ART: Assisted Reproductive Technology

ART is a relatively young clinical domain that started with the birth of Loise Brown, the first in vitro fertilization (IVF) newborn in 1978. Since then, more than 5 million babies have been born using ART.

ART has significant demographic, social, and medical impacts: In some countries, ART is responsible for about 5% of newborns. Late motherhood (even in the sixth decade of life) became, for the first time in our species history, a viable option. Oocyte vitrification enables women to preserve their fertility.

ART has with the help of Genetic testing can identify healthy embryos before transfer to the uterus, Gamete donation and surrogacy have dramatically broadened the concept of parenthood.

ART’s primary indication was “mechanical” infertility, however, it is now used in the much wider scope of indications, including male factor, unexplained and age-associated infertility. Moreover, it is also routinely used in perfectly fertile couples, carriers of genetic diseases, as a means to select healthy embryos.

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ART process usually starts with ovarian stimulation followed by egg retrieval, fertilization, in vitro embryo culture, and ultimately embryo transfer. The process is not without complications, the most significant of which are multiple pregnancies and ovarian hyperstimulation syndrome.

Yet, we do have the tools to prevent these complications in most cases. ART’s long-range effect on adulthood health is not known, though extensive research on children’s health found an increase in congenital anomalies especially if micromanipulation (intracytoplasmic sperm injection) is used.

In the future, we will probably witness an increase in ART treatments, particularly in third world countries, with further technical and clinical refinements that will contribute to a better success rate, combined with pre-implantation genetic testing.

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