Problems with infertility will affect about one couple in seven. Of these, approximately half will end up undertaking some form of assisted conception treatment. In vitro fertilization can be viewed both as a test of reproductive potential, allowing detailed assessment of oocytes, oocyte sperm interaction and embryo quality, as well as an effective treatment for most forms of subfertility. The dramatic improvements in pregnancy rates seen with IVF treatment since its inception some 22 years ago have occurred due to close collaboration between biological scientists and clinicians with interests in the area. There have been several important landmarks, including the use of drugs for superovulation and pituitary downregulation, the introduction of transvaginal ultrasound for monitoring of follicle growth and oocyte collection, and embryological developments in embryo culture and, most recently, ICSI. Despite this progress, the majority of IVF cycles do not produce a viable pregnancy and the psychological stresses imposed upon couples by assisted conception treatment need to be managed carefully and sympathetically.
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