Assisted Reproductive Technology

Overview

Assisted reproductive technology, or ART, is the name for medical treatments that help people have a baby when they cannot conceive on their own. Conception usually happens when a sperm fertilises an egg inside the body. ART helps this process in different ways — for example, by collecting eggs and sperm and bringing them together in a laboratory, then placing a resulting embryo (a very early stage of a pregnancy) into the womb. ART is an umbrella term. It includes treatments such as IVF (in vitro fertilisation), where an egg is fertilised outside the body; ICSI (intracytoplasmic sperm injection), where a single sperm is placed directly into an egg; IUI (intrauterine insemination), where sperm is placed inside the womb; and treatments using donated eggs, sperm or embryos. It also covers freezing eggs, sperm or embryos so they can be used later.

Yes. Fertility problems are common — worldwide, roughly one in six adults experiences infertility at some point in their life, according to the World Health Organization. Because of this, fertility treatment is now a routine part of healthcare in many countries, and millions of babies have been born with the help of ART.

ART can be relevant for almost any adult who wants a child but is finding it hard to conceive. That includes people of any gender, single people, same-sex couples, people with medical conditions that affect fertility (such as blocked fallopian tubes, endometriosis or low sperm counts), people who have had cancer treatment that may affect fertility, and people who want to preserve the option of having children in the future.

Symptoms

Common symptoms

• Not becoming pregnant after a year of regular, unprotected sex (or after six months if you are over 35, when fertility falls faster)
• Periods that are very irregular, very painful, or absent
• Known conditions such as endometriosis, polycystic ovary syndrome, or a history of pelvic infection
• A partner with a known low sperm count or other sperm problem
• Several early miscarriages in a row
• During treatment itself, some people notice bloating, mild cramping, breast tenderness, mood changes or tiredness — these are usually short-lived and your clinic can advise you

Symptoms in children

• Fertility treatment is for adults, so there are no symptoms in children. Children who were conceived with ART are not expected to be different in health from other children, though some clinics offer follow-up for children born after certain treatments.
• In older children and teenagers, the focus shifts to protecting future fertility — for example, before cancer treatment, families may be offered a discussion about preserving eggs, sperm or ovarian tissue.

Symptoms in older adults

• Fertility naturally declines with age, and this decline speeds up after the mid-30s. For women, pregnancy with your own eggs is generally not possible after menopause, though treatment with donated eggs may sometimes be an option.
• Older adults considering ART will usually have extra health checks first, such as blood pressure, heart health and screening for conditions that could make pregnancy riskier.
• Some people in this age group are exploring fertility preservation or surrogacy arrangements, which involve extra legal and ethical steps depending on where you live.

Causes

Main causes

• Problems with ovulation — the monthly release of an egg — often linked to conditions such as polycystic ovary syndrome or thyroid problems
• Damage or blockage in the fallopian tubes, which stops sperm meeting the egg
• Endometriosis, where tissue similar to the womb lining grows elsewhere and can affect fertility
• Sperm problems, such as low numbers, poor movement or unusual shape
• Uterine problems, such as fibroids or an unusually shaped womb
• Age-related decline in egg number and quality
• Medical treatments such as chemotherapy or surgery that affect the reproductive organs
• Unexplained infertility, where tests do not find a clear reason
• Social reasons, such as being single or in a same-sex relationship, where donor eggs or sperm are needed

Risk factors

• Increasing age, especially over 35 for women
• Smoking, including second-hand smoke, in either partner
• Being significantly overweight or underweight
• Heavy or regular alcohol use and recreational drug use
• Sexually transmitted infections that are not treated, which can scar the fallopian tubes
• Exposure to some chemicals or radiation at work
• Long-term stress, very intense exercise, or poor sleep, which can affect ovulation
• A family history of early menopause or certain genetic conditions

When to see a doctor

See a doctor urgently if:

• You have severe pelvic pain, heavy bleeding or a fever and think you may be pregnant or have just had a fertility procedure
• You have symptoms of a serious reaction after fertility hormones, such as rapid abdominal swelling or breathing difficulty
• You have pain in one side of the lower tummy with dizziness or fainting

Book a routine appointment if:

• You have been trying to conceive for a year without success, or for six months if you are over 35
• Your periods are very irregular, very painful or have stopped
• You or your partner have a known condition that can affect fertility
• You have had more than one miscarriage
• You are planning cancer treatment and want to talk about preserving fertility before it starts
• You are considering fertility treatment and want to understand your options

Diagnosis

There is no single test for 'infertility'. Instead, a doctor or fertility clinic will take a full history from both partners — how long you have been trying, your periods, past infections, surgery, medicines and family history — and then arrange a set of tests to look for likely causes. For women this usually means checking ovulation and hormone levels and looking at the womb and fallopian tubes. For men it means a semen analysis. Sometimes no cause is found, which is called unexplained infertility; treatment can still be offered.

Tests that may be done

• Semen analysis, to check sperm number, movement and shape
• Blood tests to check hormone levels and confirm whether and when you are ovulating
• A blood test for ovarian reserve, which gives an idea of how many eggs remain — it does not predict whether you can get pregnant naturally
• A pelvic ultrasound scan to look at the womb and ovaries
• A test where dye is passed through the womb to check whether the fallopian tubes are open
• Screening tests for infections that can affect fertility or pregnancy
• Sometimes a small camera test to look inside the womb, or blood tests for genetic conditions

What to expect at your appointment

The assessment usually happens over a few visits and takes a few weeks, often timed around your monthly cycle. Most tests are quick and only mildly uncomfortable. You will normally have a follow-up appointment to go through results and discuss options, including whether treatment is needed at all. It can help to bring your partner or a trusted person with you, and to write down your questions beforehand.

