How is IVF Performed?

How Is IVF Performed? Step-by-Step Guide to In Vitro Fertilisation

In vitro fertilisation (IVF) is one of the most widely used and effective fertility treatments available today. For couples or individuals facing fertility issues, IVF offers hope of conception when natural methods have failed.

But what exactly happens during an IVF cycle? In this comprehensive guide, we break down how IVF is performed, what to expect at each stage, and the emotional and physical journey it entails—especially for those navigating fertility care in the UK.

What Is IVF?

IVF, or in vitro fertilisation, is an assisted reproductive technology (ART) in which eggs are fertilised by sperm outside the body in a laboratory. Once fertilised, the resulting embryos are cultured for a few days and then transferred into the uterus to establish a pregnancy.

Since its first successful use in 1978, IVF has led to the birth of over 8 million babies worldwide.

Who Might Need IVF?

IVF is used to address a range of fertility problems, including:

• Blocked or damaged fallopian tubes
• Male factor infertility (low sperm count or motility)
• Ovulation disorders like PCOS
• Endometriosis
• Unexplained infertility
• Same-sex couples or single individuals wanting a biological child
• Genetic disorders requiring embryo screening

In the UK, the NHS may fund IVF for eligible patients, though many also choose private clinics for quicker access or personalised care.

Step-by-Step IVF Procedure

Each IVF cycle typically includes the following stages:

1. Ovarian Stimulation

The first step involves stimulating the ovaries with fertility medications to produce multiple mature eggs (unlike the single egg released during a natural cycle). Medications usually include:

• Gonadotropins (FSH, LH)
• GnRH agonists or antagonists to prevent premature ovulation

This phase lasts 8–14 days, with regular blood tests and ultrasounds to monitor follicle growth.

2. Trigger Shot

When follicles are mature, an hCG injection (known as the “trigger shot”) is given to prepare the eggs for retrieval. This occurs about 36 hours before the egg collection procedure.

3. Egg Retrieval

Also called egg collection, this is a minor surgical procedure done under sedation or light anaesthesia. A thin needle is inserted through the vaginal wall into the ovaries using ultrasound guidance to aspirate the mature eggs.

This takes about 20–30 minutes. Mild cramping and spotting may occur afterwards.

4. Sperm Collection

The male partner provides a semen sample on the same day. In cases of severe male infertility, sperm may be retrieved directly from the testes via surgical procedures like TESE or PESA. Donor sperm can also be used if required.

5. Fertilisation

In the lab, the retrieved eggs are combined with sperm in a Petri dish for fertilisation. There are two main methods:

• Conventional IVF: Eggs and sperm are placed together in a dish and fertilisation occurs naturally.
• ICSI (Intracytoplasmic Sperm Injection): A single sperm is injected directly into each egg—used for severe male factor infertility.

The fertilised eggs are then monitored for signs of cell division.

6. Embryo Culture

Fertilised eggs develop into embryos over 3 to 6 days. Embryologists assess embryo quality and may culture them to the blastocyst stage (day 5–6), which increases the chances of implantation.

In some cases, embryos are genetically tested (PGT-A/PGD) before transfer, especially for those with known genetic conditions.

7. Embryo Transfer

Usually occurring on day 3 or day 5 after retrieval, one or more embryos are transferred into the uterus via a thin catheter inserted through the cervix.

This is a painless, outpatient procedure with no anaesthesia required. The number of embryos transferred depends on age, embryo quality, and clinic guidelines. In the UK, single embryo transfer is preferred to reduce the risk of multiple pregnancies.

8. Luteal Phase Support

Progesterone supplements (via vaginal gel, oral tablets, or injections) are given to support the uterine lining and aid implantation.

9. Pregnancy Test

About 10–14 days after embryo transfer, a blood test (beta hCG) is performed to confirm pregnancy. If successful, early pregnancy scans follow to monitor development.

Frozen Embryo Transfer (FET)

In some cases, embryos are frozen (cryopreserved) for transfer in a later cycle. This is common when:

• Ovarian hyperstimulation occurs
• The uterus isn’t ideal for implantation in the current cycle
• Embryo testing requires more time

FET has similar success rates to fresh embryo transfers and offers flexibility.

Success Rates of IVF

Success depends on several factors including age, egg quality, sperm health, and uterine condition. According to the UK's Human Fertilisation and Embryology Authority (HFEA):

• Women under 35 have around a 32% live birth rate per embryo transfer
• Women aged 35–37: around 25%
• Women aged 38–39: around 19%
• Women aged 40–42: around 11%

Using donor eggs, embryos, or sperm may improve outcomes for some patients.

Emotional Impact and Support

IVF can be emotionally intense. Hormonal changes, uncertainty, and financial strain can affect mental health. It’s important to:

• Seek counselling or peer support groups
• Take time off during intense phases
• Communicate openly with your partner or support system

Many UK fertility clinics offer in-house counselling services as part of treatment.

Potential Risks and Side Effects

• Mild side effects: bloating, cramping, breast tenderness
• Ovarian hyperstimulation syndrome (OHSS)
• Multiple pregnancy (more common with multiple embryo transfers)
• Emotional stress or depression
• Rare complications from egg retrieval (bleeding or infection)

Always consult your fertility specialist regarding risks specific to your situation.

Internal Links to Related Topics

• Does Health Insurance Cover IVF?
• IVF Costs and Duration Explained
• Understanding Miscarriage During IVF
• Browse More Fertility Resources

FAQs: IVF Explained

Q1. How long does an IVF cycle take?

A complete IVF cycle usually spans 4–6 weeks, from stimulation to pregnancy testing.

Q2. Is IVF painful?

Most procedures are mildly uncomfortable. Egg retrieval may cause cramping but is done under sedation.

Q3. How many IVF cycles does it take to get pregnant?

It varies. Some conceive on the first try, while others need multiple cycles depending on age and fertility issues.

Q4. Can I choose my baby’s gender through IVF?

Gender selection is not allowed for non-medical reasons in the UK under HFEA regulations.

Q5. Does IVF always work?

Unfortunately, no. Success depends on many factors, but IVF offers a strong chance for many couples struggling with infertility.

Final Words

IVF is a complex yet hopeful journey for those seeking to become parents. Understanding the step-by-step process empowers patients to prepare mentally, emotionally, and physically. With advancements in technology and growing support systems in the UK, IVF continues to give thousands of families a reason to believe in new beginnings.