Assisted reproductive technology (ART) is a medical procedure used to address infertility issues.It involves procedures such as in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), cryopreservation of gametes or embryos, and/or the use of fertility medication.

1. Assisted Reproductive
Technology (ART)
Janet OLAWOLE
Clinical Embryologist (Trainee)
SAMEDA CLINICS

2. Outlines
• Assisted reproductive technology (ART)
• Indications for ART
• Intrauterine insemination (IUI)
• Invitro fertilization (IVF)
• Intracytoplasmic sperm injection (ICSI)

3. Assisted Reproductive
Technology (ART)
Any treatment that deals with “means of conception other
than vaginal intercourse” is termed as ART.
NICE guideline 2013
• ART involves several different procedures to help address
fertility problems and increase the likelihood of
pregnancy.
• Types of ART includes:
 INTRAUTERINE INSEMINATION –(Husband /
Donor)
 IVF + ET – In Vitro Fertilization + Embryo transfer
 ICSI – Intra Cytoplasmic Sperm Injection

4. Indications for ART
 A woman of reproductive age who has not conceived after 1
year of unprotected vaginal sexual intercourse, in the
absence of any known cause of infertility, should be offered
further clinical assessment and investigation along with her
partner.
• Couples that has infertility problem.
– Men with low sperm count, abnormal sperm, antibody
against sperms etc.
– Women with oviduct obstruction, endometriosis,
endocrine imbalance, reproductive organ infection,
antibody against partner’s sperms etc.
• A woman with a known clinical cause of infertility or a
history of predisposing factors for infertility
NICE Guidelines 2013

5. Intrauterine insemination
(IUI)
• IUI works by putting sperm cells directly into
your uterus around the time you’re ovulating,
helping the sperm get closer to your egg. This
cuts down on the time and distance sperm must
travel, making it easier to fertilize your egg.
• Sperm can either be from your partner or an
anonymous donor.

6. Intrauterine
insemination (IUI)

7. In vitro fertilization (IVF)
• IVF is the joining of a woman’s egg and a man’s sperm in
vitro (in the lab). Subsequently the embryos are
transferred into the uterus through the cervix and
pregnancy can begin after implantation.

8. Procedures for IVF
• Day 0 Egg retrieval, Sperm collection, and preparation
• Insemination in vitro
• Day 1 Check eggs for fertilization (the presence of two
pronuclei or PN's)
• Day 2 Embryos at the 4-cell or more stage of
development
• Day 3 Embryos at the 8-cell or more stage of
development
• Day 4 Embryos at the compacted morula (16-32 cell)
stage
• Day 5 Embryos at the blastocyst stage of development

9. Retrieved egg

10. Sperm cells

11. Intracytoplasmic
sperm injection
(ICSI)

12. Intracytoplasmic sperm
injection
• Intracytoplasmic sperm injection (ICSI,
pronounced "eeksee") is an in vitro fertilization
procedure in which a single sperm is injected directly
into an egg.
• This procedure is used to overcome male infertility
problems, although it may also be used where eggs
cannot easily be penetrated by sperm, and
occasionally as a method of in vitro fertilization,
especially that associated with sperm donation.

13. How is ICSI performed?
• Using micromanipulation technology, ICSI allows
fertility specialists to fertilize an egg using just one
sperm. While it is preferred to use sperm from a semen
sample, specialists can retrieve sperm from the testicles if it is
necessary. Once sperm has been collected, the specialist will
draw a single sperm into a needle and inject it directly into an
egg that has been collected from the female partner through
the usual retrieval methods.
• This process bypasses the conventional IVF methods of
fertilization, thereby ensuring that fertilization has
taken place. The fertilized eggs are then left to culture for a
few days before being transferred back to the woman’s uterus.
ICSI is always used alongside IVF.

15. Human MI oocyte with extruded polar body

16. Human MII oocyte

17. Intracellular
sperm injection
(ICSI)

18. Gamete/embryo
transfer

19. Embryo transfer
• An embryo transfer is the final stage in the In Vitro
Fertilization (IVF) process where the fertilized egg—now
an embryo—is placed in the woman’s uterus.
• The embryo is loaded into a catheter, which is passed
through the vagina and cervix and into the uterus where
it is deposited.
• This generally takes place between 3 and 5 days after egg
retrieval if having a fresh transfer and anywhere from 4
weeks to years later if doing a frozen transfer.
• There are many different types of embryo transfers:
fresh, frozen, cleavage (day 3), blastocyst (day 5), single,
and multiple embryo transfers.

20. Types of Embryo Transfer:
• Fresh Embryo Transfer
Just as the term implies, a fresh embryo transfer is
the transfer of (an) embryo(s) that has not been frozen.
• Frozen Embryo Transfer (FET)
A Frozen Embryo Transfer is a cycle in which frozen
embryos from a previous IVF or donor egg cycle are thawed
and then transferred into a woman’s uterus.

22. The End
Thank you!!