ART is an acronym for Assisted Reproductive Technology. In the broadest sense, some consider all treatment for infertility, such as Clomid for ovulation induction, to be ART. It can also include artificial insemination.
However, the term usually refers to the advanced technology used in IVF (in vitro fertilization) treatment cycles. In an IVF treatment, the female partner takes injections of FSH (follicle stimulating hormone) to grow multiple ovarian follicles with eggs. The eggs are retrieved with light intravenous sedation and vaginal ultrasound guidance. Sperm (male partner or donor) is then prepared in the laboratory and then placed into the dishes with the eggs (insemination). This is the simplest IVF cycle, usually done if the woman’s tubes are blocked and the sperm are normal. IVF was the major, Nobel Prize winning, scientific advance in Reproductive Medicine by Robert Edwards and Patrick Steptoe, which is the foundation for all the advances described below.
The next layer of technology in ART is ICSI (intracytoplasmic sperm injection), which involves injecting a single sperm into an egg to assist in fertilization when the sperm count is very low or the sperm are abnormally shaped. This was a major breakthrough in IVF treatment for male factor infertility to avoid the use of donor sperm.
Another laboratory technique is sometimes used with day 3 embryos and is called AHA (assisted hatching) to help embryos implant. This technique is also used prior to the biopsy of cells from an embryo for genetic testing (I will describe this more in a subsequent Blog). Many AHA techniques were developed in the IVF laboratory at IRMS.
Severe sperm factor problems, in which there are no sperm in the ejaculate but there is sperm in the testicles, can be treated with ICSI and TESE (testicular sperm extraction) in which the male has surgery by a Urologist to remove testicular tissue with sperm. The IVF Embryologists then dissect this testicular tissue “hunting” for sperm, which can then be used for ICSI.
Embryo freezing (often of extra embryos) is another ART breakthrough that has led to many pregnancies when an embryo is thawed and transferred. A patient may not get pregnant after a fresh embryo transfer but may with a thawed embryo. Also, if the patient gets pregnant with a fresh embryo transfer, she may return for a sibling from a thaw cycle and not have to do all of the injections that are necessary in a fresh IVF cycle. In the past decade, Egg freezing has also become successful for Cancer patients and other women who desire fertility preservation. IRMS has long experience in both embryo and egg freezing.
Margaret Graf Garrisi, MD joined the Institute for Reproductive Medicine and Science in 1999. Dr. Garrisi brings more than 20 years of experience and achievement in Obstetrics, Gynecology and Infertility to her position as Medical Director of Assisted Reproduction in the Division of Reproductive Endocrinology.