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'''In vitro fertilisation''' ('''IVF''') is a process of [[fertilisation]] where an [[ovum|egg]] is combined with [[spermatozoon|sperm]] [[in vitro]] ("in glass"). The process involves monitoring and stimulating a woman's [[Ovulation cycle|ovulatory process]], removing an ovum or ova (egg or eggs) from their [[ovary|ovaries]] and letting a man's sperm fertilise them in a culture medium in a laboratory. After the fertilised egg ([[zygote]]) undergoes [[embryo culture]] for 2–6 days, it is [[Embryo transfer|transferred]] by [[catheter]] into the [[uterus]], with the intention of establishing a successful [[pregnancy]].
 
IVF is a type of [[assisted reproductive technology]] used for [[infertility]] treatment, [[gestational surrogacy]], and, in combination with [[pre-implantation genetic testing]], avoiding transmission of genetic conditions. A fertilised egg from a donor may [[Implantation (embryology)|implant]] into a surrogate's uterus, and the resulting child is genetically unrelated to the surrogate. Some countries have banned or otherwise regulate the availability of IVF treatment, giving rise to [[fertility tourism]]. Restrictions on the availability of IVF include costs and age, in order for a person to carry a healthy pregnancy to term.
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==Terminology==
The Latin term [[in vitro]], meaning "in glass", is used because early biological experiments involving cultivation of tissues outside the living organism were carried out in glass containers, such as beakers, test tubes, or Petri dishes. Today, the scientific term "in vitro" is used to refer to any biological procedure that is performed outside the organism in which it would normally have occurred, to distinguish it from an [[in vivo]] procedure (such as [[insemination|in vivo fertilisation]]), where the tissue remains inside the living organism in which it is normally found.
 
A colloquial term for babies conceived as the result of IVF, "test tube babies", refers to the tube-shaped containers of glass or plastic resin, called [[test tube]]s, that are commonly used in chemistry and biology labs. However, IVF is usually performed in [[Petri dish]]es, which are both wider and shallower and often used to cultivate cultures.
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The first successful birth of a child after IVF treatment, [[Louise Brown]], occurred in 1978. Louise Brown was born as a result of natural cycle IVF where no stimulation was made. The procedure took place at Dr Kershaw's Cottage Hospital (now Dr Kershaw's Hospice) in [[Royton]], Oldham, England. [[Robert G. Edwards]], the physiologist who co-developed the treatment, was awarded the [[Nobel Prize in Physiology or Medicine]] in 2010. His co-workers, [[Patrick Steptoe]] and [[Jean Purdy]], were not eligible for consideration as the Nobel Prize is not awarded posthumously.<ref name="Moreton" /><ref name="ReferenceA" />
 
The second successful birth of a 'test tube baby' occurred in India just 67 days after Louise Brown was born. The girl, named Durga, was conceived in vitro using a method developed independently by [[Subhash Mukhopadhyay (physician)|Subhash Mukhopadhyay]], a physician and researcher from [[Hazaribag]]. Mukhopadhyay had been performing experiments on his own with primitive instruments and a household refrigerator.<ref>{{cite magazine |date=19 October 1978 |title=India reveals deep-frozen test-tube baby |url=https://books.google.com/books?id=Bik2nThZSYoC&pg=PA159 |magazine=[[New Scientist]] |page=159 |access-date=4 September 2021 |vauthors=Jayaraman KS }}{{Dead link|date=December 2023 |bot=InternetArchiveBot |fix-attempted=yes }}</ref> However, state authorities prevented him from presenting his work at scientific conferences,<ref>{{cite web |date=5 October 2010 |title=Test tube triumph & tragedy – Nobel for UK scientist stirs memory of a Bengal doctor |url=https://www.telegraphindia.com/india/test-tube-triumph-tragedy-nobel-for-uk-scientist-stirs-memory-of-a-bengal-doctor/cid/472542 |access-date=22 May 2012 |work=[[The Telegraph (India)|The Telegraph]]}}</ref> and it was many years before Mukhopadhyay's contribution was acknowledged in works dealing with the subject.<ref>{{cite AV media |url=https://www.youtube.com/watch?v=nkEko0DybuQ |title=Test Tube Baby |date=23 August 2013 |publisher=Educational Multimedia Research Centre, Kolkata |access-date=4 September 2021 |website=[[YouTube]]}}</ref>{{better source needed|date=September 2021}}
 
