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The IVF process has helped over 8 million women get pregnant since 1978.
Each year, about 2.3% of all babies born in the US are conceived through assisted reproductive technology (ART). IVF makes up 99% of all ART procedures, so many of those babies are due to IVF.
If you’re considering IVF, you may wonder how long it’ll take and the steps involved.
Well, don’t worry – we’re here to help. Keep reading to learn what the IVF process looks like from start to finish.
What is IVF?
In vitro fertilization (IVF) is a complex fertility treatment with many steps. In vitro is Latin for “in glass.” It refers to any procedure done outside a living body in an artificial environment.
In the case of IVF, sperm fertilizes an egg outside a woman’s body in a laboratory dish. Once fertilized, the embryo continues growing in the lab. It’s then inserted into the woman’s uterus.
If all goes well and the embryo implants into the uterine wall… then voila – you become pregnant!
When is IVF performed?
Your fertility specialist may recommend IVF treatment in cases of:
- Advanced maternal age. This term refers to pregnancy in women who are over the age of 35. Generally, fertility begins to decline at this mark. If you’re over 35 and have been trying to conceive naturally for 6 months or more, your fertility specialist may recommend IVF.
- Anovulation. Pregnancy depends on ovulation. So if you’re not ovulating, or not ovulating regularly, it can make it harder to get pregnant. This is known as anovulation, and it’s the leading cause of infertility. IVF treatment can coax the ovaries to grow more eggs if ovulation isn’t happening regularly.
- Polycystic ovary syndrome. PCOS is a hormonal imbalance marked by high androgen levels (male hormones) and insulin resistance. Some women with PCOS also develop cysts on their ovaries. PCOS often causes problems with ovulation, which affects fertility. IVF treatment can help women with PCOS get pregnant.
- Endometriosis. In this condition, the inner uterine tissue grows outside the uterus. This can cause hormonal imbalance, ovulatory issues, inflammation, formation of scar tissue, and block the fallopian tubes, which can make it tougher to get pregnant.
- Blocked or damaged fallopian tubes. Your fallopian tubes are the highway between your ovaries and uterus. They’re also the place where the sperm and egg meet. Unfortunately, sometimes the fallopian tubes can get damaged or blocked due to scar tissue, adhesions, pelvic inflammatory disease, etc. This can make it tougher for sperm to fertilize the egg and for the embryo to make it to the uterus.
- Risk of passing on a genetic disorder. Some couples opt for IVF to prevent passing a genetic disorder onto their baby. This involves an extra step, called preimplantation genetic testing (PGT). PGT checks to make sure embryos are chromosomally normal before they’re placed in a woman’s uterus. This can offer peace of mind and ensure the embryos are as healthy as possible.
- Tubal ligation. This procedure blocks a woman’s fallopian tubes to prevent pregnancy. Some women undergo tubal ligation, but afterward, they could decide they want to become pregnant. IVF can help these women without having another surgery to reverse their tubal ligation.
- Male factor infertility. Low sperm count, poor sperm motility, and abnormal sperm shape can all make fertilization difficult. If fertility testing reveals issues with the male partner’s sperm, some couples choose to use donor sperm for IVF.
- No success with other fertility treatments. Some women try other fertility treatments like medications to stimulate ovulation, without any luck. In these situations, IVF may be a good option.
- Unexplained infertility. Some couples go through fertility testing and can’t find any reason why they’re not conceiving. In these cases, IVF treatment may help.
What are the steps in IVF?
There are five main steps to the IVF process:
- Ovarian stimulation: Typically, the ovaries produce one egg each month. During ovarian stimulation, a woman takes fertility medications that tell the ovaries to grow multiple eggs. More eggs = more chances of conception.
- Egg retrieval: A fertility doctor retrieves the eggs from the woman’s ovaries.
- Fertilization: The eggs collected are fertilized by sperm in a fertility lab. Sperm may come from either the partner or donor sperm.
- Embryo growth: The fertility lab keeps a close eye on the growing embryos for 3 to 5 days.
- Embryo transfer: A fertility doctor transfers one or more of the embryos into the woman’s uterus.
Let’s take a deeper dive into the IVF process step by step…
Ovarian stimulation
In the first step of IVF, you’re given injectable hormones. The most common ones used are follicle stimulating hormone (FSH), luteinizing hormone (LH), or a combination of the two.
These meds are similar to hormones that your body naturally produces. They stimulate your ovaries to grow a large batch of follicles. Inside each follicle is an egg. The more eggs available for fertilization, the better your chances of conception.
Fertility hormones are usually started on day 2 or 3 of your menstrual cycle and taken for 10-14 days.
Your doctor will choose the right fertility drugs for you and the dosage. This will vary depending on age, hormone levels, medical conditions, and response to previous IVF cycles (if any).