Treatment

Treatment depends on what is causing the difficulty and on your preferences. Options range from simple steps — such as advice on timing sex, weight and lifestyle changes, or treating an underlying condition — to treatments that help ovulation, to insemination and to IVF. Your clinic should explain the chances of success for each option, the number of cycles typically needed, the risks, and the cost, since funding rules vary between regions.

Self-care at home

• Track your cycle so you know roughly when you ovulate, and have regular sex around those days
• Stop smoking and cut out recreational drugs, for both partners
• Keep alcohol low or avoid it, especially while trying to conceive and during treatment
• Aim for a healthy weight — even modest changes can improve ovulation and sperm quality
• Take folic acid supplements if you are trying to conceive, as advised by your doctor or pharmacist
• Keep a simple diary of appointments, medicines and how you feel, as treatment involves many steps
• Ask your clinic to write down the plan and who to contact out of hours

Medical treatments

Fertility treatment is always tailored to you. Broadly, it can involve: medicines that help the ovaries release eggs or control the timing of the cycle; insemination, where sperm is placed inside the womb around ovulation; IVF and related techniques, where eggs are collected, fertilised in the laboratory and one embryo is placed in the womb; freezing of eggs, sperm or embryos for later use; and using donated eggs, sperm or embryos. Hormone support may be given after a transfer to help an early pregnancy. Any medicine should be prescribed and explained by your fertility team — always ask what it is for, how to take it, and what side effects to watch for, and never start or stop treatment on your own.

When is surgery considered?

Sometimes an operation is part of the plan. This might be to open blocked fallopian tubes, remove fibroids or endometriosis, treat a womb problem, or collect sperm directly from the testicle when none is present in the semen. Surgery is only recommended when it is likely to improve your chances or is needed for your health, and your doctor should explain the benefits and risks before you decide.

Living with this condition

Fertility treatment can take over your calendar. Appointments are often early in the morning, scans are timed to your cycle, and plans can change at short notice. Many people find it helps to tell their employer something about the appointments, keep a shared calendar with their partner, and build in rest days after procedures. Waiting for results can be the hardest part — plan something gentle and distracting for those days.

Lifestyle tips

• Keep up normal, enjoyable movement — moderate exercise is good for wellbeing and fertility
• Protect sleep, and try to keep regular routines during treatment cycles
• Limit caffeine to moderate amounts and avoid alcohol during treatment
• Avoid overheating the testes if you are trying to conceive — for example, long hot baths or laptops on the lap for hours
• Ask your pharmacist or doctor before starting any supplement, herbal remedy or over-the-counter medicine, as some can interfere with treatment

Diet and exercise

There is no special fertility diet, but a balanced one helps. Aim for plenty of vegetables and fruit, whole grains, beans, nuts and oily fish, and limit highly processed foods and sugary drinks. If you are trying to conceive, take folic acid as advised. Being active most days — walking, swimming, cycling, yoga — supports general health and mood. Very intense training, or being very underweight, can interfere with periods and ovulation, so balance matters more than pushing hard.

Mental health and emotional wellbeing

Fertility difficulties and treatment are emotionally demanding. It is very common to feel sad, angry, anxious or isolated, and to find that questions from friends and family are hard to handle. Feeling this way is not a sign of weakness. If low mood or anxiety is affecting your sleep, work or relationships, please tell your doctor or clinic — counselling is often available and can genuinely help. If you ever feel you cannot cope or have thoughts of harming yourself, contact your local emergency number or a crisis support service straight away, and reach out to someone you trust.

Prevention

Not all fertility problems can be prevented — some are caused by age, genetics or medical conditions. But some causes can be reduced: not smoking, limiting alcohol, keeping a healthy weight, treating sexually transmitted infections promptly, and managing long-term conditions such as diabetes or thyroid problems all help protect fertility. If you are having cancer treatment or surgery that could affect your fertility, ask about fertility preservation before treatment starts, as this can keep options open.

Vaccines

Make sure your routine vaccinations are up to date before pregnancy. In particular, check with your doctor whether you need a rubella (German measles) vaccination, since this is usually checked before or during fertility assessment. Some vaccines are not given during pregnancy, so timing matters.

Screening programmes

Screening can catch problems early. This includes tests for sexually transmitted infections if you are at risk, cervical screening when it is due, and — depending on your background — genetic carrier screening, which a clinic may offer before treatment. Talking to your doctor about your family history of early menopause or genetic conditions can also help you plan.

Complications

If left untreated

• The underlying fertility problem usually continues, and the chance of natural conception tends to fall with age
• Some causes, such as untreated infection or endometriosis, can get worse over time
• Ongoing fertility difficulties can lead to significant stress, low mood and strain on relationships
• Delay can mean fewer options later, for example if egg numbers decline

Long-term outlook

The outlook is genuinely hopeful for many people. Some conceive without treatment, some with simpler options such as ovulation support or insemination, and many with IVF or donor treatment. Success rates vary widely depending on age and the reason for infertility, so ask your clinic for figures that apply to you rather than relying on general numbers. It is also reasonable to plan for what happens if treatment does not work — clinics can discuss alternatives such as donor treatment, surrogacy where legally available, adoption or choosing to live child-free. Whatever path you take, good support and clear information make the process easier to navigate.

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