Define Assisted Reproductive Technology. Mention briefly the commonly used reproductive technologies. What are the indications and contraindications of each method?

Defining Assisted Reproductive Technology

Assisted Reproductive Technology (ART) refers to medical procedures used primarily to assist infertile couples in achieving pregnancy. These techniques involve handling both eggs and sperm, or embryos, outside the body and then transferring them into the woman’s uterus.

Commonly Used Reproductive Technologies

1. Intrauterine Insemination (IUI)

IUI involves placing sperm directly into the uterus around the time of ovulation. It’s a relatively simple and less invasive procedure.

• Indications: Mild male factor infertility, cervical mucus problems, unexplained infertility, single women desiring donor insemination.
• Contraindications: Severe male factor infertility, tubal blockage, active pelvic infection, uncontrolled systemic disease.

2. In-Vitro Fertilization (IVF)

IVF involves fertilizing eggs with sperm outside the body in a laboratory dish. The resulting embryos are then transferred to the uterus.

• Indications: Tubal blockage, severe male factor infertility, endometriosis, unexplained infertility, ovulation disorders, genetic disorders.
• Contraindications: Active systemic infection, severe uncontrolled medical conditions (e.g., heart failure), active cancer.

3. Intracytoplasmic Sperm Injection (ICSI)

ICSI is a specialized form of IVF where a single sperm is injected directly into an egg.

• Indications: Severe male factor infertility (low sperm count, poor motility, abnormal morphology), previous IVF failure, retrieval of few eggs.
• Contraindications: Similar to IVF, but generally considered safe even with some degree of male factor infertility.

4. Gamete Intrafallopian Transfer (GIFT)

GIFT involves transferring eggs and sperm directly into the fallopian tubes, allowing fertilization to occur naturally within the body.

• Indications: Previously used for couples with unexplained infertility or mild tubal disease. Less commonly used now due to the success of IVF.
• Contraindications: Tubal blockage, severe male factor infertility, active pelvic infection.

5. Zygote Intrafallopian Transfer (ZIFT)

ZIFT involves fertilizing eggs with sperm in a laboratory and then transferring the resulting zygotes (fertilized eggs) into the fallopian tubes.

• Indications: Similar to GIFT, but allows for confirmation of fertilization before transfer. Also less commonly used now.
• Contraindications: Tubal blockage, severe male factor infertility, active pelvic infection.

Comparative Table of Indications and Contraindications

Technology	Indications	Contraindications
IUI	Mild male factor, cervical issues, unexplained infertility	Severe male factor, tubal blockage, infection
IVF	Tubal blockage, severe male factor, endometriosis	Active infection, uncontrolled systemic disease
ICSI	Severe male factor, previous IVF failure	Similar to IVF
GIFT	Unexplained infertility, mild tubal disease (less common now)	Tubal blockage, severe male factor, infection
ZIFT	Similar to GIFT (less common now)	Tubal blockage, severe male factor, infection

It’s important to note that these are general guidelines, and the suitability of each technique is determined on a case-by-case basis by a reproductive endocrinologist.