Does “in vitro fertilization” mean that the fetus is grown and developed in a test tube? ”In vitro fertilization-embryo transfer” is the common name for this procedure, because the embryo is grown and developed in the culture fluid and petri dishes of the embryo laboratory for a period of time. As we all remember, many of the laboratory operations are done in test tubes, so the term “in vitro fertilization” has spread widely. Worldwide surveys show that the incidence of infertility is increasing year by year, reaching up to 15%, and in some regions and countries up to 20% or more. “IVF plays a very important role in the treatment of such infertility patients. What are the conditions and procedures for IVF treatment? First, let’s look at the indications for IVF. It is intended for couples who are infertile. The cause of infertility is considered from two subjects: the female partner and the male partner. For the female partner, it may be obstruction, fluid retention, poorly functioning fallopian tubes, ovulation disorder with polycystic ovary syndrome or repeated failure of ovulation promotion, infertility due to endometriosis, low ovarian function along with decreased fertility in the male partner. The male partner, for example, has severe oligospermia, azoospermia, teratozoospermia, varicocele, sexual dysfunction, or is accompanied by reduced fertility in the female partner. It is necessary for the couple to visit the infertility clinic together and have a clinician make a diagnosis after completing various tests. To undergo IVF, you need to prepare your ID card, marriage certificate and birth certificate. These tests are similar to those required for gynecological surgery. Next, the general process of IVF is described. Once the conditions for IVF are met, the documents are prepared and the preoperative examinations are completed, the medical records are created at the fertility center and the patient can enter the normal IVF treatment cycle. Depending on the patient’s own conditions, such as age, years of infertility, cause of infertility, ovarian reactivity, body mass index, etc., the clinician will choose the appropriate protocol for the patient, such as long protocol, short protocol, extra-long protocol, antagonist protocol, etc. The term extra long, long and short here refers to the length of pituitary descending regulation prior to ovulation promotion and of course probably suggests the length of the entire IVF cycle. Pituitary descending regulation is in preparation for ovulation promotion. Normally, the pituitary gland regulates estrogen and progesterone and follicle growth and development during the menstrual cycle. If it works all the time, it will interfere with the doctor’s medication; to avoid being affected by the pituitary gland, we use medication to temporarily suppress the function of the pituitary gland so that we can get the right number of eggs of uniform size. After descending regulation, blood is drawn for hormones and a transvaginal ultrasound is done to see the number of small follicles in both ovaries; based on past experience, when the clinician feels it is appropriate and ready to start, ovulation treatment with high-purity gonadotropins is started. These ovulation-promoting drugs are high in purity and dose and are very effective, but of course the cost is higher. During this 8-13 day period, you need to come to the clinic anywhere from 3-4 times. Each time, blood is drawn for hormones in the morning, follicle monitoring is done, and when the hormone results are available, the doctor adjusts the medication according to the hormone values and follicle growth, and then the nurse administers the medication to the patient as prescribed by the doctor. The medication is simple and user-friendly, and many patients can use it at home after learning how to do so. All of these procedures are performed on an outpatient basis and do not require hospitalization. When the follicle size and hormone values are satisfactory, HCG is injected to simulate the LH peak during normal ovulation. At this point, the ovulation process is complete. This is followed by ultrasound-guided follicular puncture and embryo culture. As with other procedures, the patient is required to sign an informed consent form for the procedure and an informed consent form for the anesthesia. Because of the intravenous anesthesia, the patient does not feel anything during the procedure. The procedure takes a short time, about 5-15 minutes, depending on the number of follicles and the location of the patient’s ovaries. The removed eggs are mixed in the follicular fluid and sent to the embryo lab. The lab technician picks up the eggs under a microscope and transfers them to a Petri dish containing culture fluid and places the eggs and sperm together at the right time for fertilization by union. For severe oligozoospermia in the male partner, when normal fertilization is not possible, we will recommend the patient to undergo intracytoplasmic single sperm injection, or ICSI-ET, commonly known as second generation IVF. The procedure is done entirely under a high-powered microscope, and a single sperm with high viability and good morphology is selected for injection into the egg. After fertilization is completed, the embryos are placed in an incubator to continue the process, selecting those that develop normally and discarding those that develop abnormally. And the embryos are transferred on the 2nd, 3rd or 5th day after egg retrieval, and any remaining embryos are frozen and stored in liquid nitrogen. The transfer is a minor procedure and the patient hardly feels anything. After wiping the cervix with the transfer solution, the transfer tube containing the embryos is extended to the appropriate location in the uterine cavity under the guidance of abdominal ultrasound, and the syringe is gently pushed to keep the embryos in the uterine cavity. The patient then rests for 20 minutes after the transfer to allow the embryo to fully adhere to the endometrium in contact. Strong luteal support is then started and pregnancy is confirmed by a blood test for HCG 12-14 days after the transfer. This is the approximate description of a complete IVF cycle. The birth of IVF has opened a brand new curtain in the treatment of infertility. It is the innovation and crystallization of human wisdom, which has brought happiness and contentment to millions of families. We are gradually unveiling it, however, it is still full of mystery and attracts countless clinicians and scholars to keep exploring it.