The state of the art of in vitro fertilization

Since the first description of successful human in vitro fertilization in 1978, researchers and clinicians have been striving to improve the efficacy and safety of the technique. Advances in technology and in our understanding of human reproduction have contributed to increased success rates and decreased rates of higher order multiple births. However, there is still room for improvement as 'unexplained infertility' still affects many couples, and the incidence of twin pregnancies remains elevated. This review will discuss some of the recent advances in the fields of molecular genetics, proteomics and oocyte culture that will ultimately enhance the clinical practice of preimplantation genetic diagnosis, embryo selection and in vitro maturation. It will also discuss the potential for these advances to improve both the safety and efficacy of in vitro fertilization in the near future.