1. Infertility & Assisted Reproductive Technology (A.R.T.)

2. Did you know?
About 80% of heterosexual couples who have sex regularly (2–3 times a week) and who do not use contraception will get pregnant within a year.
Of the other 20%, most become pregnant within two years of trying. Others may face infertility issues and need medical help (assisted human reproduction) to conceive.

3. What is Infertility?
       
                       
                                                                      
Infertility is a disease that affects the reproductive organs of both men and women.
It impairs one of the body’s most basic functions, which is the ability to have children.
Roughly 16% (or 1 in 6) couples in Canada experience infertility. This number has doubled since the 1980s.
Smoking sexually transmitted infections, age, and an unhealthy body weight can increase risks of infertility.
Unlike many other disease like lung cancer or HIV/AIDS, people are rarely informed of the very direct links between their behavior and their reproductive health.
One and six couples struggle with infertility issues, with the odds of conceiving against them.
Some what recently people have been able to increase their chances of conceiving with Assisted Reproductive Technology techniques.
If people decide to use these procedures they can be painful and emotionally draining, however it can be an answer for infertile couples.

4. Stats and Facts: Infertility
Causes of infertility in Canada: Infertility can be traced to either the man or woman, or a combination of both:
3 times out of 10, the cause is in men.
4 times out of 10, the cause is in women.
2 times out of 10, the cause is a mix of factors from both male and female.
1 time out of 10, at first, no specific cause can be found.
Twelve percent of all infertility cases are a result of the woman either weighing too little or too much.
It is possible for women with body weight disorders to reverse their infertility by attaining and maintaining a healthy weight.
Men and Women who smoke have decreased fertility.
The risk of spontaneous abortion is higher for pregnant women who smoke.
Up to 13 percent of female infertility is caused by cigarette smoking.
Chlamydia causes about 4 to 5 million infections annually in the United States. If left untreated, chlamydia can cause infertility.  
1997 – Report from American Society For Reproductive Medicine. (ART cycles that resulted in pregnancies.)
81% live birth
50.1% singleton and 31.2% multiple births
38% of all ART births were multiple births compared with less than 3% of births in the general population.

5. Most infertility cases 85% to 90% can be treated with conventional medical therapies such as medication or surgery.

6. Causes of infertility in women may include:
age (fertility decreases after age 35)
problems producing eggs (which shows up when she has no period/menstrual cycle, or no regular one)
having a sexually transmitted infection (STI), like Chlamydia (which can cause blockages in the fallopian tubes)
problems in the uterus (like fibroids or polyps)
problems with the fallopian tubes (like missing tubes or blockages)
endometriosis (excess of tissue that gathers around the reproductive organs)
hormonal imbalances
early menopause (before age 40)

7. Causes of infertility in men may include:
poor sperm quality (their rate of movement and shape)
low sperm count, or lack of sperm
a history of sexually transmitted infection (STI), like Chlamydia
hormonal imbalances

8. Other causes of infertility in both men and women may include:
past treatments for cancer (like chemotherapy, radiation, and/or surgery)
some chronic illnesses (like diabetes), as well as their treatments
tobacco and alcohol use
being under-weight or over-weight

9. What options are available for a couple if pregnancy does not happen naturally?
This is when ART (Assisted Reproductive Technology) comes into the picture.
                                           
Assisted Reproductive Technologies can be defined by the first procedure that was developed, which was In Vitro fertilization.
IVF removes the human egg from the ovary, and fertilizes it with a mans sperm in a lab.
To conclude this process the fertilized egg or the embryo it placed back in the uterus.
However today’s ART also refers to many other procedures that have been tailored to individual patient’s unique conditions.
IVF is basically a four step process.
First, you take medications to make multiple follicles begin to develop on your ovaries. This step is referred to as ovarian stimulation, or superovulation.
Step two involves monitoring follicular growth by ultrasound, to determine egg growth and uterine lining development. When it is determined that the follicles and the uterine lining are appropriately mature, a trigger shot of Human Chorionic Gonadotropin is then administered.
36 hours after the trigger shot, the third step begins with retrieval of the eggs by ultrasound-guided-needle aspiration, an in-office procedure. A sperm specimen is then washed and prepared for insemination. The washed sperm is then placed in a dish with the eggs, and they are placed in an incubator for 18 hours. After 18 hours, the embryos are observed for normal fertilization, under a microscope, where the pronucleus of egg and sperm can be seen. The embryos are then incubated for further development into multi-cell embryos.
The fourth and final step involves transferring the embryos into the uterine cavity via a catheter inserted through the cervix. The number returned varies with the desires of the patient, under the guidelines of age categories; under 35 years old, up to three embryos; years and older, up to four embryos. Additional embryos may be frozen and stored for future use.

10. Fertility drugs
If you are a woman, you may need to inject drugs made of human hormones (called gonadotropins) to stimulate egg growth and ovulation, and make your uterus more likely to allow an embryo to grow.
You can also take other drugs not made of human hormones (like Clomiphene citrate) to stimulate egg growth.
Fertility drugs are sometimes used in combination with medical procedures .

11. Top 7 Ways to Make a Baby Using Assisted Reproductive Technology
Artificial insemination -- of mother with father's sperm
Artificial insemination -- of mother with donor sperm
In vitro fertilization (IVF) -- using egg and sperm of parents
IVF -- with Intra-Cytoplasmic Sperm Injection (ICSI)
IVF -- with frozen embryos
GIFT – Gamete Intrafallopian transfer
ZIFT – Eggs combined with sperm and placed in fallopian tubes
All of these ART or Assisted Reproductive Technologies are medical interventions in the processes of reproduction, including ovulation, fertilization, and implantation of the fertilized eggs into the uterus.
Numerous Reproductive technologies have allowed infertile couples to have children, but it has raised ethical and legal questions regarding the involvement of third parties as donors or surrogates and the propriety of altering natural processes of procreation.
More than 40,000 infants were born in 2001 as a result of assisted – reproductive technology
According to the Centers for Disease Control and Prevention the highest success rates were reported in patients who used donor eggs and freshly fertilized embryos. There was a 56% pregnancy rate, 47% live birth rate, and 27% singleton live – birth rate)

12. ART Procedures Types of ART Procedures –United States 2002
Fresh-nondonor 74.2% (85,826 cycles)
Frozen-nondonor 14.2% (16,383 cycles)
Fresh-donor 8.0% (9,261 cycles)
Frozen-donor3.4% (3,922 cycles)
New Treatment Procedures 0.1% (146 cycles)
The number of ART clinics in the United States in 2002:428
Number of ART cycles reported for 2002 was 115,392

13. Kids are the Last Thing on my Mind Why Does this Affect Me?
Your decisions NOW can impact your ability to conceive in the future
                                                                          
If you wait to consider your fertility until you’re ready for a family, you may be too late. Just because you aren’t ready for children now it doesn’t mean you should hurt your chances of ever having them. What you do now, even years before you are ready to have children can impact your future ability to conceive.
For the best chances for fertility don’t smoke , practice safe sex , maintain a healthy body weight, and pay attention to your body.
Myth – Infertility is a woman’s problem
Fact- This is untrue because infertility is a female problem in 35% of the cases, and a male problem in 35%of the cases. It is a combined problem in 20% of the couples, and 10% is unexplained.
Myth – Everyone seems to get pregnant at the drop of a hat.
Fact – More than 5 million people at the childbearing age in the US experience infertility.
Myth – You’ll get pregnant if you’re just patient.
Fact – Infertility is a disease, and at least 50% of people who are evaluated respond to treatment. Those who do not seek help have a “spontaneous cure rate” of about 5%after a year of infertility.

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