Blood tests and vaginal ultrasounds are done along the way to monitor how your follicles are developing.
Egg retrieval
The eggs keep growing until they reach between 12-19 mm in diameter. A “trigger shot” of human chorionic gonadotropin hormone (hCG) or GnRH (gonadotropin-releasing hormone) is then given, which primes the eggs for ovulation.
Egg retrieval occurs between 34 to 36 hours after the trigger shot. Timing is key here, as the eggs need to be collected before the body ovulates.
During this procedure, your fertility specialist uses ultrasound to guide a needle into each ovary through the vagina. This needle is attached to a suction device which pulls your eggs out of each follicle.
If any of this sounds painful, don’t worry! You’ll be given medication before the procedure, so you don’t feel any pain. You may feel cramping afterward, but it should subside within a day.
This entire procedure only takes about 20 minutes. The eggs are placed in a solution to help them develop. The healthiest, most mature eggs will then move on to the next step: fertilization.
Fertilization
Once eggs are collected, they’re fertilized by sperm in a fertility lab. If using your partner’s sperm, they’ll provide a sample on the same day as your egg retrieval. If using donor sperm, your fertility lab will have it ready.
In IVF, fertilization can be done in two different ways:
- Conventional insemination: Sperm are mixed with a mature egg in an incubator and allowed to mingle. It can take up to 18 hours for sperm to fertilize an egg this way.
- Intracytoplasmic sperm injection (ICSI): Sperm is directly injected into eggs. This method is often used if sperm quality is an issue.
Embryo growth
The fertilized eggs divide in a lab for several days until they become embryos. They’re monitored carefully by the fertility clinic staff to make sure they’re developing properly.
Typically, embryos grow until they reach one of these stages:
- Cleavage stage: These are typically day 3 embryos with between 4 to 8 cells
- Blastocyst stage: These are typically day 5 embryos that look like a ball of roughly 100 cells
One study compared the live birth rates and birth weight for cleavage and blastocyst embryos. They found live birth rates and birth weight were significantly higher when embryos grow to the blastocyst stage (day 5 or 6) versus the cleavage stage (day 3).
But there was one caveat. If the day 3 embryo was good quality and the day 5 or 6 embryo was poor quality, there wasn’t any significant difference in birth weight.
Meaning, embryo quality should be the top priority either way.
Read More: Day 3 vs. Day 5 Embryo Transfer: Which is Better?
Embryo transfer
Once the embryos grow to the desired stage, it’s embryo transfer time. This is a quick, painless procedure where the embryos are transferred to the uterus.
To do this, a thin tube (catheter) is placed into the vagina, through the cervix, and into the uterus. One or more embryos are then inserted into the uterus using a syringe.
There are two options for embryo transfer:
- Fresh embryo transfer: In this case, fresh embryos are transferred within the same IVF cycle.
- Frozen embryo transfer: This involves freezing embryos and transferring them at a later date
Both have similar success rates and come with pros and cons.
For example, fresh embryo transfers are more economical. They can also offer a shorter time to conception since they can be done 3-5 days after egg retrieval.
Fresh embryo transfers tend to work well for women who are low to intermediate responders to ovarian stimulation. Low responders are those from whom 5 or fewer eggs are retrieved during the egg retrieval process, while intermediate responders are those from whom 6 to 14 eggs are retrieved.
Frozen embryo transfers, on the other hand, may be a better fit for high responders (15 or more eggs). Women with PCOS often fall into this category. High responders face a higher risk of ovarian hyperstimulation syndrome (OHSS). This is a condition that causes the ovaries to swell and leak fluid in the abdomen. Frozen embryo transfers reduce the risk of OHSS.
Another big perk is that genetic testing can only be done on frozen embryos. As mentioned, this is known as preimplantation genetic testing or PGT. It allows you to check embryos for genetic disorders to ensure they’re as healthy as possible.
However, the downside to frozen embryo transfers is that they’re more costly and can mean a longer path to pregnancy.
No matter which route you choose, you’ll take a pregnancy test about 8-14 days after your embryo transfer.
How much time does an IVF cycle typically take?
There’s no easy answer here. It varies from person to person.
But on average, an IVF cycle takes about 8-10 weeks from start to finish. This includes:
- Consultation and fertility testing: up to 4 weeks
- Ovarian stimulation: 9-14 days
- Egg retrieval: 1 day
- Fertilization and embryo growth: 3-5 days
- Embryo transfer: 1 day
- Pregnancy test: 8-14 days later
To learn more about the IVF timeline, check out this article.
If you opt for genetic testing, it can add up to 4 weeks to the IVF timeline. However, since it can offer peace of mind, many couples find it’s worth the wait.
Keep in mind that each woman responds differently to IVF. Some women may need more than one round of IVF to have a successful pregnancy. Which brings up the next question…
What is the success rate of IVF?
