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The Art of ART
All About Assisted Reproductive Technology
By Teri Brown
When considering assisted reproductive technology (AR
T), many couples are faced with a dizzying array of options and choices. Carolyn Coke of San Antonio, Texas, remembers that feeling all too well.
"It was confusing and frustrating and even a little scary," she says. "It was a lot more intense than I thought it was going to be. It's difficult to make the right decisions and frustrating to spend all that money with no guarantees."
Coke's long road to fertility has a happy ending, though. Last year she gave birth to a healthy baby girl.
The field of ART has made numerous advances in the past couple of decades, leaving parents overwhelmed by the amount of information thrust at them. Dr. Paul B. Miller, associate professor of clinical obstetrics and gynecology at the University of South Carolina School of Medicine, says the term ART actually pertains to many different types of procedures.
"Several procedures are listed under the general heading of assisted reproductive technologies," Dr. Miller says. "Included on this list are in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), gamete intrafallopian transfer (GIFT), zygote intrafallopian transfer (ZIFT) and tubal embryo transfer (TET)."
Dr. Miller says all of these procedures involve stimulation of ovarian follicle development with injections of pituitary hormones, such as follicle stimulating hormone (FSH) and luteinizing hormone (LH), to produce multiple mature eggs.
The type of ART a couple chooses depends on many things, such as overall health, special needs and more.
In IVF, eggs are removed from a woman's ovaries during a minor procedure. A needle is passed through the wall of the vagina and into the ovaries under ultrasound guidance. Each follicle is punctured and drained, and the fluid is passed off to laboratory personnel for inspection and isolation of the eggs. According to Dr. Miller, once the eggs are in the laboratory, they may be exposed to a micro drop of concentrated sperm with conventional IVF, or in cases of male factor infertility, may be injected with a single, well-selected, normal sperm under a microscope (ICSI). Eggs fertilize and develop into embryos, which in turn are transferred back to the uterus through the cervix using a small, two millimeter catheter two to five days after egg retrieval.
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