Assisted Reproductive Technique: Treatment, Procedure, Cost and Side Effects

Assisted reproductive technology is used to treat infertility i.e. it refers to treatments that assist people to achieve pregnancy. It includes fertility treatment which handles both a woman’s egg and a man’s sperm. The most common type of ART is In Vitro Fertilization .

Depending on the cause of infertility, the type of treatment will be advised. There are various other types of treatments which include:

• Ovulation Induction is the stimulation of ovulation by medication
• Artificial insemination is the deliberate introduction of sperm into a woman’s uterus or cervix
• Donor conception
• Gamete Intrafallopian Transfer was launched as a more natural version of IVF, where eggs are removed from a woman’s ovaries and placed in one of the fallopian tubes along with man’s sperm.
• Intracytoplasmic sperm injection is an in vitro fertilisation procedure in which a single sperm is injected directly into the egg.
• Preimplantation genetic diagnosis , surrogacy is a method where a woman agrees to carry the pregnancy for another woman.
• In Vitro Maturation where immature eggs are collected from a woman’s ovary and are matured in the lab and then ICSI is performed to achieve fertilisation.

Ovulation induction may be used as a treatment method by women who are not ovulating or not ovulating regularly. Ovulation induction involves taking a hormone medication which may be a tablet or an injection, and which stimulates the production of ovarian follicle-stimulating hormone. It also reverses the anovulation or oligoovulation condition. This assist in the development of one or more than one follicles. When the follicles become large enough, another hormone is administered which releases the egg from the follicle. If the partners have intercourse during this period, the chances of being pregnant become greatly increased. Artificial insemination also known as intrauterine insemination is used to treat women who have normal and healthy but are unable to conceive for some reasons.

Artificial insemination might also be used when semen has frozen or prior to cancer treatment. The process of AI includes insertion of a male partner’s semen through the female’s cervix and into the uterus at or just before the time of ovulation. AI can be performed when a woman is having her natural menstrual cycle, or it can be taken in combination with ovulation induction in case the woman has irregular menstrual cycles. GIFT includes procedure- the woman’s eggs are retrieved from her ovaries and are inserted between the two layers of sperm in a fine tubing which is then fed into woman’s one of the fallopian tubes, where the eggs and sperm are allowed to undergo natural fertilisation process. IVF can be used for treating a variety of circumstances.

But it is commonly used to achieve pregnancy for women whose fallopian tubes are blocked. In this process, the woman’s eggs are collected along with the sperm from the male partner or any male donor. The egg and sperm are then left in a culture dish in the lab to allow the egg to be fertilised. After the fertilisation, an embryo develops which is then placed into the woman’s uterus through a process called embryo transfer. Sometimes multiple embryos can also develop which are then frozen for later transfer. ICSI is generally used for the same reasons as IVF but most commonly to overcome sperm problems. ICSI procedure involves the direct injection of sperm into an egg to achieve fertilisation. PGD is used by couples who have a history of genetic disease or chromosomal abnormality. It is also used by couples who have several miscarriages and repeated IVF failure.

According to the Assisted Reproductive Treatment Act 2008, the doctor should be satisfied that- the woman is unlikely to become pregnant other than the treatment procedures, or the woman is unlikely to be able to carry pregnancy or give birth to a child without a treatment procedure, or the woman is at a risk of transmitting a genetic abnormality or genetic disease to a child born as a result of pregnancy conceived other than by a treatment procedure, including a genetic abnormality or genetic disease for which the woman’s partner is the carrier. It is also included that people wishing to have ART must undergo a criminal record check and child protection order check. Before initiating ART or ovulation induction procedures, a thorough medical check-up must be done to ensure that patients are in appropriate health condition.

If the people wishing to have ART are not eligible according to the Assisted Reproductive Treatment Act then they will not be allowed to undergo ART. Some health conditions of the mother may limit the physiologic support a woman generally needs to provide during her pregnancy and consequently may represent a health risk as well as life risk to herself. In particular, a history of pre-existing cardiopulmonary disorder or a condition leading to significant cardiopulmonary compromise resulting from increased cardiopulmonary demands of pregnancy should lead to specific evaluation and to risk counselling. Care should also be taken for some other common medical disorders like such as diabetes, hypertension, epilepsy or obesity.

Some studies have suggested that assisted reproductive technology is associated with increased risks of birth defects. Some early studies suggest that there could be an increased risk of medical complications with the mother and baby. ART has with it a risk of heterotopic pregnancy. The risks of ART also includes the following- genetic disorders, low birth weight- in IVF and ICSI, a risk factor is the increased expression of proteins in energy metabolism, preterm birth which is associated with health problems like visual impairment and cerebral palsy, children born after IVF technique are twice as likely to have cerebral palsy, membrane damage can also occur which is reflected in the expression of membrane fusion proteins NAPA and Annexin A3. Some ART like IVF have been associated with increased risk of childhood cancer in the offspring. Medication used to induce ovulation can sometimes damage the lining of uterus. Ovarium hyperstimulation syndrome occurs in some cases. Past studies have shown that females undergoing IVF have an increased risk of developing breast and ovarian cancer. Drugs and hormones used to treat infertility may also cause various psychological side effects.

There are no such after treatment care guidelines. As there are some serious side effects associated with assisted reproductive technologies so it is advised to take care of the mother and the baby and be under a doctor’s supervision for some months.

No perfect recovery time. ART includes a range of procedures that people need to follow to overcome infertility according to their cause of infertility.

Cost of treatment depends on various factors including the technique chosen to overcome the condition of infertility. For example, the average cost of IVF is around Rs.2,50,000 for one cycle. An ICSI treatment may cost around Rs.1,50,000 -Rs.2,50,000.

There is nothing like permanency of the treatment as ART is a way of overcoming infertility.

There are some natural ways following which females can improve their fertility. These natural ways have worked miracles for many. These natural methods include- lifestyle and diet changes, stress reduction, acupuncture, meditation, various herbal combinations. These natural ways are helpful to increase antral follicle count and balance the hormones to help to attain pregnancy.