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What is Assisted Reproductive Technology? Amanda J. Weathers Assisted Reproductive Technology Assisted Reproductive Technology (ART) has been used in the United States since 1981 to help women become pregnant. The most common procedure is through the transfer of fertilized human eggs into a woman’s uterus. Infertility is often defined as not being able to get pregnant after trying for one year. Of the approximately 60 million women of reproductive age in 1995, about 1.2 million, or 2%, had an infertility-related medical appointment within the previous year, and 15% had an infertilityrelated medical visit at some point in the past. What is Infertility, Anyway? Infertility is a disease that affects the reproductive organs of both men and women. It impairs one of the body’s most basic functions, which is the ability to have children. Infertility affects about 6.1 million women and men in the United States; this is 10 percent of the reproductive-age population. Smoking sexually transmitted infections, age, and an unhealthy body weight can increase risks of infertility. Human Fertility Over A Lifetime Your decisions NOW can impact your ability to conceive in the future Stats and Facts: Infertility & ART •Infertility affects 6.1 million American women and men, about 10% of the reproductive age population. •Twenty-five percent of infertile couples have more than one factor that contributes to their infertility. •In approximately 40% of infertile couples, the male partner is either the sole cause or a contributing cause of infertility. •Irregular or abnormal ovulation accounts for approximately 25% of all female infertility problems. •Most infertility cases 85% to 90% can be treated with conventional medical therapies such as medication or surgery. •While vital for some patients, in vitro fertilization and similar treatments account for less than 5% of infertility services. Common Female Infertility Factors The most common female infertility factor is an ovulation disorder. Blocked fallopian tubes, which can occur when a woman has had pelvic inflammatory disease or endometriosis (a sometimes painful condition causing adhesions and cysts). Congenital anomalies (birth defects) involving the structure of the uterus and uterine fibroids can be associated with repeated miscarriages Common Male Infertility Factors The most common male infertility factors include azospermia (no sperm cells are produced) and oligospermia (few sperm cells are produced). Sometimes, sperm cells are malformed or they die before they can reach the egg. Also a genetic disease such as cystic fibrosis or a chromosomal abnormality causes infertility in men. Female Reproductive Organs Normal anatomy and regular menstrual cycles are key factors in establishing female fertility. The female reproductive system is mainly internal. The vagina is the passage that leads from the outside of the body to the cervix, which is the opening to the uterus. The uterus is a muscular organ about the size and shape of a pear, which is lined with a rich and nourishing mucous membrane called the endometrium. The uterus is where a fertilized egg attaches itself and develops into a baby. Male Reproductive Organs The male reproductive system is both internal and external. The testes are located within the scrotal sac, the pouch of skin located below the penis. The testes produce sperm and testosterone, the primary male hormone that helps maintain the male sexual characteristics What are the choices when using Assisted Reproductive Technology? Many couples have a difficult time admitting there may be an infertility problem. After each menstrual period and still no signs of becoming pregnant there is a high percentage that a couple is infertile.This is when ART comes into the picture. Top 7 Ways to Make a Baby Using Assisted Reproductive Technology Artificial insemination -- of mother with father's sperm Artificial insemination -- of mother with donor sperm In vitro fertilization (IVF) -using egg and sperm of parents IVF -- with Intra-Cytoplasmic Sperm Injection (ICSI) IVF -- with frozen embryos GIFT – Gamete Intrafallopian transfer ZIFT – Eggs combined with sperm and placed in fallopian tubes Artificial Insemination Artificial insemination: Introducing semen into the uterus or oviduct by other than natural means. In Vitro Fertilization In vitro fertilization: Taking eggs from a woman, fertilizing them in the laboratory with a man's sperm, and returning the resulting embryos to her uterus several days later. Intra-Cytoplasmic Sperm Injection Intra-cytoplasmic sperm injection - is a lab procedure to help infertile couples undergo in vitro fertilization due to male factor infertility. Gamete Intrafallopian Transfer (GIFT) Eggs are combined with partner’s sperm in a dish and then taken to a lab They are surgically injected into your fallopian tubes using a laparoscope Fertilization then occurs inside your body and the embryo implants naturally. Zygote Inrafallopian Transfer (ZIFT) The eggs are mixed with partner’s sperm, and then they are surgically place in your fallopian tubes. But then your doctor will wait until fertilization occurs to place the embryos inside you. Frozen Embryos Frozen embryos: Specialists may freeze additional embryos from a woman's cycle for later use. They may also freeze embryos of a donor in order to have them ready to place in a surrogate mother's uterus at the appropriate moment in the surrogate's natural or hormone-replaced cycle. ART Procedures Kids are the Last Thing on my Mind Why Does this Affect Me? If you wait to consider your fertility until you’re ready for a family, you may be too late. Just because you aren’t ready for children now it doesn’t mean you should hurt your chances of ever having them. What you do now, even years before you are ready to have children can impact your future ability to conceive. For the best chances for fertility don’t smoke , practice safe sex , maintain a healthy body weight, and pay attention to your body. Prenatal Tests Ultrasound: An ultrasound provides a non-invasive way to see inside the uterus using high-frequency sound waves to create visual images. Ultrasound can often detect major problems such as spina bifida and anencephaly, and it provides a way to measure the size of the fetus. It’s a Girl… The goal of every couple dealing with infertility is to have a positive pregnancy test. Although ART can be very expensive and time consuming, this cutting edge technology can change a person’s life. Bibliography American Family Physician. “Assisted Reproductive Technology Statistics.” InfoTrac Web. 1 February 2005. American Society for Reproductive Medicine. “Protect your Fertility.” <www.ProtectYourFertility.org>. 22 October 2005. Arizona Center for Reproductive Endocrinology and Fertility. “The Female Reproductive System.” http://www.infertility-azctr.com/repro.html. Baby Center Editorial Staff. “Fertility treatment: Assisted Reproductive Technologies.” Babycenter Medical Advisory Board. 2005. http://www.babycenter.com/recap/preconception/ fertilityproblems/4093.html. Center for Advanced Reproductive Services. Connecticut Fertility Center. “Fertility Myths.” http://www.fertilitycenter-unconn.org/education_myths.htm. Center for Fertility and Gynecology. “In Vitro Fertilization.” 2002. http://vermesh.com/in_vitro.html. Kelly, Raina. “Health Going Straight for IVF.” Newsweek 2005. <http://web2.infotrac.galegroup.com/itw.infomark/25/535. National Infertility Association. “What are my choices?” <http://www.resolve.org/main/national/ treatment/index.jsp?name= treatment>. Nova Online. “18 ways to make a baby.” April 2003. http://www.pbs.org/wgbh/nova/baby/glossary.html. Shaykh, Marwan. “Assisted Reproductive Technology.” Jacksonville Medicine, 2000. http://www.dcmsonline.org/jax-medicine/2000journals/may2000/art.htm.