Assisted Reproductive Technology (ART) includes in vitro fertilization-embryo transfer (IVF-ET), gamete intrafallopian transfer (GIFT), zygote intrafallopian transfer (ZIFT), and frozen embryo transfer (FET). These techniques also apply to oocyte donation and gestational carriers. Approximately 99 percent of ART cycles performed are IVF-ET. IVF-ET has helped many couples conceive successfully. ART may be recommended when other treatments (such as intrauterine insemination) have not been successful or when there is severe male factor infertility, severe endometriosis or tubal obstruction.
In order to perform IVF, oocytes must be obtained from the female (or oocyte donor). This is usually performed transvaginally under ultrasound guidance. During IVF-ET, the oocytes and sperm are combined in a culture dish in the laboratory. Fertilization and very early embryo development occur outside the body, rather than in the fallopian tube. Once early embryo development is recognized, the embryos are transferred either into the uterus (IVF-ET) or the fallopian tube (ZIFT). Since most programs have seen no significant difference in success rates, they usually perform IVF-ET because it is less expensive and doesn't require laparoscopy and general anesthesia. In addition, IVF-ET is the only procedure available for women with damaged fallopian tubes. Intracytoplasmic sperm injection (ICSI) is an additional procedure that is performed when the sperm count, motility, or morphology is abnormal or if there is a history of previous poor fertilization with IVF. Some programs will recommend ICSI if there is a long history of unexplained infertility as well. Gamete Intrafallopian Transfer (GIFT) is rarely performed today except for religious reasons.
Couples who are considering ART should realize that it is an intensely emotional, physically arduous, and expensive procedure. Couples should explore plans for the future, whether or not their attempts at ART are successful. In addition, psychological support can be helpful to couples undergoing this treatment.