It depends on many factors. But age plays a role. Fertility begins declining gradually at around age 32 and beyond age 37 it decreases more rapidly.
That said, women get pregnant over 37 every day. So if you’re in the advanced maternal age group, don’t lose hope. Remember, age is just one piece of the fertility puzzle. Keep this in mind when looking at success rates.
The Society for Assisted Reproductive Technology (SART) puts out an annual report with the latest IVF data. Here’s what their 2021 summary had to say about IVF success rates:
As the chart shows, not everyone gets pregnant during their first IVF cycle. Each woman’s response to IVF is unique. Some women may need two, three, or even more rounds for a successful pregnancy.
Case in point: one study found the cumulative live birth rate can reach as high as 65.3% after six IVF cycles.
However, the birth rate remained low for women over 42 using their own eggs. In these cases, donor eggs may increase the chances of IVF success.
Which brings us to our last topic…
How to increase your chances of IVF success?
Here are a few things that may boost the success rate of IVF:
- Choose a good fertility clinic. Look for clinics with experienced staff, state-of-the-art technology, and high success rates. You can check the success rate of clinics here.
- Keep a healthy lifestyle. Habits like exercising regularly, getting quality sleep, and effective stress management all support healthy hormone balance. This may, in turn, improve your IVF outcomes.
- Try the Mediterranean diet. This diet is rich in colorful fruits and veggies, whole grains, legumes, fish, and healthy fats like olive oil, nuts, and seeds. One study found that women who followed the Mediterranean diet closely obtained more embryos during IVF.
- Consider using an egg donor. If your egg quality is low, using an egg donor may boost your chances of IVF success. In particular, donor eggs can dramatically increase the chances of IVF success for women over 42 years.
Consider using donor sperm. If your partner’s sperm quality is low, you may want to consider using a sperm donor.
Takeaways
- In vitro fertilization (IVF) is a fertility treatment that’s helped over 8 million women get pregnant.
- During IVF treatment, a mature egg is fertilized by sperm in a lab.
- There are five main steps to IVF: ovarian stimulation, egg retrieval, fertilization, embryo growth, and embryo transfer.
- In the first step, the woman is given injectable hormones for 10-14 days. These meds tell the ovaries to grow several eggs, instead of just one.
- A fertility doctor then retrieves the mature eggs from the ovaries.
- Once removed, the highest quality eggs are fertilized by sperm. This may be from the male partner or donor sperm.
- After fertilization, the eggs are monitored carefully for 3-5 days. Once the eggs have developed to the cleavage or blastocyst stage, they’re transferred into the woman’s uterus.
- About 8 to 14 days later, the woman takes a pregnancy blood test. If an embryo implants, the test detects hCG and you get a big fat positive.
- An average IVF treatment cycle takes between 8 to 10 weeks from start to finish. This includes the initial appointment, fertility testing, the five steps of IVF, and pregnancy testing.
- The success rates of IVF vary widely depending on a woman’s age and IVF cycle.
- You can increase your chances of success by choosing a good fertility clinic and keeping a healthy lifestyle. The Mediterranean diet is also worth trying. It’s shown to increase the number of embryos during IVF.
FAQs
This is hard to say. It varies depending on your IVF protocol, type of medication, and dosage. But on average, 1-2 injections per day are common during the ovarian stimulation phase (which lasts 9-14 days). You’ll also get one “trigger shot” injection of hCG before egg retrieval.
The injections can cause some discomfort. However, a fertility nurse will walk you through the process step-by-step. While the injections can feel daunting at first, they do get easier.
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- More than 8 million babies born from IVF since the world’s first in 1978 | ScienceDaily
- ART Success Rates | CDC
- Fact Sheet: In Vitro Fertilization (IVF) Use Across the United States | HHS.gov
- In Vitro Fertilization – StatPearls – NCBI Bookshelf
- Follicle Size on Day of Trigger Most Likely to Yield a Mature Oocyte – PMC
- Effect of Day 3 and Day 5/6 Embryo Quality on the Reproductive Outcomes in the Single Vitrified Embryo Transfer Cycles
- Freezing of all embryos in in vitro fertilization is beneficial in high responders, but not intermediate and low responders
- Transfer of Fresh versus Frozen Embryos in Ovulatory Women | New England Journal of Medicine
- Transfer of thawed frozen embryo versus fresh embryo to improve the healthy baby rate in women undergoing IVF: the E-Freeze RCT. – PMC
- Female Age-Related Fertility Decline | ACOG
- National Summary Report
- Live-Birth Rate Associated With Repeat In Vitro Fertilization Treatment Cycles | Neonatology | JAMA
- Mediterranean diet improves embryo yield in IVF: a prospective cohort study – PMC
