Update on in vitro fertilization.

Abstract

I. Introduction THE TECHNIQUE for in vitro fertilization was originally devised by Edwards and Steptoe (1) for the relief of otherwise uncorrectable tubal infertility. Oocytes are retrieved surgically from the Graafian follicles and fertilized in the laboratory with the husband's sperm. The conceptus is cultured for 40 h, at which time it is transferred into the uterus at the four-cell stage. A program for in vitro fertilization, therefore, involves the marriage of three major disciplines: reproductive surgery, embryology, and endocrinology; with surgery for the retrieval and transfer of the oocyte and conceptus; embryology for the oocyte culture and fertilization; and endocrinology for stimulation of multiple follicle development. The importance of surgical skills is self-evident, as laparoscopic oocyte retrieval may be difficult in patients who have had multiple operative procedures. Because the procedures are done under anesthesia, hospital facilities, at least on an outpatient basis, are a requirement.