What Does ART Mean in Fertility?
ART stands for Assisted Reproductive Technology, which encompasses all fertility treatments where both eggs and sperm are handled outside the body in a laboratory setting, primarily including in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). 1, 2
Core Definition and Scope
ART specifically refers to procedures involving laboratory manipulation of both oocytes and sperm, distinguishing it from simpler fertility treatments like intrauterine insemination (IUI) where only sperm handling occurs 1, 3
The primary ART procedures include IVF with or without ICSI, representing the standard techniques used in modern reproductive medicine 3
Types of ART Procedures
ART procedures are categorized into four major types based on embryo source and preparation:
Fresh embryo transfer using the patient's own eggs (approximately 72-74% of all ART procedures) 2, 4, 5
Frozen embryo transfer using the patient's own eggs (approximately 14-16% of procedures) 2, 4, 5
Fresh embryo transfer using donor eggs (approximately 8% of procedures) 2, 4, 5
Frozen embryo transfer using donor eggs (approximately 4% of procedures) 2, 4, 5
Clinical Context and Applications
ART is indicated when both male and female gametes require laboratory handling to achieve fertilization, including cases of severe male factor infertility, tubal factor infertility, or unexplained infertility after failed conventional treatments 6, 7
For severe male factor infertility (such as 90% teratozoospermia), IVF/ICSI is the recommended first-line ART approach, bypassing less effective treatments like IUI 6
Single embryo transfer (eSET) is strongly recommended in ART with donor oocytes or donated embryos to minimize multiple pregnancy complications 8
Success Rates and Outcomes
Overall, approximately 42-44% of ART transfer procedures result in pregnancy, and 35-36% result in live-birth delivery 2, 4, 5
The highest live-birth rates occur with fresh embryos from donor eggs (51-54%), compared to other ART procedure types 2, 4, 5
Approximately 1% of all U.S. infants are conceived through ART, but these infants account for 17-18% of all multiple births nationwide 2, 4, 5
Critical Risks and Complications
The most significant complication of ART is multiple pregnancy, with 48-51% of ART-conceived infants born as multiples, carrying substantially increased risks for both mothers and infants 2, 4, 3, 5
Among ART multiples, 57% of twins and 94-96% of triplets or higher-order multiples are low birthweight, compared to only 9% of ART singletons 2, 4, 5
Preterm birth affects 14-15% of ART singletons, 65-66% of ART twins, and 97% of ART triplets or higher-order multiples 2, 4, 5
Important Clinical Distinctions
ART differs fundamentally from simpler fertility interventions like ovulation induction with timed intercourse or IUI, which do not involve laboratory handling of both gametes 7
The term ART should not be confused with all fertility treatments—it specifically requires ex vivo manipulation of eggs and embryos, not just sperm preparation 8, 1