Oocyte retrieval is the starting point of a complex laboratory process that is the final aim of delivering a healthy baby. Exposure of oocytes to inappropriate conditions could potentially disrupt fertilization and early development. It is well accepted that minimizing stress during gamete and embryo their manipulation is critical for optimizing outcomes. The potential physicochemical stressors that can affect oocytes and embryos must be controlled to diminish possible negative effects. These include temperature control, maintaining osmolarity, pH, and protection from oxidative stress and toxic substances such as volatile organic compounds (VOC). Therefore, precautions must be taken to maintain adequate conditions to protect zygote and embryo homeostasis.

Oocyte pick-up is the process whereby oocytes are microscopically identified and pipetted from follicular fluid aspirates and placed into a culture environment prior to in vitro fertilization (IVF). This chapter sets out the laboratory operating procedure for oocyte pick-up and considers practical training methods and competency assessment. From the outset, it is important for embryologists or technicians to be aware that changes in the wider environment of a gamete or embryo can affect its immediate culture environment. The external environment includes not only the space in which the pick-up is performed – the flow hood, which much provide stable temperature and pH maintenance for the oocytes – but also the consumables and culture media used. Task-based training leading to competency should follow a robust pathway. Oocyte pick-up is a critical process and, as such, should be performed effectively and reproducibly by the embryologists within the team.

Assisted reproduction technology (ART) encompasses fertility treatments which require manipulation of oocyte, sperm or both in vitro. This chapter aims to provide an overview of ART, including indications for treatment as well as the procedures involved. This will also include complications of ART as well as the evidence assessing the perinatal outcomes of children resulting from ART.