Assisted Reproductive Technology (ART)

With all of the talk and various organizations dedicated to raising awareness about contraception and ways to avoid pregnancy (which is remarkably important in the field of human sexuality), information regarding conception is sometimes neglected. This is a topic that may seem self-explanatory, but several difficulties can arise, especially for gay and lesbian couples, along with heterosexual couples that encounter fertility problems. Luckily, modern technology offers several alternatives to “traditional” conception.

Artificial Insemination

Artificial insemination is the easiest alternative to conception via intercourse, and it has been used successfully with animals for centuries. This method simply entails inserting sperm into the vagina without sexual intercourse. In humans, there are two variations: artificial insemination by the husband (AIH) and artificial insemination by a donor (AID). AIH is used when the husband, boyfriend, etc. has a low sperm count. Many samples of his semen are combined to produce a higher sperm count, increasing the chances of a healthy sperm reaching the egg. This sample is then placed into the vagina or uterus of the female by artificial means. AID (very different from the sexually transmitted disease AIDS) is used when the father-to-be is sterile, a lesbian couple would like to have a child with one of them serving as the biological mother, or when a woman desires pregnancy but does not have a partner. Some people have tried to use artificial insemination for gender selection (using the process to choose a desired sex of the child), but the success rates are not significantly higher than the natural probability of having a boy or a girl.

Embryo Transfer

Another method of ART is embryo transfer, which is the exchange of a developing egg from one woman's uterus to another's. It is generally used for two groups. A woman who can conceive, but is prone to miscarriage (perhaps the lining of her uterus is an inhospitable environment for the egg to implant), can use embryo transfer with the help of a surrogate mother to ensure a more successful pregnancy. In this instance, the genetic material is that of the two parents, only the utilized uterus is of another female. In a brief surgical procedure, an egg is removed from the mother-to-be’s ovary, fertilized by the desired sperm, and is placed into the uterus of the surrogate. There the fetus can grow to full term in the womb of another woman, but it still the genetic combination of the initial female and her partner.

Also, embryo transfer can provide a solution for women who do not produce viable eggs. This process can potentially be seen as the opposite procedure of the first. Sperm taken from a male donor or the female’s partner artificially fertilizes another woman's egg, which is then transplanted into the mother's womb and continues growing. In this situation, the female carrying the child is not the biological mother (because she is using another woman’s embryo), but she is able to carry the fetus to term and give birth to the child as if it were her own. This process can be quite expensive for the parents-to-be. For the surrogate mother or donor of the viable egg, however, embryo transfer is very profitable.

In Vitro Fertilization

A third method of assisted reproductive technology is In Vitro, which literally translates to "in glass." In vitro fertilization (IVF) takes place outside of the woman's body and in a laboratory, thus explaining the popular phrase, "test tube babies." First, the woman’s ovulatory cycle is stimulated and monitored in order to remove a naturally ovulating egg for fertilization (versus removing one directly from the ovary before ovulation and risking the chance of an unhealthy egg). A needle is inserted directly into the ovary to retrieve the embryo in a surgical procedure lasting about 15 minutes. The patient is given pain medication and is typically able to go home within a couple of hours. The egg is placed in a liquid solution, typically in a Petri dish, along with the sperm of either her partner or a donor. Between one and five days after fertilization occurs, the resulting embryo is inserted into the female's uterus using a thin catheter. While almost anyone can take advantage of this technology, it is especially useful in instances of fallopian tube obstruction, when egg and sperm cannot unite due to physical abnormalities. The Reproductive Fertility Center provides valuable information for individuals considering this type of reproductive assistance:

For Women:

-Avoid drugs, alcohol, and smoking for three months before and during treatment

-Have no more than two caffeinated beverages a day

-Avoid dietary changes and weight fluctuation during IVF cycle

-Avoid hot tubs and saunas

-Abstain from sexual intercourse 3 to 4 days before the egg is removed, and after the embryo transfer before the pregnancy test

For Men:

-Sperm quality can be affected by fever. Men who have had a fever 1-2 months before the IVF process should inform their doctor

-Also avoid hot tubs and saunas (can lower sperm count)

-Avoid wearing tight-fitting underwear

-Avoid drugs, alcohol and smoking for 3 months before and during the IVF cycle

-Avoid excessive exercise

-Abstain from intercourse at least 3 but no more than 7 days prior to semen collection

GIFT and ZIFT

GIFT (gamete intrafallopian transfer) and ZIFT (zygote intrafallopian transfer) are two more methods of assisted reproductive technology similar to In Vitro. Many women turn to this method of conception because it is a much quicker process or if they have not been successful with IVF. GIFT involves the insertion of unfertilized eggs and sperm (not yet joined together) into the fallopian tubes, which allows natural mechanisms to take over after the initial introduction of the reproductive gametes (sex cells). Zygote intrafallopian transfer (ZIFT) is quite similar to GIFT, except the unification of the sperm and egg occurs in a laboratory, not in the female’s oviducts. The resulting zygote is then placed into the fallopian tubes to allow for natural implantation. In the United States, IVF is still far more popular than either of these methods, due in part to the fact that it faster and does not require a surgical procedure. Also, neither of these processes are effective for women with damaged or missing fallopian tubes. Roughly 98% of ART procedures in the U.S. are done by In Vitro, while less than 2% of the American population utilizes GIFT or ZIFT.

While assisted reproductive technology is making conception easier for many couples, it is worth mentioning three details. First, success rates vary quite a bit, typically hampered by factors like older age and/or poor health. Second, these procedures require advanced medical expertise and technology, making them expensive and difficult to access. Finally, some ethical dilemmas may arise concerning the nature of the procedures, and therefore may not be the right choice for everyone. Adoption is another alternative for people who want children but cannot conceive. 

References:

The Society of Assisted Reproductive Technology is a valuable resource that was instrumental in compiling this information.

To visit the webpage of the Reproductive Fertilization Center for more information on ART, visit http://www.reproductivefertility.com/?ibp-camp=G_RFC&gclid=CJGFlrnCxq8CFWvktgodynrdaQ

WebMD: http://www.webmd.com/baby/gift-and-zift

 

Last Updated 20 February 2013.

 

 

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