In most cases total bed rest is not required unless there is some risk associated with the development of OHSS ("In Vitro Fertilization"). The NIH further explains that women who utilize IVF must take the hormone progesterone for at least two months following the embryo transfer ("In Vitro Fertilization"). The hormone is taken through daily shots or pills. Progesterone is a naturaly produced hormone produced that assists in thickenign the lining of the uterus ("In Vitro Fertilization"). This thickening makes it easier for the embryo to implant to the wall of the uterus. If there is ot enough progesterone the woman will miscarry ("In Vitro Fertilization").

In additon to the risks associated with this type of reproductive technology, IVF is very expensive ("In Vitro Fertilization"). The NIH explains that many states require that insurance companies cover the procedure in some capacity. However there are many insurance plans that do not cover any type of infertility treatment. This can be problematic because fees for just one IVF cycle -- including costs associated with surgery, medicines, anesthesia, blood tests, ultrasounds, processing the eggs and sperm, embryo storage, and embryo transfer -- can cost between $12,000 - $17,000 ("In Vitro Fertilization"). This price varies for each patient.

The NIH also explains that statistics for the success rates of IVF vary from clinic to clinic. The rates are representative of the amount of women who became pregnant as a result of IVF but all of these pregnancies did not result in live births ("In Vitro Fertilization"). In addition the live birth rates represent the amount of women who deliver a living baby. The Society of Assisted Reproductive Technologies (SART) presents the statistics, related to the chance of giving birth to a live baby after IVF is: 41-43% for females under 35; 33-36% for females 35-37; 23-27% for females 38-40; and 13-18% for females over 41("In Vitro Fertilization").

Intracytoplasmic sperm injection

Although many assisted reproductive technologies are centered on female reproductive problems, the Intracytoplasmic sperm injection (ICSI) has to do with male reproductive problems. Sparks (2000) explains that this type of technology assist couples in conceiving when there is below-normal sperm count and insufficient sperm-producing capacity. ICSI occurs by circumventing all normal or assisted reproduction techniques...Life starts with the union of a single sperm and one ovum, an event that can be duplicated in the laboratory. This revolutionary technique is referred to as intracytoplasmic sperm injection (ICSI). The ICSI process is fascinating to some but disturbing to others, for more so than any other method of assisted reproduction, ICSI utilizes human sperm and ova as if they were little more than reproductive spare parts (Sparks 2000, pg 358)."

The author explains that for conception to occur there not only must be a bringing of the sperm and ova together, the sperm also has to penetrate the out covering of the ovum known as the zona pellucida. Normally the zona provides a protective barrier for the ovum, and it only surrenders to the fittest and most vigorously swimming sperm, while also rejecting the sluggish and defective sperm (Sparks 2000). However, it is apparent that a woman's ovum is not completely unreceptive to these rejected sperm. This is because when the environment is right the ovum can be persuaded to accept sperm that is not perfect (Sparks 2000).

This is what makes this form of reproductive technology different from other forms of reproductive technology (Sparks 2000). The author explains that even though is has many of the same steps as other forms of reproductive technology, it differs in that it involves micromanipulation techniques (Sparks 2000). These techniques are used to introduce a single selected sperm through the zona pellucida and into the body of the ovum (Sparks 2000).

Like many of the other reproductive technologies ICSI also require hyperovulation (Sparks 2000). In addition, men must produce a sperm sample and in some cases sperm has to be extracted from the testicle or sperm-transporting ducts (Sparks 2000). During ICSI a single ovum is isolated and steadied so that a single sperm can be injected into the cytoplasm of the ovum so that fertilization can begin (Sparks 2000).

In addition studies have shown that ICSI is most successful when it involves males who release less, than the 20 million sperm per cc that fertile men ejaculate; as the amount of sperm ejaculated declines, so do prospects for conception (Sparks 2000). The author explains that "Even with all of the sophisticated methods commonly used to improve sperm quality during IVF, the chances of initiating a pregnancy with such a low sperm count are virtually nil. With ICSI, however, fertilization rates, followed by embryo implantation, have been almost 39%, compared to the 18-20% achieved with IVF (Sparks 2000, pg 360)."
Gamete intrafallopian transfer

According to Sloan (1993) Gamete intrafallopian transfer (GIFT) was created in 1984 by Dr. Ricardo H. Asch, who had a theory that in many occurrences of mysterious infertility, pregnancy wasn't taking place because the egg and sperm were not uniting in the fallopian tube like they were supposed to. As a result the doctor developed a procedure that will cause the egg and the sperm to meet in the fallopian tube and GIFT was created (Sloan 1993). Gamete intrafallopian transfer (GIFT) involves injecting of one or more eggs and prepared sperm directly into the fallopian tubes, to allow fertilization to occur in vivo (Bleiklie et al. 2000).

The initial step in this process would be to retrieve the eggs through laparoscopy.

After the eggs are retrieved they are examined for quality and the eggs and sperm would be placed into a catheter with beads of air separating them. The laparoscope would then be used to inject the eggs and sperm into each fallopian tube. This entire process take about 45 minutes and the woman can return home but must rest for a day. The couple would then wait to see of pregnancy occurred. The author explains that "An advantage of GIFT is that it allows egg and sperm to meet inside...the fallopian tube. Besides the advantage of residing in their own temperature- and pH controlled environment, becoming fertilized in the fallopian tube allows the embryo to move to the uterus at its own pace...All of these factors have no doubt helped to bolster GIFT's pregnancy rate, making it about twice as high as for IVF (Sloan 1993, pg. 205)."

Future Technologies and Conclusions

It seems that in the future the aforementioned technologies will continue to develop and have better success rates. In addition, it appears that many couples will become more dependent upon donated eggs and embryos as couples delay pregnancy until later in life. There is also a trend toward the use of surrogacy or gestational carriers. As the legal parameters are put into place, surrogacy may become a more popular form of alternative reproduction. The purpose of this discussion was to examine the developments and advancements in assisted reproductive technologies. The research indicates that there are many alternatives available to infertile couples. The research also indicates that IVF and GIFT remain among the most popular and successful types of reproductive technologies.