Global Health: Assisted Reproductive Technology
11.05.2019
Assisted Reproductive Technology (ART) refers to the treatments and procedures that are carried out in order to achieve pregnancy. These complex procedures are options for people who have infertility problems or genetic diseases and therefore require a form of assistance for a healthy and successful conception. According to Centers of Disease Control and Prevention (CDC), ART comprises all fertility treatments where eggs and embryos are handled. Generally, ART procedures involve the surgical removal of eggs from a woman’s ovaries, mixing them with sperm in the laboratory to be fertilized, and then transferring them to the woman’s, or another woman’s uterus for implantation.
There are different types of ART and some of them include:
- Intrauterine Insemination (IUI): This is a procedure where a man’s sperm is injected into a woman’s uterus with the aid of a long, narrow and hollow tube similar to a straw. IUI is most effective for treating infertility in the following situations: scarring or defects on the cervix, low sperm counts or mobility, erectile dysfunction, retrograde ejaculation and in couples who experience difficulty having intercourse. IUI can be used in combination with medications that stimulate ovulation to increase the chances of pregnancy. The success of IUI usually depends on the cause of infertility, use of fertility medications, age of the female and other factors that could impact the success of the cycle.
- In-vitro Fertilization (IVF): IVF represents the most common method of ART with a higher success rate compared to others. During IVF procedure, eggs and sperm from the couple are mixed and incubated in the laboratory for fertilization to occur. Following fertilization and the subsequent production of an embryo, a health care provider places the embryo into the woman’s uterus, where it may implant and result in a successful pregnancy. Stages of IVF include superovulation, egg retrieval, fertilization and embryo transfer.
- Third Party Assisted ART: In situations where couples do not achieve pregnancy from the above options, they may choose to use a third party–assisted ART method to get pregnant. Third party assistance can consist of one or more of the following: sperm or egg donation, surrogates or gestational carriers and embryo donation.
Despite the benefits of ART in alleviating the burden of infertility on individuals and families, it presents significant challenges to public health. ART increases the risks and rates of multiple pregnancies, preterm delivery, and low birth-weight. Multiple pregnancy babies have a much higher risk of being born prematurely, as well as having a low birth weight and disabilities. Additionally, the risk of certain complications is higher when pregnant with multiples and this requires a closer and more frequent prenatal care.
Globally, ART has presented ethical, legal, and social challenges and concerns that society must address. Many countries have therefore taken steps to regulate certain aspects of ART. Consequently, monitoring the outcomes of technologies that affect reproduction, such as contraception and ART, is an important public health activity