الفهرس 
Introduction and Aim of the workOnly 14 pages are availabe for public view
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Abstract
This review was carried out to highlight the factors thought to optimise the outcome of assisted reproductive techniques regarding patient, clinic and laboratory factors as an evidencebased practice. Recent findings: A higher success rate occurs with immediate compared with delayed IVF for cases with tubal factor of infertility. PCOS patients have increased cancellation rate, but more oocytes retrieved per retrieval and a lower fertilisation rate. IVF may not be the preferred first line of treatment for couples with unexplained infertility. IVF is an appropriate treatment for infertility associated with endometriosis especially if tubal function is compromised, if there is also male factor infertility, and/or other treatments have failed. Couples with borderline & poor semen will have better fertilization outcomes with ICSI than with subzonal sperm injection or additional IVF. In all cases, facilities for cryopreservation of spermatozoa should be available. The recognised indications for treatment by ICSI include: (i) severe deficits in semen quality, (ii)obstructive azoospermia, (iii) nonobstructive azoospermia. In addition, treatment by ICSI should be considered for couples in whom a previous IVF treatment cycle has resulted in failed or very poor fertilisation. For pituitary downregulation as part of IVF treatment, using gonadotrophinreleasing hormone agonist in addition to gonadotrophin stimulation facilitates cycle control and results in higher pregnancy rates than the use of gonadotrophins alone. The routine use of gonadotrophinreleasing hormone agonist in long protocols during in vitro fertilisation is therefore recommended. Human menopausal gonadotrophin, urinary folliclestimulating hormone and recombinant folliclestimulating hormone are equally effective in achieving a live birth Luteal phase support with hCG or progesterone after assisted reproduction results in an increased pregnancy rate. HCG does not provide better results than progesterone. Conclusions: Evidencebased management of assisted reproductive treatment is a dynamic process with the need for more randomised controlled trials and metaanalyses.