- Genetics & Public Policy Center || Science || Assisted Reproduction -

Infertility, which affects men and women equally, is defined as the inability to get pregnant after 12 months of trying to conceive. Infertility affects about 10 percent of those at reproductive age in the United States. The majority of those affected can be treated successfully with medication, artificial insemination, or surgery. The remaining 10-15 percent require more advanced assisted reproductive technologies. Assisted reproductive technologies (ART) include all medical and laboratory procedures used to help people have children.

The following is a list of currently available ART (in alphabetical order):

Artificial Insemination (AI) is the placement of semen into a woman's uterus using a thin tube, called a catheter. The semen can be provided just prior to insemination or it can be obtained in advance and frozen. A male partner, a known donor, or an anonymous donor may provide the semen.

Cytoplasmic transfer (CT) is also known as ooplasmic transfer. The cytoplasm is the portion of the egg that includes fluid and organelles such as mitochondria (the energy powerplants of the cell). In cytoplasmic transfer, the cytoplasm from a donor egg is removed and injected in to the cytoplasm of a recipient egg before fertilization. The mitochondria from the donor cytoplasm may improve the development of the egg. However, the donor mitochondria are present in each cell of the embryo as it develops. In 2001, the FDA issued a letter to investigators stating the CT could be done only as an investigational procedure following FDA permission, effectively prohibiting the procedure.

Gamete intrafallopian transfer (GIFT) places harvested eggs and semen directly into the fallopian tube at the same time. This allows conception to occur in the body.

Intracytoplasmic sperm injection (ICSI) is the process of injecting a single sperm directly into the egg. Successfully performed for the first time in 1992, ICSI is now used with about 40% of all in vitro fertilization (IVF) procedures.

In vitro fertilization (IVF) and Embryo transfer (ET) is the process of fertilizing eggs in the laboratory. First, drugs are used to induce ovulation then a needle is used to remove the eggs from the woman's ovary. The eggs are then placed in a laboratory dish and sperm is added. After the eggs have been inseminated, they are placed in an incubator for 2-6 days in anticipation of fertilization and the development of an embryo. The couple may then decide whether each embryo will be transferred into the woman, frozen for later use, donated to another couple or discarded.

Ovarian Stimulation is the process of using drugs to increase a woman's ability to develop a mature egg or eggs for natural ovulation or IVF harvesting.

Preimplantation Genetic Diagnosis (PGD) involves removing one or two cell(s) from a 6 to 8 cell embryo, created through IVF. Each cell can be analyzed to detect either a chromosome or single gene disorder or a specific genetic characteristic such as sex. Occasionally, the analysis is done on a polar body.

Sperm retrieval is the harvesting of sperm from the testis or surgically removing sperm from the epididymis (a tube that connects the testes to the vas deferens) to be used to inseminate the eggs by ICSI . Sperm retrieval is necessary when a man is unable to produce enough sperm to fertilize all the eggs obtained from a single IVF cycle.

Sperm sorting separates the X-chromosome bearing sperm from the Y-chromosome bearing sperm. This technique, which is considered experimental, can be used to increase the chance of having a boy or a girl.

Third party reproduction is the use of sperm, eggs, or embryos from a donor and/or gestational surrogacy. Couples may decide to pursue one or more of these options for a variety of reasons. Some couples cannot produce sperm or eggs and treatments such as surgery or medication are unsuccessful or cannot be used. For these couples the use of a donor sperm or egg is the only effective alternative. Some women that are unable to carry a pregnancy use a surrogate mother to carry a pregnancy for them. Couples at increased risk for transmitting a genetic condition may choose to reduce the risk of transmission by using an egg or sperm from a donor.

Zygote intrafallopian transfer or Tubal embryo transfer (ZIFT, TET) is the transfer of zygotes (eggs fertilized through IVF that are not yet embryos) or embryos into the fallopian tube.

Last updated 5/2006