INTRODUCTIO·N

Assisted Reproducfr,1e Techniques are medical procedure·s used primarily to address infertility. It
includes procedures such as In Vitro 1Fertii1lization {IVF). It may indudeJntracytoplasmic Sperm
Injection (ICSI, Cryopreservation of gametes or embryos, and/or may involve the use of ferti lity
medication. When used to address infertilityJit may also be referred to as. fertility treatment. ART
mair1ly belongs to the field of reproductive endocrinologry and infertility. Some forms of ART are
a1lso•used concerning fertile couples for gene·tic re·asons {preimp!lantation genetic diagnosi1s). ART
may also be used in surrogacy arra ngements, although not all ·surrogacy arrangements i1nvolve
ART. It is treatments or procedures t hat i1nclude hand lingi of human eggs and sperm or embryos.
to establish a pregnancy.

It in\lolves surgically removing eggs from

women and combi ning them with sp-e1nm in the
laboratory. ART also helps in solving
abnormalities due to genetic issues infertile
couples. Cou ples also choo~e ART if they are
incongruous to particular communica ble
diseases. ART techn iques help to reduce the infection risks at the time of pregnancy parturition
and lactation.
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These ART data are a rich source of information that can give potential ART users an idea of their
average chances of success per ART cyde or ART transfer. Average chances, lloweverr do not
necessarity apply to a partrcular individual or couple. ART success rates vary in the context of
patient and treatment characteristics, such as age, infertility d ia,gnosis. number of embryo·s
transferred, type of ART procedure, use of tech niques such as ICSI, and history of previous births,
miscarriage~ and ART cycles. IPeople consideri ng ART should consult ai physician to discuss their
treatment options.
 INFER TXLITY
Infertility is the inabi lity o'f a
person to reproduce by natural means.
It is usuaUy not the, natural state of a
healthy adult. It is the inability to
become pregnant after one year of
int,ercourse without contraception
involving a male and female partner. It
may be that one partner cannot
contribute to ,conception_or that a woman is unable t o carry a pregnancy to full term.
There a,re many causes of infertility, including some that medical interventfon can treat.
Estimates from 1997 suggest that worldwide about five percent of all heterose>eual
couples have an unresolved problem with infertility, Many more coup les, however,
experience involuntary childlessness for at least one year: estimates range from 12% to
28%. Infertility 1
in 25-40% cases are due to c,o mbined problems in both parts (both the
femafe and male).

Causes of InfertlUty
Factors affecting Con~eption:

,. production of healthy sperm.

,,,. healthy eggs by the woman.
:..- Unblocked fallopian tubes.
, The ability of the sperm to fertilize the 1egg.
, The ability of the embryo to implant in the uterus.
- O vularory C::l~runcuon
- 1.. bdl d i':11".. ~i<! Fertility declines with age in both men and women,
- 1\1..! le tri fo r1L 11\'but the effects of age are much greater in women. In
- End c,miP. trlcn h,
u ru•xpla l,wd the ir 30s, women are about half as fertile as they are in
0 1i.e !\
1 their early 20s, and women •s chance of con,ception
declines significantly aft,er age 35.6 Male fert ility also declines with ag,e, but more
gradually.
·¥sirna11t Inf~rtititg
Female infertillity refers to infertility in women_ It affects an estimated 48 miHion women,
with the highest prevalence of infert1 iI~ty affecting people in South Asia, Sulb-Sah~uan Africa.
North Africa/Middl e East, and Ce ntra VEastem Eu ro1pe and Centra I Asia_ Infenil1ity is caused by
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many sou re~ including nutrition! diseases, and other mailformations of the uterus. Infertility
affects women1from around the world. and the ,cultural! and social st~gma surrounding it varies.
Fe1male lnfertili1ty is. the cause· for 20-35% of Infertility cases.

Causes:
► Age: The ability to conceive starts 't,o,f.alll around t ne age of 32 years.

► Smoking: Sm.0 king significantly iinoreases 'the risk of infertility i1n both men and wo,m en 1
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and it may undermine the e·ffects of fertility treatment. Smoking during 1pregnancy
1ncreases the cha nee of pregnancy Ioss.

► Alcohol: Any amount of alcoholl ,c onsumption can affect the chances of conceiv•ng .

