Fertilization in vitro (in a tube) enables or improves the probability of the encounter between the ovule and the spermatozoon. In vivo (in the body), this encounter takes place in the Fallopian tube. Indeed, in vitro fertilization was devised to circumvent problems posed by tubal obstruction. Its range was later extended to other causes of subfertility in women and to problems of male subfertility, shedding light on the performance of spermatozoa.

In-vitro fertilization (IVF) is a process in which your eggs collected from your ovaries are mixed with your husband's sperms in a test tube or plastic dish with the objective of one sperm entering one egg and combining to produce one embryo. One to three embryos are then placed in your uterus for implantation and development into one or more babies.

New, more complex assisted reproductive technologies, or ART, procedures, including in vitro fertilization (IVF), have been available since the birth 18 years ago of Louise Brown, the world's first "test tube baby." IVF makes it possible to combine sperm and eggs in a laboratory for a baby that is genetically related to one or both partners. IVF is often used when a woman's fallopian tubes are blocked. First, medication is given to stimulate the ovaries to produce multiple eggs.

This involves stimulating the ovary, collecting the oocytes, fertilization of the oocytes with activated semen, and then transfer of the embryos back to the mother. This is the most modern technique for the treatment of infertility, particularly for couples where there is male factor infertility.

The statistics of success can be confusing. The current standard, as per the Society for Assisted Reproductive Technology (SART), measures of success are clinical pregnancy and live birth rates per retrieval, the difference between them being primarily due to miscarriages. For recent experience, ongoing pregnancy rate (defined by the presence of a viable fetus with a heartbeat at 12 weeks) approximates closely the ultimate birth rate. The woman's age is the main determinant of outcome.

Although SCI frequently affects sexual functioning, there are many therapies that allow people with SCI to have an active and satisfying sex life. In general, experts encourage each person to determine his/her level of function by learning how their own body and mind react in certain situations. Complete and open communication and exploration between partners is recommended. Fertility is frequently affected in men with SCI.

Endometriosis is a medical condition where cells that usually remain confined to the cavity of the uterus, grow outside of the uterus usually on or in the ovaries and also on the surface of the pelvic cavity between the uterus and the rectum. Endometriosis can cause pelvic pain and may also decrease the chances of natural conception, as it can affect tubal function and ovulation.

During the course of a natural or spontaneous cycle, usually only one oocyte matures completely with the 'intention' of being fertilized. Thus, only a single embryo can be obtained. Only half of the embryos obtained either spontaneously or after in vitro fertilization are capable of developing and terminating in the birth of a child.

Spermatozoa and oocytes (ovules or eggs) must be available. Most of the time, spermatozoa are isolated from the ejaculate obtained by masturbation. In certain cases, notably when an obstacle blocks the male genital system, it is possible to retrieve spermatozoa by puncture of the deferent canal, the epididymis or even the testicle. The oocytes are extracted from the follicular fluid obtained by ultrasonography-guided aspiration of follicles within the ovary.

Tubal sterilities, when they allow no chance of passage of either the ovule or spermatozoa (agenesis, complete obstruction, voluntary sterilization). Male subfertilities, when the number of competent spermatozoa (motile and morphologically of good quality) is too low to offer an acceptable chance of conception resulting from sexual intercourse. In these cases, in vitro fertilization is an adequate response because fewer spermatozoa are needed.

In vitro fertilization has been a routine procedure only since the early 1980s, when artificial media imitating the natural conditions found in the Fallopian tube were perfected and thus could assure the survival of spermatozoa and oocytes, enabling fertilization and embryo development through its first stages.

The various steps are conducted in the laboratory over a period of 3 to 7 days. They are: the preparation of spermatozoa for insemination; the localization of oocytes, putting them in culture and preparing the ovules for insemination; insemination of the culture; observation of the embryos for a variable period; preparation of embryos in the laboratory for transfer into the uterus by the gynecologist; and the cryopreservation of embryos to be transferred at a later date.

The main rule is that all embryos are obtained with the objective of being transferred, immediately or after cryopreservation, into the uterus of a woman where they will pursue a 'normal' course, leading to implantation in the uterine mucosa or not. If at the end of the cryopreservation term (5 years) the couple has not requested their thawing for a new transfer, we ask them to decide what should be done with their frozen embryos: donated to science or another couple, or destroyed.

The Canadian Fertility and Andrology Society (CFAS), collects statistics voluntarily from participating clinics. Our success rate graphs are contrasted against these national averages. IVF/ICSI success rates

Endometriosis can cause a great deal of pain, because when the endometrial material goes through the normal cycle, it has no way of leaving the body. This causes a build-up of this tissue. In areas where endometriosis occurs may certain chemicals may be secreted and irritate other nearby tissue, causing pain. Over time, endometrial tissue can grow and harden into nodules or bumps that look like individual organs. During menstruation, women with endometriosis will feel more severe symptoms.