ABSTRACT

Since the birth of the fi rst IVF baby almost 30 years ago, dramatic developments have occurred in the fi eld of in vitro fertilization (IVF). IVF was initially designed to overcome the problem of tubal infertility but is now widely held to represent the treatment of choice for unexplained infertility, male factor, endometriosis, and ovarian dysfunction resistant to ovulation induction (1,2). The introduction of intracytoplasmic sperm injection (ICSI) has rendered severe forms of male infertility amenable to treatment and further widened the scope of IVF. High profi le publicity given to the latest achievements with IVF has led to its perception as a panacea for all those having diffi culty in conceiving a pregnancy. This has been refl ected in the rapid expansion of indications for IVF (for the estimated annual IVF cycles in the EU, for example, see reference (3)). The degree to which IVF merits this growth in application remains unclear however, since prospective randomized trials comparing the effectiveness of IVF with simpler fertility treatments remain scarce.