ASSISTED REPRODUCTION TECHNIQUES (ART)

Welcome to the ART programme in O&G Fertility Centre, Gleneagles Hospital, Singapore. This booklet is designed to answer many of your questions and give some insight into the procedures involved in Assisted Reproductive Technique s (ART) programmes.

Infertility is a complex problem and our staff are fully aware of the major difficulties and mood changes that patients undergoing treatment suffer. Please feel free to bring up and clarify any medical, emotional social or ethical issues that you may have and we will try our best to resolve them. In any event, you can be assured of our utmost efforts to ensure a successful outcome.

Assisted Reproductive Techniques or ART means the use of techniques to bring the egg and sperm together (fertilisation) outside of the woman's body, in a laboratory. It removes the need for the sperm to swim through the cervix and fallopian tube to meet the egg. ART requires sophisticated laboratory facilities and highly trained staff as compared to simpler techniques that involve deposition of the sperm at the entrance of the cervix such as artificial insemination using the husband's sperm into the cavity of the uterus (also called Intra-Uterine Insemination or IUI). This is not considered an ART procedure and by the time a couple comes for ART, such simpler methods would usually have been attempted and been unsuccessful. Occasionally we will advise that you start on the ART program early, esp if you are close to 40, or there is severe sperm problems.

ART has revolutionised the management of infertility. In most instances, ART involves recovering the eggs from the ovaries and fertilising them with sperm outside the body, in the laboratory (often giving rise to the misleading concept of a "test-tube baby"). The developing embryos, usually between 3 - 5 days old, are then replaced back into the womb.

ART used to be called In-Vitro Fertilisation (IVF), which is the medical term for the technique. It was originally designed to help women with damaged tubes, as the eggs and sperm were prevented from meeting as the tubes were blocked. The introduction of new advances have allowed its use in a wide range of infertile conditions including male infertility. ART is a complex, time consuming, and stressful procedure; and your work/domestic schedule during the period of treatment should be as light as possible. Before starting the programme, the nurses and doctors will explain the steps involved and you will have to sign a consent form.

Generally, ART may be used in the following situations:

1. When there is damage or blockage of the fallopian tubes such that sperm are unable to meet the egg in the woman's body.

2. When the husband's sperm count is reduced or the sperm are abnormal.

3. For some women who have problems with cervical mucus which may impair sperm activity and survival.

4. For some women with endometriosis.

5. For women not able to release an egg (ovulation) on her own who have not conceived despite fertility drugs and/or IUI.

6. For unexplained infertility of long duration.

Your doctor would be the best person to decide whether you need ART. At O&G Partners Fertility Centre, we would recommend ART only if simpler treatment procedures have not worked, unless you are close to 40, or there is severe sperm problems.

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