Of 142 patients who initiated in vitro fertilization cycles, 52 underwent oocyte collection by laparoscopy, 58 by the ultrasonically guided transvesical route, both under general or local anesthesia and 36 by the ultrasonically transvaginal route under local anesthesia. When the three methods were compared the results did not differ significantly. An average of 6.4, 6.2, and 5.7 oocytes, respectively, were retrieved. Cleavage rates were 82.6, 79.4, and 81.6%, respectively, while 20.2, 22.6, and 21.1% clinical pregnancies per cycle were obtained. Complications with this procedure such as exacerbation of previous pelvic inflammatory disease, urinary tract infections, transient hematuria, and mild hemoperitoneum were rare. In general, patients greatly preferred the transvaginal method. In addition to providing greater comfort for the patient, this method requires no general anesthesia and is less expensive than other methods. Our initial experience demonstrates that in vitro fertilization can be performed successfully through this simplified alternative to oocyte retrieval.