Conceiving with In Vitro Fertilization (IVF): A step at a time

In Vitro Fertilization is a procedure that helps thousands of couples all over the world to have a baby. Like many others around us, you must have heard this too. Depending on who you ask, IVF will be made to sound you like a miracle or an intense medical process with no guarantees. However, you should know exactly how it works. Here is the entire process of IVF decoded step by step that will clear your apprehensions and deepen your understanding of it.

Step 1 – Administration of oral contraceptives

The first step is to reduce the formation of any cysts in the ovaries that compromise fertilization. In order to do this, your doctor initiates a therapy of oral contraceptives that lasts for 2-4 weeks, right from the first day of your menses. This helps to regulate your hormonal levels and simultaneously limits the development of any potential cysts. This also helps to synchronize the egg follicles and to allow better control of the timing of the cycle.

Step 2 – Stimulation of the ovary

This process usually lasts for about 8 to 12 days. In this process, the doctor starts administering single or combination of injections containing hormones to increase production of more eggs in the ovary that it typically would with a natural cycle. The number of injections can be 1-2 per day or 1-2 for one cycle. The more the number of eggs available, the higher the chances of pregnancy. This will be monitored via transvaginal ultrasound for measurements of the egg follicles growth along with blood tests. When everything seems in place, the doctor initiates the process of egg release by administering a shot of human chorionic gonadotropin (hCG) injection.

Step 3 – Retrieving the Eggs

Once the hCG is given, the next step is to retrieve the eggs from the ovaries. This is a one day’s procedure which is performed within 36 hours of administering the hCG injection. The doctor administers general anesthetic as the procedure is invasive. He also gives oral pain medications to avoid any discomfort. The doctor advances a very thin needle through the upper vaginal wall. An ultrasound is used to separate the fluid from the follicles using suction pressure. Once the fluid is withdrawn from the follicle, the eggs are removed and separated from it. On an average, 8 to 15 eggs are retrieved. They are then placed in a cultured nutrient media followed by a transfer to an incubator.

Step 4 – Fertilizing the Eggs

The eggs are then fertilized using a frozen or donor sperm or a fresh sperm. Egg and sperm are mated in a special chamber, followed by transfer to an incubator, and monitored until a healthy embryo starts to develop. Eggs are tested for viability generally after three days of fertilization. If the fertilization is successful, the next step will be an embryo transfer.

Step 5 – Embryo Transfer

This is the last step of the IVF. In this process, the healthiest embryo is chosen from all the embryos for transfer. This process does not require anesthesia. A slender, plastic tube is used by the doctor to transfer a five-day-old embryo into the uterus. There are high chances of multiple pregnancies happening. Extra viable embryos can be preserved and frozen for future use.

Step 6 –Testing for pregnancy

The transferred embryo takes up to 2 weeks to implant or attaches to the lining of the uterus. Once implanted, it stimulates the production of pregnancy hormone (hCG) signaling that you are pregnant. This wait time between transfer and testing for pregnancy is called the ‘two-week wait’ (2WW). This can be a very anxious, scary, and exciting time. You may have severely mixed feelings which are completely normal. Tasting success with your first round of IVF can be a phenomenal and rare experience.
Unfortunately, this is not always the case, and some couples may choose to continue trying with subsequent rounds of the IVF treatment if the first is not successful.

Summing up…

In-vitro fertilization procedure can be a long-drawn and stressful one. Even once you go through everything that it entails, there is no guarantee of a successful pregnancy or birth. It’s important to take many things into consideration such as your health, your age, and your financial situation. Discuss all aspects of these things with your partner and your healthcare professional and make whatever decision you truly feel is best for your family.


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