Follicle Aspiration Sperm Injection and Assisted Follicular Rupture (FASIAR)

Follicle aspiration sperm injection and assisted follicular rupture (FASIAR) is an infertility treatment that tends to be less expensive than traditional assisted reproductive procedures. It's one of the newer infertility treatments available and involves removing one or more eggs from a woman's body into a syringe containing sperm. The mixture is then immediately injected back into the fallopian tubes.

The Division of Reproductive Endocrinology and Infertility at the University of Southern California describes the procedure as "mid-way between artificial insemination and the more high-tech IVF methods in terms of complexity." It's often offered as an option to women who have unsuccessfully tried other methods of insemination, but do not want to go to the level of IVF.

The Process

FASIAR requires egg development to be stimulated just like most other assisted reproductive technology. The fertility drugs used contain hormones called gonadotropins, specifically the follicle stimulating hormone (FSH) and the luteinizing hormone (LH). By raising the hormone levels of both these hormones in a woman's body to higher than what is produced naturally, the ovaries work extra hard to mature and release more eggs in a single cycle. The eggs are already there since every girl is born with a set number of eggs to last her lifetime. The eggs are just not mature or some may not be healthy enough end in a properly developing embryo.

The development of the eggs is closely monitored just like other fertility treatments such as GIFT and ZIFT. Just before the egg is released, the physician punctures the egg containing follicles with a thin needle after using an ultrasound to locate them. The doctor suctions the fluid and eggs into a syringe already containing the partner's sperm. The sperm is washed so that only the healthiest are available for possible fertilization. The sperm and egg mix is then immediately injected back into the woman's body through or near the ruptured follicle. The egg is outside the body for only seconds and the entire procedure can be performed within minutes. The procedure provides only minimal discomfort.

Why It's Good

With many other artificial reproductive technologies a woman needs to be able to release eggs from her ovaries and these eggs must be able to travel to the fallopian tubes for fertilization. Sometimes the eggs get trapped in the ovaries and don't make it to the tubes. Other times they're destroyed by the woman's immune system. These risks are eliminated by FASIAR since the eggs are removed directly from the follicle giving the sperm more time to fertilize the egg. If many follicles develop, any extra eggs can be removed to reduce the risk of multiple pregnancies. There is still the risk that the woman's immune system could prevent implantation. The procedure is less expensive since no lab time is required to culture and fertilize eggs.

Success Rates

FASIAR is a new procedure and there isn't enough data to accurately say success rate of this treatment. Preliminary data that has not been published in a peer-reviewed medical journal suggests that the treatment is about twice as successful as insemination on its own. The data has not been critically evaluated which means that the procedure is still considered experimental. It isn't available yet in many clinics.