In vitro fertilization (IVF) and embryo transfer (ET) are procedures designed to enhance the likelihood of conception in an individual/couple for whom other treatment approaches have not been successful. IVF is a process by which egg cells are fertilized by sperm outside the womb, in vitro. The process involves hormonally controlling the ovulatory process, removing the eggs from the woman's ovaries and letting sperm fertilize them in a fluid culture medium.

IVF may be used to overcome female infertility in the woman due to problems of the fallopian tube, making fertilization in vivo difficult. IVF may also assist in cases of male infertility, where there is sub-optimal sperm quality; in such cases intracytoplasmic sperm injection (ICSI) may be used, where a sperm cell is injected directly into the egg cell. This is used when sperm have difficulty penetrating the egg, and in these cases the partner's or a donor's sperm may be used. ICSI is also used when sperm numbers are very low. ICSI results in success rates that are similar to those of IVF fertilization.

Generally speaking, the success of IVF relies on three key factors, viable, healthy ova, viable sperm that can fertilize the ova, and a healthy womb that can support and maintain a pregnancy. Due to the costs of the procedure, IVF is generally attempted only after less expensive options have failed. IVF can also be combined with preimplantation genetic screening (PGS) to rule out the presence of genetic disorders.

Preparing for an IVF cycle involves a series of steps at specific times, which lead to the fertilization of oocytes (eggs) in the laboratory; the fertilized eggs or pre-embryo(s) are replaced back into the womb 3 to 7 days later to allow for implantation and further growth resulting in pregnancy. The first "test tube baby", Louise Brown, was born in 1978 in England.

The following is a brief description of the steps involved in an IVF cycle:
  1. Suppression of a woman's own reproductive hormones
  2. Stimulation of the ovaries with medications to produce mature eggs
  3. Retrieval (harvesting) of the eggs from the ovary
  4. Collection and processing of a sperm sample for IVF-ICSI
  5. Fertilization and In Vitro Culture of the eggs in the Embryology Laboratory
  6. Transfer (ET) of the embryos back into the uterine cavity
  7. Luteal phase support with progesterone
  8. Pregnancy determination and monitoring

1. Suppression of Reproductive Hormones: The production of a woman's natural hormones is temporarily suppressed to allow for effective stimulation of her ovaries resulting in thw production of several oocytes (eggs) for in vitro fertilization. Our physician(s) may use different types of medications for ovarian suppression; these include oral contraceptive pills (OCP), gonadotropin releasing hormone (GnRH) agonists such as Lupron®, or Synarel®, or antagonists such as Antagon® or Cetrotide®. Lupron®, Antagon® or Cetrotide® are given as daily subcutaneous injections. Synare®l is a nasal spray; The side effects with these medications may include hot flashes, headache, lethargy, swelling of the injection site, vaginal dryness, decreased libido, itching or irritation, pain and/or bruising of the injection site. Inhaled medications (Synarel®) can cause nasal irritation. Other side effects have been reported but with very low frequency. An intramuscular injection may cause sciatic nerve injury if given in the wrong place.
2. Stimulation of the Ovaries: Medications used to stimulate the production of eggs by the ovaries include three major groups, a combination of these may be prescribed depending on your own clinical circumstances:

1. a. Human Menopausal Gonadotropins also known as hMG, (Repronex®, Humagon®)
2. b. Highly purified Follicle Stimulating Hormone (FSH) (Bravelle®).
3. c. Recombinant Follicle Stimulating Hormone (FSH) Follistim®, Gonal-®F)
4. d. Human Chorionic Gonadotropin also known as (hCG), Pregnyl®, Novarel®, and Ovidrel®.