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Understanding Treatment

IVF

IVF from beginning to end: stimulation, retrieval, the laboratory and embryo transfer.

  • 2 minread
  • 5sections
  • 2myths checked
  • 4sources

IVFin vitro fertilisationICSIegg retrievalembryoembryo transferstimulation

IVF process illustrated in four steps: egg retrieval, fertilisation, embryo development and embryo transfer.
IVF process illustrated in four steps: egg retrieval, fertilisation, embryo development and embryo transfer.

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IVF can sound like an intimidating collection of injections, scans, laboratory procedures and medical terminology. It helps to step back and look at it as a series of stages.

Kara explains

IVF is not one event. It is stimulation, monitoring, egg retrieval, fertilisation, embryo development, and then decisions about transfer or freezing. Protocols vary from woman to woman and between clinics.

1. Ovarian stimulation

Medication helps several follicles grow at once; scans track their growth.

Medication encourages several follicles to develop at once. Their growth is tracked mainly with ultrasound scans; some clinics also use blood tests. Sometimes the ovaries respond more strongly than intended; this over-response is called ovarian hyperstimulation syndrome (OHSS). Mild bloating and discomfort are common during stimulation. Severe OHSS is uncommon but can be serious: it usually starts in the week after egg collection and can get worse if you become pregnant. Contact your clinic straight away if you have worsening tummy pain or swelling, nausea or vomiting, or feel faint. Go to your nearest emergency unit, or call an ambulance on 10177 (112 from a cellphone), if you are short of breath, have chest pain or a painful swollen leg, or are passing very little urine, or if you can’t reach your clinic quickly. Before you start, ask your clinic for an out-of-hours number.

2. Egg retrieval

Egg collection is a short procedure, usually under conscious sedation.

When the follicles are ready, eggs are collected from them in a short procedure, usually under conscious sedation, with a doctor or an anaesthetic nurse monitoring you throughout.

3. Fertilisation in the laboratory

In the laboratory, eggs are combined with sperm by IVF or ICSI.

Eggs are combined with sperm, either by conventional insemination or by ICSI, where a single sperm is injected into each mature egg. ICSI helps when there is a sperm problem, but with a normal semen analysis it hasn’t been shown to lead to more babies, and it costs more.

4. Embryo development

Embryos are cultured in the laboratory for several days.

Embryos are cultured in the laboratory for several days. Some clinics offer testing embryos for chromosome problems (PGT-A). It can only choose among embryos that already exist; trials haven’t shown that it leads to more babies overall, and European and UK guidance don’t recommend it routinely.

5. Transfer or freezing

Transferring one embryo at a time is the safest approach.

An embryo may be transferred to the uterus, and suitable embryos may be frozen for later use. Transferring one embryo at a time is the safest approach, because twins carry higher risks for mother and babies.

Myth vs evidence

Myth

“IVF guarantees a pregnancy.”

Evidence

IVF can be an effective treatment, but no treatment guarantees an outcome. Individual results differ.

Myth

“Every IVF cycle follows the same protocol.”

Evidence

Protocols are tailored to each woman and vary between clinics.

Take to your appointment Ask your healthcare professional
  1. Which protocol are you recommending, and why?
  2. Will you use conventional IVF or ICSI in our case?
  3. How will you decide how many embryos to transfer or freeze?

Words you may hear

ICSI
Intracytoplasmic sperm injection: injecting a single sperm into an egg.
Blastocyst
An embryo at around day five or six of development.
Frozen embryo transfer (FET)
Warming a frozen embryo and transferring it in a later cycle.
Kara’s key takeaway

IVF is a series of stages. Understanding each one makes the whole process far less overwhelming.

Watch with Kara

Videos on this topic are coming to the channel:

  • What Is IVF?
  • IVF Step by Step
  • What Happens During Ovarian Stimulation?
  • What Happens During Egg Retrieval?
  • What Happens in the IVF Laboratory?
  • How Does Fertilisation Happen in IVF?
  • What Is an Embryo Transfer?
  • Fresh vs Frozen Embryo Transfer Explained
  • IVF or ICSI: What’s the Difference?
  • Understanding IVF Success Rates
  • Embryo Grading Explained
  • Embryo Testing: What It Can and Can’t Do

See the video schedule

It takes two
Concept illustration, not to scale.

Male fertility belongs in the same conversation. These illustrated guides pair with this topic:

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Sources 4 studies and guidelines Show the research