ART refers to treatments and procedures for couples who have already gone through various infertility treatment options but who still have not achieved pregnancy or single parents who wishes to have a child of their own.
Assisted reproductive techniques can be classified into levels I, II, and III based on their complexity and invasiveness, while the suitability of a specific technique depends on the couple and the cause of infertility.
The selection of the technique should consider the couple’s clinical condition and adhere to the principle of graduality. This approach prioritizes the least invasive procedure, both physically and emotionally, as long as it offers therapeutic efficacy comparable to more complex methods.

The legislation surrounding Assisted Reproductive Technology (ART) varies significantly across countries, influenced by legal, cultural, and ethical factors. Therefore, it is essential to understand the legal framework of the country where the procedures will take place, as the laws can significantly impact the process and its outcomes.
Given the complexity, time requirements, and the inability to select specific phenotypic characteristics of donors in some countries, parents are increasingly opting for IVF clinics abroad. Among the most popular destinations are Spain, Greece, the United States, Ukraine, and Albania.

Ovulation Induction (OI) is a level I Assisted Reproductive Technology used to treat infertility related to ovulation disorders. The procedure uses fertility medications to stimulate the follicles in the ovaries hence the production of multiple eggs in one cycle. This technique is recommended for women with irregular periods or the lack or absence of ovulation (anovulation) due to hormonal imbalances or Polycystic ovary syndrome (PCOS).

Intrauterine insemination (IUI) can be included in level I Assisted Reproductive Technology. With IUI, sperm that has been washed and concentrated is placed directly into a woman's uterus during ovulation. This helps healthy sperm get closer to the egg when it’s released by ovaries. IUI is often good for couples diagnosed with mild male factor infertility or failed previous Ovulation Induction attempts.

When Level I techniques prove ineffective or unsuitable, Level II Assisted Reproductive Techniques are employed. FIVET (In Vitro Fertilization and Embryo Transfer) involves the creation of embryos in vitro (in the laboratory) and their transfer to the woman’s uterus. This technique is based on the "natural selection" of gametes as eggs and sperm, placed on a culture dish, spontaneously select each other. There are two types of in vitro fertilization: homologous and heterologous. In the homologous IVF, gametes of the couple are used while in the heterologous, either sperm or egg is donated by a third party.

Intracytoplasmic sperm injection (ICSI) is a Level II IVF technique that involves injecting sperm directly into an egg to induce fertilization. The procedure is exactly the same as with IVF. The only difference is that instead of mixing the sperm with the eggs and leaving them to fertilize, an embryo specialist will inject a single sperm into the egg. Like In vitro fertilization, can be homologous (where the gametes of the couple are used) or heterologous (where donor eggs or sperm are used).

These invasive methods are rarely used as they require surgical intervention, often under general anesthesia (such as laparoscopy or celioscopy).
GIFT procedure involves removing eggs from the woman's ovary and using a laparoscope to place the unfertilized gametes (eggs and sperm) into the woman's fallopian tube.
ZIFT is a procedure where eggs are collected from a woman's ovary and fertilized outside her body. A laparoscope is then used to place the resulting zygote (fertilized egg before it begins to divide) into the woman's fallopian tube. This technique is called TET when 2-4 cells embryos are placed in the fallopian tubes. It is classified as either homologous, where the couple's gametes are used, or heterologous, when donor eggs or sperm are utilized.

These procedures are recommended for men suffering from infertility due to (azoospermia). These are classified as third-level Assisted Reproductive Techniques because they require general anesthesia and intubation.
MESA, Microsurgical Epididymal Sperm Aspiration, involves the aspiration of sperm from the epididymis using microsurgical techniques.
PESA, Percutaneous Epididymal Sperm Aspiration, involves the transcutaneous aspiration of sperm from the epididymis.
TESA, Testicular Sperm Aspiration, involves the aspiration of sperm from the testes using a needle.
TESE, Testicular Sperm Extraction, involves the retrieval of sperm through surgical or microsurgical biopsy.

The ROPA method (Reception of Oocytes from Partner) is a reproductive technique tailored for same-sex female couples who wish to share biological involvement in parenthood. This process allows one partner to provide the eggs, which are fertilized via in vitro fertilization (IVF) with donor sperm, while the other partner (gestational mother) carries the resulting embryo during pregnancy.
The ROPA method consists in performing a conventional in vitro fertilization however, in this case, the embryo will not share any biological links with the gestational carrier. As for assisted reproductive technique with donated semen, both women will be legal mothers.
Given the different points of view regarding same-sex couples reproduction, national legislation varies between countries: [email protected]

Mitochondrial donation, or Mitochondrial Replacement Therapy (MRT), is a highly specialized medical procedure allowed in the United Kingdom and a few other countries worldwide.
This procedure is designed to prevent the transmission of mitochondrial diseases from mother to child, in which some or all of the future baby's mitochondrial DNA, comes from donor. Third party nuclear genetic material is extracted from her eggs (at different developmental stages) and replaced with the patient's genetic material.

Access to assisted reproduction techniques (ART) is governed by a range of requirements that vary depending on multiple factors. These include the specifics of each case, the nationality of the intended parents, their country of origin, and the legal framework of the destination country where the procedure will be carried out.

According the assisted reproductive technology laws, regardless the country where the technique is performed, intended parents are legally recognized as the baby's parents from the moment of birth, with both intended parents' names listed on the birth certificate.

Costs vary greatly depending on the type of procedure and the country where it is performed. Regulation and public funding availability might shape costs too.
info: [email protected]