Source: Consumer HealthDay
Assisted reproductive technology (ART) covers a range of procedures that aim to help individuals achieve pregnancy and involve the handling of sperm, eggs or embryos outside the body.
ART includes artificial insemination and in vitro fertilisation (IVF) procedures. ART also includes surrogacy and donor assisted conception.
WA Department of Health
Non-ART fertility treatments include oral medications or injections used to boost ovulation among women who do not ovulate or to stimulate the development of multiple eggs among women who have trouble getting pregnant. Because it is difficult to predict or control the number of eggs that will be fertilised during non-ART fertility treatments, many of these treatments also result in multiple births.
ART and multiple births. (2023). Centers for Disease Control and Prevention.
Embryonic screening or Preimplantation genetic screening (PGS) is a method where embryos from presumed chromosomally normal genetic parents are screened for abnormalities. It involves screening all 24 chromosomes in a developing embryo to select the embryo/s without any chromosomal errors that is most likely to result in an ongoing pregnancy.
What is embryo screening and is right for me. (2023). IVF Australia.
Human perspectives : ATAR units 1 & 2
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In vitro fertilisation (IVF), also called test-tube conception, medical procedure in which mature egg cells are removed from a woman, fertilised with male sperm outside the body, and inserted into the uterus of the same or another woman for normal gestation. Although IVF with reimplantation of fertilised eggs (ova) has long been widely used in animal breeding, the first successful birth of a human child from IVF, carried out by British gynecologist Patrick Steptoe and British medical researcher Robert Edwards, did not take place until 1978.
In vitro fertilisation. (2023). In Encyclopædia Britannica.
The chances of having a healthy baby using IVF depend on many factors, such as age and the cause of infertility. What's more, IVF involves getting procedures that can be time-consuming, expensive and invasive. If more than one embryo is placed in the uterus, it can result in a pregnancy with more than one baby.
In vitro fertilization IVF. (2023). Mayo Clinic
IVF has some disadvantages, including potential risks from the fertility medications, the invasive procedures used and high costs.
Other risks include: ovulation hyperstimulation syndrome, symptoms following egg retrieval, egg retrieval complications, ectopic pregnancy, miscarriage, premature birth and low birth weight, multiple births, birth defects, and emotional stress.
In the world of infertility, in vitro fertilisation (IVF) is often viewed as “the last stop” on the infertility track. What most people don’t realize is that IVF can be the first and most successful option for many couples who battle infertility, or for whom traditional conception and pregnancy aren’t an option.
Gamete intrafallopian transfer, or GIFT, is a variation of IVF. After the ovaries have been stimulated and mature oocytes collected, the latter are mixed with sperm and, under laparoscopic guidance, placed in the unobstructed fallopian tube. Fertilization then occurs naturally—inside the body (in vivo)—rather than in the laboratory. This procedure is usually used when a woman has at least one normal fallopian tube; however, unlike standard IVF, GIFT requires anesthesia.
Infertility. (2023). In Encyclopædia Britannica.
Doctors cannot visually confirm fertilisation or determine the quality of embryos. Also, women with blocked or damaged fallopian tubes are not able to perform gamete intrafallopian transplantation.
Gamete intrafallopian transfer – GIFT. (2023). American Pregnancy Association.
The risks are very similar to those for IVF treatment. They include the risks of multiple births and drug reactions. Additional risks include those related to any surgical procedure which includes laparoscopy.
Side effects of Gamete Intra-Fallopian Transfer. (2023). Medic8.
Because the fertilisation happens inside her body instead of a petri dish, the success rate with GIFT is relatively high. Experts think that the journey through the fallopian tube nourishes the new embryo, giving it a better chance of being healthy and able to implant in the uterus. Another reason for the increased success rate could be timing. The embryo arrives at the “right” time for implantation. as opposed to IVF, in which the embryo arrives in the uterus when the doctor places it there, and that may not be the right timing for her body.
Gamete intrafallopian transfer – GIFT. (2023). American Pregnancy Association.
Ovulation Induction is a form of Assisted Reproductive Technology (ART) and involves taking medication to improve ovulation. It is a first-line fertility treatment and is typically used when you ovulate irregularly or not at all.
