ASSISTED REPRODUCTIVE

TECHNOLOGIES (ART)

Introduction ART is a general term referring to methods used to

acquire pregnancy by artificial or partially artificial means.

Several methods have been used to modify or stimulate the process of human reproduction & to treat severe cases of infertility in human male & female.

Assisted Reproductive Technologies are new techniques that have developed over years to help infertile couples to have children's.

Assisted Reproductive Technologies ( ART )

In vitro fertilization ( IVF ) Embryo Transfer Artificial insemination ( AI ) with fresh or frozen

semen Gamete intra fallopian transfer ( GIFT ) Zygote intra fallopian transfer ( ZIFT ) Intra cytoplasmic sperm injection ( ICSI )

Female

Harvest the ovum

Mix in a test tube

Natural ejaculation

Collect semen

Mature Ova

Motile sperms

Keep to develop embryo

Transfer to mother

Male

Basic Principle of IVF

Gamete intra fallopian transfer ( GIFT )

Suitable for women who have normal fallopian tube , but suffering with unexplained ( idiopathic) infertility

Fertilization occur but pregnancy does not result In this technique sperm & eggs are added separately

to the oviduct so that fertilization takes place naturally in the women body rather than out side as in IVF

The initial steps of IVF & GIFT are the same

• Laparoscopic device used for collection of eggs• Catheter used for injection of sperm and ovum in to

fallopian tube without fertilization ( Gamete transfer )

• Sperm and ovum kept in same catheter• Success rate is about 21%

ovaryuterus

Intrauterine Insemination (IUI)

Zygote intra fallopian transfer ( ZIFT )

This is the another treatment for unexplained infertility In ZIFT fertilization is done in vitro as in IVF & the

zygotes are transferred to the fallopian tube before cell division occurs

Zygote represent first or pronuclear stage in the life of an embryo

Select the best quality embryo for transfer & are laparoscopically inserted to the fallopian tube

Success greater than GIFT

ovaryuterus

Intra cytoplasmic sperm injection( ICSI )

In this techniques , the sperm is directly injected into the ovum in vitro

It has a very important advantage for men with extremely low sperm numbers or sperm motility ( oligospermia )

It can restore fertility after vasectomy or failed reversal vasectomy

Because ICSI can be used together with aspiration of sperm directly from the testes or the epididymis

Intracytoplasmic Sperm Injection (ICSI)Polar body

Egg

Sperm

Intra cytoplasmic morphologically selected sperm injection ( IMSI )

Next level of ICSI A very high power microscope is used to

magnify the sperm around 7000 times Once the best sperm has been selected the

IMSI procedure is carried out in exactly the same way as ICSI

Tubal embryo transfer ( TET )

This is new technique similar to ZIFT The only difference is that the embryos are

transferred back to the fallopian tubes two days after fertilization at the 2 cell to 4 cell stage

While in ZIFT one cell or zygote stage embryo is used for transfer into the fallopian tube

Success rate is greater than ZIFT

Oocyte donation In an IVF unused frozen eggs ( Oocytes ) are given to other

couples or women for transfer with the goal of producing a successful pregnancy.

A need for egg donation may arise for a number of reasons Infertile couples may resort to acquiring eggs through egg

donation When the female partner cannot have the genetic children

because she may not have eggs that can generate viable a pregnancy.

If donor agree for donation of eggs. Donors are subjected to tests for infectious ( HIV , gonorrhea , hepatitis etc..) as well as hereditary disease ( sickle cell anemia , thalassemia etc…)

Some women are born without ovaries or other reproductive organs.

Sometimes a woman’s reproductive organs have been damaged due to disease or other problems surgically problems.

Genetic disorders

Once the eggs are harvested it is used for fertilization or can be cryopreserved for future use. Such a system that stores & supply healthy ovum to couples suffering from infertility is known as an ovum bank.

Embryo donation

This is the form of third party reproduction In a IVF technology extra embryo developed The extra embryos are given to other couples or

women for transfer with the goal of producing a successful pregnancy

The resulting is considered the child of the woman who carries it and give birth , & not the child of the donor

Same as occurs with egg donation ( Oocyte donation ).