ART stands for assisted reproductive technology, an umbrella term for fertility treatments that involve handling eggs or embryos outside the body to help achieve pregnancy. The most common form is in vitro fertilization (IVF), but ART also covers egg freezing, embryo donation, and several lesser-known procedures. If you’ve seen the abbreviation on a fertility clinic’s website or in insurance paperwork, here’s what it actually includes and how it works.
What Counts as ART (and What Doesn’t)
The CDC defines ART as any fertility treatment where eggs or embryos are physically handled. That means eggs are surgically retrieved from the ovaries, combined with sperm in a lab, and then either transferred back into the uterus or frozen for later use. Egg freezing and embryo donation both fall under the ART umbrella.
What doesn’t count: treatments that only involve sperm, like intrauterine insemination (IUI), where sperm is placed directly into the uterus without retrieving eggs. Fertility medications taken to stimulate egg production also aren’t ART on their own, unless the plan includes surgically retrieving those eggs. This distinction matters because insurance coverage, clinic reporting requirements, and success rate statistics all hinge on whether a procedure meets the formal ART definition.
Types of ART Procedures
IVF dominates the field. Eggs are retrieved, fertilized in a lab dish, grown for several days, and then transferred to the uterus. A related technique called ICSI involves injecting a single sperm directly into an egg, which is especially useful for male-factor infertility or when previous fertilization attempts have failed.
Two older procedures still exist but are rarely performed. GIFT (gamete intrafallopian transfer) places unfertilized eggs and sperm together directly into the fallopian tube through a surgical procedure, letting fertilization happen inside the body. ZIFT (zygote intrafallopian transfer) fertilizes the egg in the lab first, then surgically places the resulting embryo into the fallopian tube rather than the uterus. Both require at least one healthy fallopian tube and general anesthesia, which is part of why they’ve been largely replaced by standard IVF.
Third-Party Options Within ART
ART isn’t limited to using your own eggs and your partner’s sperm. Several third-party arrangements fall under the same umbrella:
- Egg donation: A donor goes through ovarian stimulation and egg retrieval. Her eggs are fertilized with the intended parent’s or donor’s sperm, and the resulting embryo is transferred to the recipient’s uterus. This is particularly relevant for people with premature ovarian insufficiency, those who’ve undergone chemotherapy, or carriers of known genetic conditions.
- Sperm donation: Donated sperm can be used in either IUI or IVF cycles.
- Embryo donation: A previously created embryo from another couple or donor is transferred to the recipient. Some people choose this after repeated IVF failures or when both partners face fertility challenges.
- Gestational carriers: An embryo created from the intended parents’ (or donors’) eggs and sperm is transferred to another person who carries the pregnancy. The carrier has no genetic connection to the child. This differs from traditional surrogacy, where the surrogate’s own egg is used.
What a Typical IVF Cycle Looks Like
Before treatment begins, you’ll go through a fertility workup that includes blood tests, an evaluation of the uterine cavity, a semen analysis, and possibly genetic carrier screening. Once your specialist confirms IVF is the right path, the process follows a predictable sequence.
First comes ovarian stimulation: daily hormone injections that prompt your ovaries to produce multiple eggs instead of the usual one. This phase lasts roughly 8 to 14 days, with several monitoring appointments along the way. When the eggs are mature, a trigger shot is given exactly 36 hours before retrieval.
Egg retrieval itself is a short procedure, about 15 to 30 minutes under light anesthesia. You’ll stay at the clinic for about an hour afterward for observation. The collected eggs are then fertilized in the lab, and the resulting embryos are monitored over the next several days. Most embryos reach the blastocyst stage (the point where they’re ready for transfer) around day 5, though some take until day 6 or 7.
At that point, you and your doctor decide whether to do a fresh transfer in the same cycle or freeze the embryos for a later transfer. After transfer, you’ll typically be advised to avoid vigorous activity and intercourse for about two weeks, until a pregnancy test confirms the outcome.
Genetic Testing Before Transfer
One of the most significant additions to modern ART is preimplantation genetic testing, or PGT. Before an embryo is transferred, a few cells can be biopsied and screened for genetic issues. There are three main types, each looking for something different.
PGT-A screens for the wrong number of chromosomes, the kind of abnormality that causes most early miscarriages and conditions like Down syndrome or Turner syndrome. It’s most commonly recommended for people over 35 or those with a history of repeated miscarriage. A retrospective analysis of CDC data found that PGT-A reduced miscarriage risk for women over 35 and improved both pregnancy and live birth rates for women over 37.
PGT-M targets specific inherited diseases like cystic fibrosis, Tay-Sachs, or muscular dystrophy. If you or your partner are known carriers of a single-gene disorder, this test identifies which embryos are unaffected before transfer. PGT-SR looks for structural chromosome rearrangements, which can cause implantation failure or recurrent loss. Together, these tools allow clinicians to select the embryos most likely to result in a healthy pregnancy.
Who ART Is For
ART is used across a wide range of diagnoses. Blocked or damaged fallopian tubes, severe male-factor infertility, advanced maternal age, endometriosis, unexplained infertility, and diminished ovarian reserve are all common reasons. It’s also the path for people using donor eggs, donor sperm, or gestational carriers, as well as for individuals or same-sex couples building families.
Lifestyle factors play a measurable role in outcomes. A large meta-analysis of 77 studies found that people with a BMI of 25 or below were about 22% more likely to achieve a pregnancy or live birth through ART compared to those with a higher BMI. Non-smokers were roughly 46% more likely to succeed than smokers. The evidence on alcohol was too limited to draw firm conclusions.
Risks to Be Aware Of
The most well-known risk of ovarian stimulation is ovarian hyperstimulation syndrome, or OHSS, where the ovaries overreact to hormones and swell painfully. In its mild form, OHSS affects an estimated 20% to 33% of stimulated cycles, usually causing bloating and discomfort that resolves on its own. Moderate to severe OHSS, which can require medical intervention, occurs in about 3% to 8% of cycles. The good news: incidence has been dropping steadily since the 1990s, falling from 3.6% to 1% at one large center between 2005 and 2009, thanks to improved stimulation protocols.
Multiple pregnancies (twins or higher) have historically been another concern with ART, since transferring more than one embryo increases the chance of multiples. The trend in recent years has been strongly toward single-embryo transfer, which significantly reduces this risk while maintaining competitive success rates.
What ART Costs
A conventional IVF cycle typically runs $15,000 to $30,000 or more, depending on the clinic and where you live. That base price generally covers ovarian stimulation medications, monitoring visits, egg retrieval, fertilization, embryo development, and a fresh embryo transfer.
Several common additions aren’t included in that base price. ICSI adds $1,000 to $2,500. Genetic testing runs $3,000 to $7,000. Embryo freezing costs $500 to $1,000 upfront, plus $500 to $1,000 per year for storage. A frozen embryo transfer, if you don’t do a fresh transfer in the same cycle, is an additional $3,000 to $5,000. Medication costs for a conventional cycle typically range from $4,000 to $8,000, though a mini-IVF approach using lower doses can bring that down to $700 to $2,700.
Insurance coverage varies dramatically. Some states mandate fertility treatment coverage, while others offer none. It’s worth checking both your state’s requirements and your specific plan’s language, since many policies distinguish between diagnostic fertility testing (often covered) and ART procedures (often not).