Assisted Reproductive Technology

What is assisted reproductive technology?

Assisted reproductive technology (ART) is a fertility treatment or procedure that helps you get pregnant. In vitro fertilization (IVF) is the most common ART.

ART is a treatment for infertility or when natural conception isn’t possible. It can also be helpful if you have a genetic condition that you don’t want to risk passing on to your child.

Using ART to start a family is a big and important step. Your fertility team knows you’ll have questions. They’ll help you understand the benefits, risks, costs and steps. And they’ll get to know you, your preferences and why you’re seeking help. They’ll suggest procedures and processes that make sense in your situation.

ART isn’t common. Fewer than 2% of all babies born in the U.S. each year are conceived using ART.

Types of ART

Assisted reproductive technology involves a person handling eggs, sperm or embryos. Healthcare providers use different fertility treatments and procedures. Your provider will recommend treatment based on the cause of your infertility and your preferences.

The most common examples are:

• IVF: A provider removes eggs from your ovaries and mixes them with sperm to fertilize the egg. Then, they place the fertilized egg into your uterus.
• Donor sperm/donor eggs: Your provider uses donated eggs or sperm to help you get pregnant.
• Intracytoplasmic sperm injection (ICSI): This procedure involves injecting sperm directly into the center of an egg.
• Freezing eggs or embryos: This process lets you delay pregnancy while preserving your fertility.
• Gestational surrogacy: This is when another female carries the pregnancy.

What is involved with assisted reproductive technology?

All ART procedures start with getting eggs from your ovaries. Then, a healthcare provider combines the egg with sperm to make an embryo. The last step is placing the embryo into your uterus.

The exact steps vary, but ART typically involves all or most of the following steps:

1. Ovarian stimulation: Hormone medications help your ovaries produce multiple eggs.
2. Preparing sperm: Your fertility team confirms sperm are healthy and active. They use a process called sperm washing.
3. Egg retrieval: A provider uses a thin needle to take mature eggs from your ovaries. They may freeze the eggs for you to use later.
4. Fertilization: Providers combine eggs and sperm to create embryos. They may use ICSI or other steps to increase the chance that sperm will fertilize the egg and create an embryo.
5. Embryo monitoring: Your provider watches the embryos in incubators for several days. They find out which embryos are most likely to result in pregnancy. Some people choose to freeze embryos at this step in the process.
6. Embryo transfer: This is the process of placing the embryo back into your uterus to achieve a pregnancy.

Some people do preimplantation genetic testing (PGT) on the embryos before embryo transfer. These tests can tell you the chances of the embryos having a genetic disorder.

What are the pros and cons of assisted reproductive technology?

The main benefit is that it helps couples and individuals become pregnant or have a family. It can also give you control over when you start a family. This can be helpful when you know you’d like to be a parent in the future.

Possible disadvantages of ART are:

• Risk of multiples: Your risk for having more than one baby is higher.
• Ovarian hyperstimulation syndrome (OHSS): A rare side effect of the hormone medication that helps you produce multiple eggs.
• Expense: Not all insurance plans cover fertility treatment. You should check with your plan to make sure you understand the costs
• Stress: It may take several tries for ART to be successful. The process can take a toll on your physical and emotional health.
• Ectopic pregnancy: There’s a slightly higher risk of ectopic pregnancy with ART compared to a natural conception.

There are other risks specific to each type of ART. Your provider can give you a better idea of what to expect based on your circumstances.

How successful is assisted reproductive technology?

According to the CDC, the overall average success rate of ART is about 21% per cycle in the U.S. An ART cycle begins when you start taking fertility drugs or a provider begins to check your ovaries for signs that your follicles are making eggs.

Some types of ART are more successful than others. There are many factors that go into determining if ART is successful. Some of those are:

• Your age
• Underlying health conditions
• Reasons for infertility
• Embryo quality
• If you use your own eggs or donor eggs
• The technique you use
• The clinic or laboratory success rate

Your provider can give you the best sense of how successful ART will be for you.