What are the different Types of Assisted Reproductive Technology |IVF | IUI | IMF | GIFT | ICSI

What is Assisted Reproductive Technology?

Assisted Reproductive Technology is an umbrella term which is used for anything other than conception through sexual intercourse. There is no exact definition but covers a range of fertility treatments including In Virto Fertilization (IVF), Artificial Insemination, Cryopreservation and many more.

Can you guess when the first known assisted reproductive technology was performed?

1770

If like me, this is a lot earlier than you expected here is some details. The famous John Hunter was a Scottish Surgeon, artificially inseminated a woman with her husbands’ sperm and believe it or not it worked. She gave birth 9 months later.

It has a long history let’s take a brief look at each of the main assisted reproductive treatments in turn.

In Vitro Fertilization (IVF)

I thought we would start with this one because it’s the most well known of the treatments and the one most people imagine when thinking about assisted reproduction.

IVF is a simple premise. It’s placing the egg and sperm in a petri-dish aiming for fertilize the eggs. The development of these is then monitored and good quality blastocysts are then placed back in the uterus of a woman.

This technique is much more recent than artificial insemination the first IVF treatment resulting in pregnancy was first performed in Oldham Hospital, UK in 1977 and resulted in the Birth of Louise Brown. The first IVF baby. Today there are more than 8.5 million IVF babies.

If you are interested in learning more about IVF then check out our guide to IVF.

Artificial insemination (AI)

This is probably the 2nd most common type of assisted reproductive treatment. Artificial insemination as you have already seen was first performed 250 years ago. But it has come a long way since. Artificial insemination is a catch-all term used in itself for a number of treatments including Intracervical Insemination (ICI), Intrauterine Insemination (IUI), Intrauterine Tuboperitoneal Insemination (IUTPI) and Intratubal Insemination (ITI). Each of them has one thing in common it involves getting the sperm inside the woman without sexual intercourse, it’s the method and location that differs for each.

Intracervical Insemination (ICI) – This is one of the most common as it’s the cheapest form of assisted reproduction. In simple terms a medical practitioner injects the sperm into the base of the cervix using a needleless syringe. This is the closest to sexual conception. Some people do perform ICI themselves in their homes with their partner or donor sperm. Also, some women wear a conception cup (similar to a menstruation cup) to keep the sperm in the right place.

Intrauterine Insemination (IUI) – This form of artificial insemination is the most common and can have success rates similar to IVF for those that IVF might help. You need the help of a licensed clinic for this procedure to be performed safely. The sperm is washed and prepared, using a thin plastic catheter this is passed through the cervix into your uterus where the sperm is injected in time with your natural cycle. The video shows it beautifully.

Intrauterine Tuboperitoneal Insemination (IUTPI) – This is a relatively new treatment. The procedure is similar to the above, but sperm is injected into the uterus and the fallopian tubes. The cervix is then clamped for some women to prevent leakage. This treatment is sometimes recommended for those with mild endometriosis to bypass the affected areas.

Intratubal Insemination (ITI) – This procedure is exactly the same as IUI except the sperm is ONLY injected into the fallopian tubes. Some clinics offer careful monitoring after this procedure due to the increased risk of ectopic pregnancy.

All of the above can be done in time with your natural cycle or as part of a stimulated cycle (stimulating your body to create and release more eggs). If you want more information then check out our Artificial insemination guide.

Intracytoplasmic sperm injection (ICSI)

ICSI is often thought about in combination with IVF but it is a standalone unique assisted reproductive technology. The first successful birth from ICSI was in 1992 so it’s only been around for 28 years and is much newer than the treatments we’ve looked at before. ICSI is often used to help couples with moderate and severe male factor infertility.

ICSI is simply the process of injecting a single sperm which is selected and injected directly into the egg to cause fertilization. This egg is then implanted back into the woman’s uterus after it’s development has been assessed.

 If you want to learn more about ICSI then check out our guide to ICSI

Important note: There are many additional treatments for IVF and ICSI which come under the assisted reproduction umbrella such as embryo glue, PGS testing and assisted hatching. Most of these treatments aren’t based on evidence and so we won’t list them, but If you are interested in what they are and whether we would recommend them read our IVF addons guide.

Cryopreservation

This is the process of freezing sperm, eggs or embryos for use in future. Early cryopreservation methods meant that many didn’t survive the freezing or thawing process. Major advances in this technology and in what is used to freeze them mean that the fast method of vitrification is now used. This means that the freeze thaw cycles are now much better. Essentially it freezes them much faster and prevents ice crystals from developing which can damage the eggs, sperm and embryos.

Eggs, sperm and embryo’s can generally be stored for up to 10 years, although those in specific situations i.e. have conditions which WILL impact their fertility very early can be allowed to store for up to 55 years – only a doctor can advise if you can legally hold them for this long.

In Vitro Maturation (IVM)

The first successful pregnancy from IVM was in 1989. This is still a controversial treatment -even though it has had a lot of research it’s still generally not offered as a conventional treatment. IVM is the process of gathering immature eggs from follicles generally without stimulation medications and then maturing them in the lab ready for freezing or fertilisation through IVF.

This is still a fringe treatment which is generally only offered to those who are at high risk of OHSS. Although there are now some clinics who are offering this more routinely – we’re not sure if this is a good thing or bad thing yet and will be a future article.

Gamete Intrafallopian Transfer (GIFT)

This process is pretty much becoming redundant and is only offered in a small number of clinics and should only be done for very specific reasons. IVF success rates are higher and are less invasive as GIFT requires a laparoscopy a surgical treatment. In GIFT the woman is stimulated in a similar way to IVF. And a hCG trigger injection is given. Then the eggs will be harvested, combined with the sperm, and placed back into the woman’s Fallopian tubes using a laparoscope.

Mitochondrial replacement therapy (MRT)

This is also sometimes known as mitochondrial donation. It is used in people who have mitochondrial disease which is a genetic condition which affects the mitochondria which create the bodies energy. About 1/5000 people are thought to have a form of mitochondrial disease and it can be passed onto children. This is designed to prevent this. It uses the mitochondrial DNA from another person in combination with the mother and fathers’ egg and sperm to produce an embryo free from Mitochondrial diseases.

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What next?

We hope you found this informaiton useful

 

I’m sure you have plenty of other questions and want to read more specific information about specific assisted reproductive technologies so here are some articles we think might be of interest to you.

A complete guide and timeline to IVF – A detailed look at each of the IVF phases and how long you can expec them to take

A step by step guide to FET (Frozen Embryo Transfer) – From your IVF cycle you may have been lucky enough to get some of your little emby’s frozen. If so take a look at our guide to FET to help prepare you for the next step in the process.

What is ICSI – An exploration of ICSI and when it should and shouldn’t be used

What is artificial insemination – An overview of the specific types of artificial insemination and tips on how to do it yourself at home.

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