In fertility tourism, ART or assisted reproductive technology is a very closely related term employed to fulfill the dream of childless couples longing to have a baby of their own, and for which they have been craving since long facing a lot of mental and physical hardships. ART programs include pregnancy achieving procedures like fertility medication, artificial insemination, egg or sperm donation, in-vitro fertilization and surrogacy. These are complex medical techniques designed for infertility treatment for which childless couples may travel from one corner of the globe to the other in search of clinics that would offer a reliable standard of Assisted Reproductive technology guaranteeing achievement of pregnancy and subsequent child birth.
ART covers an area of medical treatment where reproductive endocrinology and infertility are taken care of including Intra-cytoplasmic sperm injection (ICSI) and preservation of sperms and eggs for future use through a technique called cryopreservation. ART also investigates any trace of genetic disorders or hereditary diseases that could pass from the carrier parents to the baby by way of genetic transmission during fertilization and development of embryos. The affected embryos are identified and removed by a highly technical process known as Pre-implantation genetic diagnosis (PGD).The success rates of these highly upgraded infertility solutions covered by ART have rekindled a flame of hope encouraging childless couples to travel around the world through infertility tourism. In most cases, the dreams of these childless couples are realized and they happily come back home with their bundle of joy after a fulfilling trip.
The primary ART programs include the following procedures:
(a) Fertility medication:
Fertility medications are in fact drugs administered to trigger the development of follicles in the ovaries enabling the intending mother or an egg donor release healthy eggs having a high potential of fertilization.
(b) Artificial Insemination:
This medical procedure involves placement of sperms in the uterus of a female by an artificial process instead of achieving it through normal sexual intercourse. However, this could be achieved with an indigenous support at home itself using conception caps. A small quantity of semen is put on the cap which is positioned onto the cervix. If the male partner is incapable of producing enough healthy sperms, a sperm donor may be hired to collect active sperms from him.
(c)In-vitro fertilization technology (IVF):
Basically, in IVF, the fertilization of the eggs and sperms and the production of embryos is achieved outside the body of the female. A highly monitored and medically supported laboratory environment is chosen instead. This artificial arrangement becomes a necessity when the woman’s body fails to offer the right ambiance for fertilization process to take place successfully due to some reproductive disorder. IVF again encompasses a set of medical procedures like Trans-vaginal Ovum retrieval where the back of the vagina is penetrated by a small needle and the path of insertion is guided by an ultrasound wave to locate the ovarian follicles for collecting the fluid containing eggs.
The next step involves embryo transfer where one or more embryos are positioned into the female’s uterus so that pregnancy ensues. A lesser known ART is assisted zona hatching, which is affected prior to the transfer of the embryo to the uterus. A tiny orifice is made in the outer layer of the egg through which the embryo hatches out and help in the implantation process.
(d) Intra-cytoplasmic sperm injection (ICSI):
When the male partner is incapable of producing healthy sperms, they fail to penetrate the egg membrane in which case ICSI is sought after. Even when previous attempts of fertilization met failures, ICSI becomes the resolving factor. In this high precision medical procedure, a single sperm is very meticulously injected right through the center of the egg using a fine needle. In case, a donor’s sperm is used, ICSI is employed. There is Autologous endometrial co culture in ART where the fertilized eggs are positioned on the top of a lining of cells from the patient’s own uterine lining creating a favorable environment for embryo development. This is sought in case of poor embryo quality.
(e) Egg and sperm donors:
When the male and female partners are incapable of producing healthy eggs or sperms, the intending parents look for the services of egg or sperm donors capable of producing high potential eggs and sperms, which would successfully fertilize resulting in the formation of embryos. They can be contacted through reputed fertility clinics maintaining a large database of these donors who qualify entry into the approved panel after a rigorous screening of their medical, psychological and physical health. The donors offer their services for a fee. Just prior to implantation of embryo inside the uterus of the female, an examination is conducted to see if any genetic disease or defects are being transferred from the donors to the embryo that may pose a high risk of genetic disorders like HIV and AIDS to the new born. By Pre-implantation genetic diagnosis (PGD), such unwanted embryos are identified and removed at the initial stage. Only healthy embryos are selected for implantation.
The final stage of ART program is the surrogacy service availed by intending parents for incapability of the biological mother to conceive and carry on the entire pregnancy term. A surrogate mother is hired who is implanted with a healthy embryo in her uterus that would lead to her pregnancy followed by child birth. Infertility clinics around the world, which are resourceful and reliable, have given rise to infertility tourism drawing in a myriad of infertile parents. These clinics help them with an extensive database of surrogate mothers to choose from. Surrogate mothers get entry into the database by a tough screening process with respect to their mental and physical potential. Surrogate mothers are young usually in the age group between 18 and 35 and healthy in terms of their reproduction capabilities. They offer service for an agreed fee and other compensations. Here we are talking about gestational surrogacy where the baby born is not genetically related to the surrogate mother. The birth certificate carries the names of the intending parents and not of the surrogate mother.