Chapter 11 - In vitro fertilization:

Summary

In vitro fertilization (IVF) and other assisted reproductive techniques are now fully accepted modalities of treatment for subfertility in our modern world. The indications for IVF have increased with the development of newer techniques such as ICSI, surgical sperm retrieval, embryo biopsy, and cryopreservation techniques, and IVF has become the cumulative step for the diagnosis and treatment for unexplained infertility. Certain indications for subfertility discussed in this chapter include tubal infertility, endometriosis, ovarian dysfunction, surrogacy, and male factor. The typical IVF cycle involves the following stages: stimulation for multiple follicular development, monitoring follicular growth and development, trigger of follicular maturation, oocyte recovery and identification, insemination/ICSI, embryo culture, embryo replacement, luteal phase support and confirmation of pregnancy. Traditionally, pregnancy rate per cycle has been used to compare results but gradually cumulative pregnancy outcome over the course of treatment may become more pertinent to the couple.