[[Adriana Iliescu]] held the record as the oldest woman to give birth using IVF and a donor egg, when she gave birth in 2004 at the age of 66, a record passed in 2006. After the IVF treatment some couples are able to get pregnant without any fertility treatments.<ref name="reuters.com" /> In 2018 it was estimated that eight million children had been born worldwide using IVF and other assisted reproduction techniques.<ref name="ESHRE 2018">{{cite web |author=European Society of Human Reproduction and Embryology |date=3 July 2018 |title=More than 8 million babies born from IVF since the world's first in 1978 |url=https://www.sciencedaily.com/releases/2018/07/180703084127.htm |access-date=8 December 2018 |website=ScienceDaily}}</ref>
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===Egg retrieval===
{{Further|Transvaginal oocyte retrieval}}
The eggs are retrieved from the patient using a transvaginal technique called [[transvaginal oocyte retrieval]], involving an ultrasound-guided needle piercing the vaginal wall to reach the ovaries. Through this needle follicles can be aspirated, and the follicular fluid is passed to an embryologist to identify ova. It is common to remove between ten and thirty eggs. The retrieval process, which lasts approximately 20 to 40 minutes, is performed under [[conscious sedation]] or [[general anesthesia]] to ensure patient comfort. Following optimal follicular development, the eggs are meticulously retrieved using transvaginal ultrasound guidance with the aid of a specialised ultrasound probe and a fine needle aspiration technique. The follicular fluid, containing the retrieved eggs, is expeditiously transferred to the embryology laboratory for subsequent processing.<ref>IVF Process, Methods and Solutions https://techxplore.online/ivf-process-methods-and-solutions/ {{Webarchive|url=https://web.archive.org/web/20230609095407/https://techxplore.online/ivf-process-methods-and-solutions/ |date=9 June 2023 }}</ref>
 
===Egg and sperm preparation===
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===Industry corruption===
In 2008, a California physician transferred 12 embryos to a woman who gave birth to octuplets ([[Suleman octuplets]]). This led to accusations{{by whom|date=January 2024}} that a doctor is willing to endanger the health and even life of people in order to gain money.{{citation needed|date=January 2024}}

Robert Winston, professor of fertility studies at Imperial College London, had called the industry "corrupt" and "greedy" stating that "one of the major problems facing us in healthcare is that IVF has become a massive commercial industry," and that "what has happened, of course, is that money is corrupting this whole technology", and accused authorities of failing to protect couples from exploitation: "The regulatory authority has done a consistently bad job. It's not prevented the exploitation of people, it's not put out very good information to couples, it's not limited the number of unscientific treatments people have access to".<ref>{{cite news| url=https://www.theguardian.com/science/2007/may/31/medicineandhealth.health | location= London | work = The Guardian | vauthors = Jha A | title=Winston: IVF clinics corrupt and greedy | date= 31 May 2007}}</ref> The IVF industry has been described as a market-driven construction of health, medicine and the human body.<ref>{{Cite book| vauthors = Dumit J |title=Drugs for life : how pharmaceutical companies define our health|date=2012|publisher=Duke University Press|isbn=978-0-8223-4860-3|location=Durham, NC|oclc=782252371}}</ref>
 
The industry has been accused of making unscientific claims, and distorting facts relating to infertility, in particular through widely exaggerated claims about how common infertility is in society, in an attempt to get as many couples as possible and as soon as possible to try treatments (rather than trying to conceive naturally for a longer time).{{citation needed|date=January 2024}} This risks removing infertility from its social context and reducing the experience to a simple biological malfunction, which not only ''can'' be treated through bio-medical procedures, but should be treated by them.<ref>{{cite conference | vauthors = Dietrich H | date = May 1986 | title = IVF: what can we do? | conference = Liberation or Loss? | location = Canberra }}</ref><ref name="pmid11649236">{{cite journal | vauthors = Warren MA | title = IVF and women's interests: an analysis of feminist concerns | journal = Bioethics | volume = 2 | issue = 1 | pages = 37–57 | date = January 1988 | pmid = 11649236 | doi = 10.1111/j.1467-8519.1988.tb00034.x }}</ref>
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