IVF is the process by which eggs are removed from ovaries and mixed with sperms in a laboratory culture dish. Fertilisation takes place in this dish, "in vitro" means "in glass". Successful IVF procedure is combined with a procedure known as embryo transfer, which involves physically placing the embryo in the uterus. ( IVF-ET) The first successful birth of a "test tube baby", Louise Brown, occurred in 1978. Thousands of IVF babies have been born since the first in 1978. Indications of IVF : blocked or damaged fallopian tubes. male partner has a minor problem with his sperm. Failed treatment cycles with fertility drugs like clomiphene or IUI trying to conceive for at least two years you are 40 years or more. Five Basic Steps in vitro fertilization and embryo transfer : 1. Monitor and stimulate the development of healthy egg(s). 2. Collection of eggs. 3. Preparation of sperms. 4. Combining the eggs and sperm together in the laboratory under appropriate environment for fertilization and early embryo growth. 5. Transfer embryos into the uterus. Step 1: Fertility medications are prescribed to control the timing of the egg ripening and to increase the chance of collecting multiple eggs. Then daily hormone injections will be given for 12 days .The hormones used are follicle stimulating hormone (FSH) and luteinising hormone (LH). Egg development is monitored using ultrasound ,urine or blood tests . Step 2: When eggs are mature , an injection of human chorionic gonadotrophin (hCG) is given to trigger the release of eggs between 34 hours and 38 hours after injection . Eggs are retrieved by a procedure called follicular aspiration or ovum pick up (OVU) which involves ultrasound guidance . Sedation and local anesthesia may be provided to reduce discomfort . Step 3: Sperms usually obtained by ejaculation ( ideally inside the clinic )and is prepared for combining with the eggs. Step 4: In a process called insemination, the sperms and eggs are placed in incubators located in the laboratory. The incubators enable fertilization and the fertilized eggs are considered embryos. Step 5: The number of embryos that are transferred will depend on age & particular fertility problem.The embryos (one or two , maximum three) are usually transferred into the woman's uterus between two to three days following egg retrieval. At this stage, the fertilized egg has developed into a two-to-four cell embryo. Following embryo transfer , you will be given luteal phase support for 10-14 days in the form of Progesterone gel/pessary/tablets/injections which help in the process of conception . These steps are followed by rest and watching for early pregnancy symptoms. A blood test and potentially an ultrasound will be used to determine if successful implantation and pregnancy have occurred. The success rate of IVF depends on a number of factors including patient characteristics and treatment protocols . · 30-35% for women under age 35 · 25% for women ages 35 to 37 · 15-20% for women ages 38 to 40 · 6-10% for women ages over 40 Repeated cycles : Extra embryos (if any) are usually frozen for future use when a cycle doesn't succeed or a couple wants a baby after your successful treatment. Duration of IVF treatment cycle : One cycle of IVF takes between four weeks and six weeks . You and your partner can expect to spend about half a day at your clinic for the egg retrieval and fertilisation procedures . You’ve to attend the clinic two to three days later for the embryos transfer or five to six days later for blastocyst transfer. There are no long-term problems for most children conceived by IVF . Only it offers you a chance of having a baby if you are unable to conceive naturally . Disadvantages of IVF : IVF increases risk of certain complications , such twins ,triplets,premature baby ,low birth weight baby , ectopic pregnanacy .Side-effects from fertility drugs are usually mild , and include hot flushes , headaches ,nausea & ovarian hyperstimulation syndrome .