S INCE THE BIRTH of Louise Brown, the first "test tube'(actually, petri-dish in-vitro fertilized) baby in 1978,1 an ever-increasing number of procedures known as assisted reproductive technologies (ARTs) have been performed. With refinements in the science, live birth rates have increased; the most recent survey of North American clinics reported that 65,863 initiated ART cycles resulted in the delivery of 21,196 neonates from 14,702 pregnancies. 2 Although staggering, these numbers also suggest that the majority of cycles do not result in midnight trips for diapers and formula. Although the application of ARTs to increasingly diverse infertility etiologies may be responsible for these limited results, subtle differences in hormolaal manipulation, techniques, and laboratory methods may affect outcome as well. As such, anesthesiologists should be vigilant to the potential impact anesthetic agents have on the success of ARTs. This article will review the techniques that comprise ARTs and the anesthetic relationship to and management of these procedures.