Assisted Reproduction

Third Party Assisted Reproduction

Although various definitions have been used for Assisted Reproductive Technology (ART), the definition used by CDC is based on the 1992 Fertility Clinic Success Rate and Certification Act that requires CDC to publish the annual ART Success Rates Report. According to this definition, ART includes all fertility treatments in which either eggs or embryos are handled.

In general, ART procedures involve surgically removing eggs from a woman’s ovaries, combining them with sperms in the laboratory, and returning them to a female patient or gestational carrier, or donating them to another patient.

ART includes but is not limited to in vitro fertilization (IVF), gamete intrafallopian transfer (GIFT), zygote intrafallopian transfer (ZIFT), tubal embryo transfer, egg and embryo cryopreservation, egg and embryo donation, and gestational surrogacy.

In Vitro Fertilization

In Vitro Fertilization (IVF) is an Assisted Reproduction Technology procedure that involves removing eggs from a woman’s ovaries and fertilizing them outside her body. The resulting embryos are then transferred into a woman’s uterus through the cervix. Specifically, it is the common name of in vitro fertilization-embryo transfer technology, which refers to the use of artificial methods to fertilize eggs and sperm in vitro, and carry out early embryonic development, and then transfer to the mother's uterus to develop and give birth to a baby.

Embryos developed through in vitro fertilization, prior to transplantation, are subjected to genetic diagnosis and analysis of their genetic material to exclude chromosomal or genetic abnormalities. Healthy embryos are selected and implanted into the uterus to prevent the transmission of genetic diseases. Suitable for patients with gender preferences for twins/fetuses, recurrent natural miscarriages, family history of genetic diseases, and a history of giving birth to children with genetic diseases.

Egg Freezing

Egg freezing is the process by which eggs are taken out and frozen before they are fertilized. This technology can preserve high-quality eggs and prepare women's future fertility plans in advance. Suitable for patients who are of childbearing age, but currently do not have a family plan due to being single or other physical reasons, and still want to add a layer of security to their future mother's dream.

Egg freezing process also includes processes of Egg retrieval and Egg transfer. Egg retrieval (also called oocyte retrieval) is a procedure to collect the eggs contained in the ovarian follicles. Egg transfer (also called oocyte transfer) is the transfer of retrieved eggs into a woman’s fallopian tubes through laparoscopy.

Generally, fertility begins to drop as early as your late 20s or early 30s. It tends to fall more rapidly after age 35 as your egg reserves become even more depleted. Thus, the best age for freezing your eggs likely falls somewhere between 27 and 34.

Sperm Freezing

Sperm freezing and cryopreservation refer to the collection, freezing and storage of sperms. Sperms can be extracted from freshly ejaculated semen or obtained through a testicular puncture.

Freezing sperms at the optimal quality can help men preserve their existing fertility and is one of the best fertility insurance options. Suitable for healthy men who currently do not have a family plan but have future fertility needs and male patients with diseases that affect sperm quality and fertility.

There are lots of reasons to freeze sperm, explains urologist Amin Herati, M.D., director of Male Infertility and Men’s Health Clinic at Brady Urological Institute. “The most common reason is if you need treatment for cancer,” says Herati. “After chemotherapy or radiation therapy, there might be very few sperm or no sperm left in the ejaculate (seminal fluid). Or a surgery such as orchiectomy (removal of the testicles) for testicular cancer means sperm can no longer be produced.”

Other reasons for sperm banking include:

Age: Sperm quality diminishes with age, so you may choose to freeze sperm if you are getting older and want to preserve fertility.
Medical Procedures or Conditions: Those who choose to have a vasectomy may want the option of having children in the future. Some medications, such as testosterone therapy or sickle cell therapy, can affect fertility.
Occupation: People with high-risk jobs, such as those in the military, can freeze sperm to make it available to them or their partners.
Posthumous Sperm Retrieval: Family members may choose to collect sperm from someone who is deceased. Sperm can be extracted and frozen up to 72 hours after death.

Surrogacy

Surrogacy is a process in which a woman carries and delivers a child for a couple or individual. Surrogate mothers are impregnated through the use of in vitro fertilization (IVF).

For some, welcoming a child into the world is among life’s top priorities. If a woman is unable to carry a pregnancy to term, gestational surrogacy may be the best option. Also called a surrogate, a gestational carrier is a woman who carries and delivers a child for a couple or individual.

Surrogate mothers are impregnated through the use of in vitro fertilization (IVF). In this process, doctors create an embryo by fertilizing eggs from the intended mother or an egg donor with sperm from the intended father or a sperm donor. Because the gestational carrier doesn’t provide the egg, she is not genetically related to the child.

After a comprehensive medical evaluation, experts will determine if a person needs a gestational carrier. A carrier may be recommended for the following patients:

Women without a functioning uterus
Women who have acquired disorders that make their uterus unsuitable for pregnancy, such as extensive fibroids or scarring of the uterine cavity
Women who have a medical condition that puts them at significant medical risk if they become pregnant
Women who have a history of recurrent pregnancy loss
Men who are single but wish to have child