In vitro fertilisation (IVF) is a major treatment in infertility when other methods of assisted reproduction have failed. It is a process by which egg cells are fertilised by sperms outside the womb by artificial means. The resultant embryo is then put into the womb for further maturation. The term in vitro is used to refer to any biological procedure that is performed outside the organism. The first successful IVF procedure was carried out in England way back in 1976 which resulted in a child birth in 1978. Now the technology is used as an effective clinical treatment for providing infertile couples a gateway to parenthood.

Initially IVF was developed to overcome infertility due to problems of the fallopian tube, but it is now used for a wide range of disorders such as unexplained infertility, endometriosis and male factor infertility.

Conventional or standard IVF treatment involves-
• Ovarian stimulation
• Egg retrieval from the patient
• Sperm retrieval from the male
• Fertilization of the retrieved eggs with sperms
• Embryo transfer to the patient's uterus

Several medicines, usually gonadotropins, are administered to the patient from the third day of her menstrual cycle to cause the growth of multiple follicles in the ovaries. Spontaneous ovulation during this period is prevented by the use of other medicines. When the follicle maturation reaches a satisfactory level the retrieval of ova is done through the use of an ultrasound guided needle which pierces the vaginal wall to reach the ovaries. Sperms are collected from the intended donor. Eggs and sperms, stripped off their surrounding cells, are incubated and placed in culture media for fertilization to happen. However, in cases where the sperm is from someone with a low sperm count, it is directly injected into the egg. After fertilisation the egg is subjected to a growth medium where it grows to reach the 6-8 cell stage. Two to three embryos which are judged best are transferred to the patient's uterus using a catheter to increase the chances of implantation. Rest of the embryos are frozen for future use. About 15 days after the procedure patient is tested for pregnancy.

Important prerequisites for a successful IVF procedure are healthy ova or egg from the mother, sperms from the father and the mother possessing a uterus that can carry the pregnancy to its full term. Therefore any infertility that is caused by reasons other than defects in these three areas can be countered by IVF. Thus the technique allows homosexuals, single and even menopausal women to become pregnant.

The major complications of IVF are multiple births, increased risk of pregnancy loss, obstetrical complications, prematurity, and neonatal morbidity with the potential for long term damage. It is a very complicated procedure and not every attempt results in pregnancy. IVF is also too expensive to help all aspiring parents. Despite the demerits IVF is the only method which can make proud parents of a women otherwise considered traditionally hopeless for pregnancy.