nowadays, thousands of children are born year after year thanks to assisted reproduction techniques.
Recently, Louise Brown has had children of her own naturally, which has proved that the use of assisted reproduction for conceiving a child does not translate into the baby born as a result being childless by default.
When to go see a fertility specialist
For a couple to be diagnosed with infertility or sterility problems, firstly at least one year of unprotected intercourse without success in achieving a pregnancy is necessary. This period of time is usually shortened to 6 months when the woman is aged 36 years or over. In cases where infertility is manifest, as when uterine malformations are present, these guidelines have no sense.
In these cases, couples are recommended to visit a fertility clinic to undergo a fertility evaluation firstly, and learn about the potential causes that are preventing them from having a child.
What follows is a summary of the most common infertility or sterility problems that make conception difficult or prevent it:
- Male infertility
- poor sperm quality or zero sperm count.
- Female infertility
- alterations in the menstrual cycle, diminished egg quantity and/or quality, and problems that affect embryo implantation or the normal development of the embryo.
Should there exist a disease that could lead to the birth of an ill baby, couples are recommended not to try to conceive naturally, and rather visit a fertility clinic to have a genetic screening done.
Regarding single males and females, lesbian couples, or gay couples, they are advised to get as much information as possible beforehand about their options according to the regulations governing assisted conception in their countries, and use it whenever it is possible.
Types of assisted reproduction techniques
The main goal of assisted reproduction in humans is to achieve a successful pregnancy that leads to the birth of a healthy baby.
Progress made in reproductive sciences, along with the emergence of new technologies, allows the continuous growth in number of assisted reproduction techniques, while at the same time helps improve the existing protocols and methods.
Artificial insemination and in vitro fertilization are the most widely used assisted reproduction techniques, each one of them with a series of advantages and disadvantages that one should be aware of.
The use of one technique or another depends on the existing type and cause of infertility, as well as on medical recommendations. Fertility specialists will always try to use the simplest and least invasive method in the first place.
If the expected chances of getting pregnant are lower than normal for a particular case, or if a pregnancy has not been achieved after several attempts, you will be encouraged to move to another technique.
Artificial Insemination (AI)
It is the fertility treatment involving the lowest complexity, and the most similar one to natural conception. It involves the insertion of sperm directly into the female reproductive system, usually in the womb, to ease make it easier for the sperm to reach the egg in the Fallopian tube, as it happens when pregnancy is achieved naturally.