Ovulation Induction. (2023). Fertility Society of Australia and New Zealand.
Ovulation induction isn't recommended for women who
Ovulation induction. (2023). Fertility Society of Australia and New Zealand.
In some women, fertility medication causes a risk of OHSS or Ovarian Hyperstimulation Syndrome. Symptoms include nausea, vomiting, shortness of breath, excessive weight gain, and dehydration. If you experience these symptoms, it is important to contact your fertility clinic immediately. In mild cases, OHSS may improve on its own, while severe cases may require hospitalisation and additional treatment.
Ovulation induction. (2023). Fertility Society of Australia and New Zealand.
Ovulation induction can help women who do not ovulate, women who do not release the eggs they do ovulate, or those who do ovulate but it doesn’t result in pregnancy. Ovulation inducing medications can also increase the number of mature eggs for use with in vitro fertilization (IVF) treatments.
Ovulation induction. (2023). Loma Linda University.
Artificial insemination, the introduction of semen into the vagina or cervix of a female by any method other than sexual intercourse. The procedure is widely used in animal breeding and is used in humans when a male is sterile or impotent or when a couple suffers from unexplained infertility (when the cause of infertility cannot be identified). Impregnation of a woman through artificial insemination may also be used by women or men in same-sex partnerships who wish to produce children of their own.
Artificial Insemination. (2023). In Encyclopædia Britannica.
Artificial Insemination or IUI treatment is not recommended for:
Artificial insemination process. (2023). City Fertility.
Intrauterine insemination is a relatively simple and safe procedure, and the risk of serious complications is low. Risks include:
There are several benefits of artificial insemination that help explain why it’s become one of the most popular ways to overcome conception problems – and why so many use it as the first step on the way to having a child as well as a basis for surrogacy.
Ultrasound uses measurement of NT between 12-14 weeks of pregnancy, together with other ultrasound markers for chromosomal abnormalities, to calculate a statistical risk for Down syndrome. This is based on extensive research by the Fetal Medicine Foundation (www.fetalmedicine.com).
All WUMe doctors are accredited by the Fetal Medicine Foundation which requires regular individual audit.
The detection rate for Down syndrome using ultrasound alone is approximately 70%. Addition of MSS increases the detection rate of Down syndrome to ~90%.
NIPT detection rate for Down syndrome is >99%.
Women's Ultrasound Melbourne, 2023.
First trimester combined screening test
This test combines the results of a blood test taken at around 10-12 weeks and an ultrasound at 11-13 weeks. The test will show the risk or your chance of having a baby with Down syndrome or Trisomy 18. It will not tell you if your baby has Down syndrome.
If you are at increased risk you will be offered a diagnostic test, either a CVS (Chronic Villus Sampling) or amniocentesis.
Maternal serum screening
This is a blood test collected between 15-20 weeks of pregnancy. The test shows your risk of having a baby with Down syndrome, Trisomy 18 or neural tube defects such as spina bifida. If the test shows you are at an increased risk you will be offered amniocentesis and ultrasound.
Non-invasive prenatal test (NIPT)
This blood test is done after week 10 of pregnancy. It screens for Down Syndrome and certain other chromosomal irregularities in a baby. In Australia it is only available in some specialist centres.
The Royal Women's Hospital Victoria, 2023.
Amniocentesis is a diagnostic test. It is usually done between 15 and 20 weeks of pregnancy, but it can also be done up until you give birth.
To perform the test, a very thin needle is used to withdraw a small amount of amniotic fluid. Ultrasound is used to guide the procedure. Depending on the way the cells are analysed and the information that you want, results can take from 2 days to several weeks.
There is a very small chance of pregnancy loss with amniocentesis. Leakage of amniotic fluid and slight bleeding can occur after amniocentesis. In most cases, both stop on their own.
In CVS, a sample of tissue is taken from the placenta. The main advantage of having CVS over amniocentesis is that CVS is done earlier than amniocentesis, between 10 and 13 weeks of pregnancy. The chance of miscarriage with CVS is slightly higher than the chance of miscarriage with amniocentesis.