During the last few decades, millions of healthy children have been born with the aid of in vitro fertilization (IVF). This success belies the fact that IVF treatment is comprised of a complex series of interventions starting with a customized control ovarian stimulation protocol. This is followed by the induction of oocyte maturation, the retrieval of mature oocytes and in vitro fertilization, which often involves the microinjection of a single sperm into the oocyte. After fertilization, the resulting embryos are cultured for up to 7 days. The best embryos are transferred into the uterus where the embryo implants and hopefully develops into a healthy child. However, frequently the best embryos are biopsied and frozen. The biopsied cells are analyzed to identify those embryos without chromosomal abnormalities. These embryos are eventually thawed and transferred with pregnancy rates as good if not better than embryos that are not biopsied and transferred in a fresh cycle. Thus, IVF treatment requires the coordinated efforts of physicians, nurses, molecular biologists and embryologists to conduct each of these multifaceted phases in a seamless and flawless manner. Even though complex, IVF treatment may seem routine today, but it was not always the case. In this review the evolution of human IVF is presented as a series of innovations that resolved a technical hurdle in one component of IVF while creating challenges that eventually lead to the next major advancement. This step-by-step evolution in the treatment of human infertility is recounted in this review.

中文翻译：

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需要是发明之母，是推动体外受精成功的进化力量

在过去的几十年里，数以百万计的健康儿童在体外受精 (IVF) 的帮助下出生。这一成功掩盖了试管婴儿治疗由一系列复杂的干预措施组成的事实，从定制的控制卵巢刺激方案开始。随后是诱导卵母细胞成熟、取回成熟卵母细胞和体外受精，这通常涉及将单个精子显微注射到卵母细胞中。受精后，产生的胚胎最多培养 7 天。最好的胚胎被转移到胚胎植入的子宫中，并有望发育成一个健康的孩子。然而，最好的胚胎经常被活检和冷冻。分析活检细胞以识别没有染色体异常的胚胎。这些胚胎最终会被解冻并移植，其妊娠率与未经活检并在新鲜周期中移植的胚胎一样好，甚至更好。因此，IVF 治疗需要医生、护士、分子生物学家和胚胎学家的协同努力，以无缝和完美的方式进行这些多方面的每个阶段。尽管复杂，IVF 治疗在今天看起来似乎很常规，但情况并非总是如此。在这篇综述中，人类试管婴儿的进化被呈现为一系列创新，这些创新解决了试管婴儿一个组成部分的技术障碍，同时创造了最终导致下一个重大进步的挑战。本综述详细叙述了人类不孕症治疗的这种逐步演变。