ART at a glance



Procedure: Artificial insemination


  • Large numbers of healthy sperm are injected at the entrance of the cervix or high in the uterus, bypassing the cervix and giving direct access to the fallopian tubes
  • Prior to injection, sperm is specially prepared in the laboratory to maximize its fertilizing ability


  • Existence of sperm antibodies in a woman's cervical mucus
  • Male infertility due to low sperm count or low number of healthy sperm (see also ICSI)
  • Other sperm abnormalities which prevent fertilization (see also ICSI)

Remarks: A minimum of 5-10 million/ml viable sperm needs to be available - chances of success decrease if sperm count is low or if only a few spermatozoa are motile



Procedure: IVF (In Vitro Fertilization)


  • Hormone therapy with gonadotropins is given to stimulate the ovaries to produce several mature eggs
  • Eggs are retrieved and fertilized in vitro with either the partner's or donor sperm
  • If fertilization occurs within 24 to 28 hours, one or more embryo(s) are placed in the uterus


  • Treatment of infertility due to fallopian tube occlusion and endometriosis
  • Male infertility due to sperm abnormalities which prevent fertilization
  • Some cases of unexplained infertility

Remarks: As fertilization occurs in vitro, IVF used in male infertility can serve to detect specific sperm abnormalities, such as the inability of seemingly good quality sperm to fertilize



Procedure: ICSI (Intracytoplasmic Sperm Injection)


  • An in vitro microsurgical fertilization technique in which a single sperm is selected and injected into an egg
  • Performed with eggs obtained after ovulation stimulation as done in IVF


  • Male infertility when very few normal sperm are available and/or
  • Fertilizing ability of sperm is dramatically reduced


  • Has become an alternative to artificial insemination with donor sperm
  • Can be used in patients who have undergone IVF, & the eggs have not fertilized



Procedure: MESA (Microsurgical Epididymal Sperm Aspiration)


  • Spermatozoa are retrieved directly from the epididymis (area in the testes where spermatozoa mature and are stored)
  • Fertilization is then attempted with ICSI


  • Severe male infertility
  • Absence of sperm in the ejaculate (azoospermia)
  • Congenital abnormalities (e.g. absence of vas deferens)

Remarks: Usually enough sperm can be retrieved from one procedure to be frozen for later use if required



Procedure: TESE (Testicular Sperm Extraction)


  • Biopsy of the testes is performed in order to obtain spermatozoa directly from testicular tissue
  • Fertilization is then attempted with ICSI


  • Severe male infertility
  • Absence of sperm in epididymis
  • Absence of epididymis

Remarks: Option if MESA is not possible


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Dr. Patil’s Fertility and Endoscopy Clinic

Center for Assisted Reproductive Technology, Endoscopic Surgery and Andrology

No 1, Uma Admirality, First Floor, Bannerghatta Road, Bangalore - 560029
Ph: 080 - 41201357, 41462419 Mobile: 9945221622

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