► IBei ng obese or overweight: This can ancrease ·the risk of infertility in women as well as
men.
}.- !Eating disorders: If an eating disorder l eads to serious weight loss, fe,r tility proble,ms m.a~
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arise·.
► Sexually Tran<Smitted Infections (STls):
► Eg: Chla1mydii a can damage the falllopian tubes in a woman.
► 1E_xiposure to some ,chemicals: S01me pesticides, herbicides, metalls, such as lead, and
solvents have been Ii nked to fertility 1
problems in both men and women. A mouse study
has suggested that ingredients in some household detergents may·r,educe fertility_
► Ow lation Disorders
► Blocked falllopia1n tube,s ca used by a pelvic inflam mato ry disease or endornetri:osis.{ a
condition that cau.ses adhesions ,and cysts)
Male lnferti lity
Mal,e infertilirty r,efers to a male's inalbilli ty to ,cause pregnancy in a fertile female. In humans, it
ac,counts for 40-50% of 1infert1Uity. It affects approximately 7% of aH men. Male infertility 1•s
commonly due to d efic i,encies in the semen. and semen quality 1,s used as a surrogate,me·a1su re
of malle fecundity. The main sig1n ,o f male in·fertiliity is the inability to conceive a child. There ma1 y
be no other obvious sig RS or symptoms, In some cases, howev,er. an underlying problem such a:
an in herited disorder, a hormonal imbalance, di1la·ted veins around the testic lie or a condnion tha
blocks the p,assaige of sperm causes signs and symptoms.
Causes:
Mal,e inferti1lirty is due to low sperm product,ion, abnormal sperm functiio,n oir blockages that
prevent the delivery of ·sperm. llln1esses, injuries# chronic health problem·s, lifestyle choices., and
other factors,can play a 1role in caiusing male infertility.. Some c:ommon causes are
. Azoospermia - Iack of sperm pr,oducti on .
· Inability to ejaculate normaUy.
, Varicocele - Veins in the scrotllm are enlarged which can he.at the inside of the scrotu1m and
can affect sperm production.
· Terato5ipermia - increased percentage of abno:rma,I shapes.of the sperm.
Statistics of l1nferti lity :
• llnf,ertility affects more ·than 11So/o of the couples in the United Staites.
• About ,on,e-third of infertillity cases are caused by male factors.
• lln about 20% of infertile couplesj the ~use is unknown.

• The remiaining one -third of infertile cas.es is caused by a combination of factors in both
partners.
• The chainces of becoming pregnant decreases 3-5 % per year after the age ,o f 30.

lnfertillity is not an ea,sy condition aind is certainly very diffi cu It to deal and face. Fortunately.. we livE
in a time where there ar,e•many ART treatments available that help to deail with this sUuation .and
solve it
lnfertiility is not an easy condition and is certainly·very difficult to deal and face. Fortunately, we live
in a time where there .are many ART treatments available that help to deal with this situation and
so1ve it.

Assisted R•p,odudive 'iechnology (ART)

.Assisted Reproductive Tedhnology is a number of different processes for the treatment of infertility.
It helps to own pregnancy in different methods like in vitro ferti lization. surrogacy, and fertili~
medkatl,ons. ART falls into the catego,y of field endocrinology and cryopr,eservation, reproductive
technologiy and infertility treatments, and intracytopl asmk sperm injection (ICSI)•
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.ART also helps in solrving1abnOffl'l,alities due to genetic 1issues in the fenile couples. Couples also
choose ARTif they aire Incongruous to particular c01mmuni·cable diseases, ART techniques help to
reduce the 1infection risks at the time of pregnancy parturi,ti:on and lactation.
 !Infertility is not an easy condition and i5 certainly very diffiwl~t 10 deal and face. However. there are
many ART treatments availlable that hel,p to deal with this situation and solve it. Various types.,o f
ART to solve infertility complications are

• In V:itro FertH ization1(IVF)

• GIFT
• ZllFT
• lntracytoplasmic sperm 1injection (l:CSII)
• lntrauterl ne In semi l\ation (I UI)
• Surrogacy
• Donor Eggs

11n Vitro Ferti llization (IVf )

lln Vitro F'ertil ization •or IVF is one of the most common types of ART techniques~Majority of the
patients opt for IVF over otiher ART methods. In this method. a woman's ,egg and a man's sperm
a'fe undergoing combinaition in the laboratory. The next step is to tran~fer the embryo i1nsidethe
woman's uterus immediately after the ferti lization of the embryo.

