The existence of sterility will not always require ART to be the first option to consider, as there are occasions when its cause is a mild disorder that can be solved with more conventional treatments or with behaviors based on promoting health and reproductive habits.

[citation needed] In the US, the Centers for Disease Control and Prevention (CDC) defines ART to include "all fertility treatments in which both eggs and sperm are handled.

[4] Ovulation induction is usually used in the sense of stimulation of the development of ovarian follicles[5][6][7] by fertility medication to reverse anovulation or oligoovulation.

A health care provider closely monitors the development of the eggs using transvaginal ultrasound and blood tests to assess follicle growth and estrogen production by the ovaries.

When follicles have reached an adequate size and the eggs are mature enough, an injection of the hormone hCG initiates the ovulation process.

Some of these include low birth weight, placental insufficiency, chromosomal disorders, preterm deliveries, gestational diabetes, and pre-eclampsia (Aiken and Brockelsby).

It found that assisted conception pregnancies were associated with an increased risk of cardiovascular diseases, including acute kidney injury and arrhythmia.

[27][28] In theory, ART can solve almost all reproductive problems, except for severe pathology or the absence of a uterus (or womb), using specific gamete or embryo donation techniques.

[citation needed] For the community as a whole, the cost of IVF on average pays back by 700% by tax from future employment by the conceived human being.

A European directive fixes standards concerning the use of human tissue and cells,[37] but all ethical and legal questions on ART remain the prerogative of EU member states.

For example, Portugal made ART available in 2006 with conditions very similar to those in France, before amending the law in 2016 to allow lesbian couples and single women to benefit.

Italy clarified its uncertain legal situation in 2004 by adopting Europe's strictest laws: ART is only available to heterosexual couples, married or otherwise, and sperm donation is prohibited.

In France, ART is subsidized in full by national health insurance for women up to age 43, with limits of 4 attempts at IVF and 6 at artificial insemination.

Germany tightened its conditions for public funding in 2004, which caused a sharp drop in the number of ART cycles carried out, from more than 102,000 in 2003 to fewer than 57,000 the following year.

10 countries have established an upper age limit, varying from 40 (Finland, Netherlands) to 50 (including Spain, Greece and Estonia).

Since 1994, France is one of a number of countries (including Germany, Spain, and the UK) which use the somewhat vague notion of "natural age of procreation".

In France, the principle of anonymous donations of sperm or embryos is maintained in the law of bioethics of 2011, but a new bill under discussion may change the situation.

[41] In the United Kingdom, all patients have the right to preliminary testing, provided free of charge by the National Health Service (NHS).

In 2013, the National Institute for Health and Care Excellence (NICE) published new guidelines about who should have access to IVF treatment on the NHS in England and Wales.

For example, the Cheshire, Merseyside and West Lancashire Clinical Commissioning Group insists on additional conditions:[43] Some treatments are covered by OHIP (public health insurance) in Ontario and others are not.

Women with bilaterally blocked fallopian tubes and are under the age of 40 have treatment covered but are still required to pay test fees (around CA$3,000–4,000).

[45] On 27 January 2009, the Federal Constitutional Court ruled that it is unconstitutional, that the health insurance companies have to bear only 50% of the cost for IVF.

In July 2020, the French Parliament allowed assisted reproductive technology also for lesbian couples and single women.

[55] Some assisted reproductive technologies have the potential to be harmful to both the mother and the child, posing a psychological or physical health risk, which may affect the ongoing use of these treatments.

In Israel, there is research supporting using ART, including recycled lab materials from the IVF process, to help women work through some of these mixed emotions.

[60] For specific examples, refer to the fiction sections in individual subarticles, e.g. surrogacy, sperm donation and fertility clinic.