In life, many people face infertility. The so-called infertility refers to the inability of women of reproductive age with normal sex life to conceive for more than one year without contraceptive measures taken by the couple. In recent years, with the progress of society and the change of people’s concept of marriage and childbirth, the age of childbirth is gradually postponed and the number of infertility patients increases year by year. How to solve this social problem and meet people’s normal need of raising children? Assisted reproductive technology, especially “IVF” technology, provides a powerful help to infertility patients, who can also have lovely babies with the help of IVF! I’m sure many people have heard of the term IVF. But what exactly is IVF? What kind of people are suitable for IVF? I’m afraid that very few people know about it. In fact, although IVF is “unknown”, it has already influenced and changed our lives in a real way. It has been more than thirty years since the birth of Louis Brown, the world’s first IVF baby, and twenty years since IVF technology was introduced in China. More than three million healthy children have been born through this technology, and thousands of families in China have had their own babies through IVF. Below, I invite you to join me in unraveling the mystery of IVF. The medical name for IVF is in vitro fertilization-embryo transfer (IVF-ET for short). In the past, test tubes were often used in scientific research, so it is commonly referred to as IVF. Specifically, it is the process of removing eggs from a female patient, culturing them in vitro, fertilizing them with sperm, and then transferring the embryos that have developed to a certain stage in vitro into the woman’s uterine cavity, where they can be implanted and develop into a fetus. Normally, the sperm passes through the cervix and uterine cavity and enters the fallopian tube where it meets the egg and the two unite to form a fertilized egg, which then runs, returns to the uterine cavity and lays a pregnancy. However, when the fallopian tubes are obstructed, the sperm cannot reach the fallopian tubes to meet the egg and this causes infertility. The in vitro fertilization-embryo transfer technique allows the egg and sperm to be removed separately and allowed to fertilize outside the body, which solves the problem of tubal obstruction. In addition to this, the IVF-embryo transfer technique has been developed to treat infertility due to endometriosis, ovulation disorders, sperm abnormalities (abnormal number or morphology), and other failed fertility assistance measures or unexplained infertility. This is the earliest in vitro fertilization-embryo transfer technique, commonly known as the first generation of IVF technology. With the development of medical science, it was found that in vitro fertilization-embryo transfer alone cannot solve all infertility problems. In particular, patients with severe oligospermia, weakness and teratozoospermia, whose sperm count is too low to meet the sperm count requirement for in vitro fertilization, need the help of the second generation IVF technology (i.e. intracytoplasmic single sperm injection, or ICSI for short). Under a microscope, an extremely fine glass needle is used to select a robust, morphologically normal sperm and inject it directly into the oocyte plasma to form a fertilized egg. This technique can also be used for azoospermia due to vasal obstruction, where sperm are removed from the testes and epididymis using puncture. In addition, intracytoplasmic single sperm injection can be used in patients with abnormal sperm acrosome and in cases where conventional in vitro fertilization has failed. Scientists have also invented the third generation IVF technique (i.e., pre-implantation embryo genetic diagnosis, or PGD). This technique is mainly used for patients with genetic disorders. Since the oocytes in the early stages of embryonic development are allopatric, the removal of the first and second oocytes does not affect the embryonic development. Single cell PCR or fluorescent in situ hybridization is used for genetic testing to reject abnormal embryos and transfer normal embryos. This technology helps humans to select for healthy offspring from a biogenetic point of view and offers future parents with genetic disorders the opportunity to have healthy children. IVF is an excellent option for infertility patients, especially after repeated failed treatments with other methods, and is the only clinically viable solution available. IVF is particularly suitable for the following types of patients: ① tubal factors: tubal obstruction, hydrocele, tuberculosis, post-surgical ligation or congenital tubal agenesis; ② endometriosis: those who have failed with medication or surgery; ③ oligospermia and weak spermatozoa that have failed with treatment; ④ those who have failed with repeated artificial insemination; ⑤ immune infertility in both men and women; ⑥ unexplained infertility; ⑦ monogenic related genetic diseases, chromosomal diseases, sex-linked genetic diseases and potential fertility. (vii) monogenic genetic disorders, chromosomal disorders, sex-linked genetic disorders