The method starts with the keeping track of the woman's ovulatory process and stimulatiog rt in
order to remov,e an egg (ovuim or ova1 ) from the woman's ,ovaries. The eggs are kept with sperm in
a liquid for fertillization in a laboratory. The fertilization of egg results in the formation of zygote,

!Furthermore, the zygote undergoes ,embryo OJlture for the duration of 2-6 days. Finally, trans.fer of
the e,mbryo culture i1n the same or another woman's uterus takes place with the aim for the
establ'ishm,ent of a succ:esstul pregnancy.

Game1e Intra.fallopian Transfer (GIFO

IEartier before the advancement of technology, Gam,ete lintJrafaUopian transfer (GIIFn was very
common for couples ha\A ng infertility issues. l n th is method, eggs from woman and sperms from
man undergo combinatilon by employ! ng laboratory techniq1ues in ~he·lab.

!Later, the eggs are i1mplanted 1in the fallopian wbe of the femalle., The fertil~ation occurs inside the
body ,o f the women by ap1plying Gl'FT t11eatments and not in the lab. c:oup Ies who want a natural
treatment so that the ·fertilization and im:plantation process occurs inside the woman's body qpt for
this form o,f assisted reprodudive technology.
(Source: expla-rebiotech)

Zyg,ote Intrafa Ilopiia n r ransfer (ZJl:FT)

This is another form of assisted reproductive techno~. ZIFT is si1mila'r to IVF and embryo transfer.
However, the primary difference iiS that the embryo tJansfer after fertilization is done 1in the
fallopian tu be 1i n case of ZIFT whereas in case of M the embryo is transferred in the uterus. The
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other name of this,method is,T1ET (tubal embryo transfer) due t,o the transfer of embryo directly
into the tubes. The next ·step in the !Process is to transfer the fertil azed egg1i1n the fa lllop ian tube at
24 hours,

Intra Cytoplasmic Sperm Injection

It is a spedal form of in vitro fenilization techniq...e that helps in the formation of an embryo in the
man by direct injecliton ,o f the sperm into tiheegg/owm. lnthistechnique·, rt i~ possible to directly
inject a si nglle sperm oel I into the cytoplasm1of the,ova. This techfil'ique helps in the prep aration of
metes and formation of embryos which 1is finaUy transferred into the uterus of the woman .
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Source: Wi kipedia
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Intrauterine !Insemination (I UI)

Intrauterine Insemination is the process of transfer of a man's sperm into a woman's uterus with
the help of a long narrow tube. Moireover,. it is possible to apply this method in combination with
sti mutation of ovulation. Tog ether the processes can sometimes increase the chances of pregnancy

The success rate of this technique co•mplet:ely depends upon the reason of infertility. Additionally, it
is possiible·to inorease the success rate of this method by nearly 20 percent if the inseminations
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take place on a monthly basis with fres.h or frozen sperms. However, the il'\Cfe.ase of :success rat,e
depends upon woman's age, fertility medications. infertility diagnosis. and many other reasons.

(Source: Wfkimedia)

Surrogacy

Surrogacy refers to the process wher,e another woman bears a,baby oft he couple faoing inferti1lity
issues. The formation of the baby can take plac-e either by fertilization of egg .and ~perm from the
couple or from donor egg and sperm_ Thus we can say a surrogate act as the carrier of the baby.
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condition until the transfer of the embryo to the woman·s uterus. The same process is applicable
using sperm from a donor if the same problem liies in male member of the couple.

As we can see, there are many options available for the treatment of infertil1ity. However, these
techniques require very high precision technique along with expensive instruments and
experienced and trained professi-onals. The numbers of centres are gradually increasing but still,,
there are very few centres in the country. Moreover, many factors such as relig1 ious, social and
emotiona l play an important role and sometime deterirent in the adoption of ·this method.

The main aim of d'te·method is to have children. However. one thing that majority of the couple
unable to ha,ve children o\Jerlook is that there are many orphan and destitute children in need of
proper a Iife. These children wi II not even survive·til I maturity if they do not get a1good Iife.
Moreover, there are laws in India that help a couple to adopt these childr,e.n.

The couples if opting for this option for parenthood, not only they will be able to ha,ve a chi I'd but
they will also be able to give a proper and healthy life for the children who are in dire need for ,this.