Ultrasonically guided invasive procedures have been introduced into clinical practice for more than 15 years. Interest for interventional ultrasound in gynecology has increased dramatically after Lenz et al. had described the technique of ultrasonically guided transabdominal aspiration of human oocytes for an in vitro fertilization (IVF) program. Ultrasonically guided follicular punctures should be performed in sterile conditions, but operating room conditions are not required. Recently, specially designed high-frequency puncture vaginal probes became commercially available. In all patients who are scheduled for the IVF program and ultrasonically guided puncture, the presence of active inflammatory disease should be excluded, by the estimation of sedimentation rate, blood cell count, and bacteriological examination of the urine. The patient comes for puncture 30 min before scheduled time and is examined immediately to confirm the presence of the preovulatory follicles. Actually, transabdominal ultrasonically guided puncture is a relatively simple procedure and can be performed easily in most cases.