and patients who may have abnormal children. With continuous research and improvement, the operation steps of IVF technology have been standardized and programmed. The main procedures are: ① Controlled superovulation: the pituitary gland is desensitized with gonadotropin-releasing hormone agonists (e.g., Dabigal, Daphylline, etc.) and follicle development is stimulated by injection of human recombinant follicle stimulating hormone (e.g., nafion) or urinary sex stimulating hormone, with the aim of having about 10 follicles develop and mature. (ii) Egg retrieval: usually under intravenous anesthesia with transvaginal ultrasound guidance. ③Sperm retrieval: Sperm is removed at the same time as egg retrieval ④In vitro fertilization: 4-5 hours after egg retrieval, the treated sperm and eggs are cultured in the same Petri dish. ⑤Embryo transfer: Embryos are developed to the 4-8 cell stage. A flexible plastic tube is used to transfer 2 or 3 embryos through the cervix into the uterine cavity. (6) Luteal support: Progesterone injections are now mostly used for luteal support. Before IVF, infertile patients must prepare marriage certificate, couple’s ID card and birth certificate. The male partner needs to have his semen tested and the female partner needs to complete some basic examinations such as gynecological examination, diagnostic scraping, tubal patency test, liver function and screening for infectious diseases such as hepatitis B, C, syphilis and AIDS, as well as routine blood analysis and clotting time. Vaginal ultrasound and basal endocrine hormone measurements (day 2-4 of menstruation) are used to evaluate ovarian function. If there are no abnormalities, your doctor will create a medical history to tell you when to start IVF treatment. Depending on the ovulation protocol, the time required for treatment varies. The medication is usually started in the mid-luteal phase, i.e. day 21 of menstruation, to lower the gonadotropins in the body, and the menstruation will start around 7-8 days after the medication. Follicle development medication is started on day 3-7 of menstruation and follicle development is monitored by vaginal ultrasound. Follicle development medication is usually applied for about 10 days. The entire cycle takes about 3 weeks. The whole process is minimally painful and usually does not require hospitalization. IVF technology can bring hope to patients with long-standing infertility, but as with any clinical medical technology, it is not a cure-all, nor does it guarantee 100% success. Many factors affect the success rate of IVF technology, including the patient’s own condition, stable laboratory culture conditions, and the skill level of the technicians. Among them, the patient’s age is an important influencing factor. The success rate of IVF for women under 35 years old is higher than the average of 30%-40%, sometimes reaching or exceeding 50%, and after 35 years old, the success rate gradually decreases and can only reach about 20% at the age of 40. The reason for this is that the quality and quantity of eggs declines and pregnancy loss increases with age. At present, the success rate of pregnancy assistance in major hospitals in China, such as Peking University People’s Hospital, has reached or is close to the international advanced level. Infertility patients who use IVF technology should overcome some misconceptions and actively cooperate with their doctors. There are often patients who believe that IVF is “artificially created” by the hospital and is not the flesh and blood of the couple, so they cannot accept this technology psychologically. In fact, this is a great misunderstanding. From the process we describe, IVF is produced from the eggs and sperm of both spouses, and is the same as a natural pregnancy, and is the flesh and blood of the couple, carrying the genes of both spouses. Some patients are also concerned about the intelligence and health of IVF babies. Scientists have found that children born with first-generation IVF technology have the same IQ as children born with natural pregnancies, and children born with second-generation IVF technology have a slight difference in intelligence, but this can be compensated for within 5 years through education. Larger research studies have all confirmed that there is no significant difference between IVF and naturally conceived babies in terms of birth defects and later mental development. The first IVF babies have now given birth to normal babies of their own, all of which indicate that IVF is safe and reliable. Some patients even worry about the low success rate and high cost of IVF. In fact, the 30-40% success rate of IVF is much higher than the 20% pregnancy rate of normal couples who have monthly intercourse. As for the cost, it varies from hospital to hospital, but the current cost of IVF in major hospitals in China is about 20,000 RMB per visit, which is not as high as it is said to be. Why don’t infertility patients put down their burdens, release their worries and enjoy the convenience brought to you by modern medical technology with confidence. We believe that IVF will give you a chance to fulfill your dream of raising a child!