Going through IVF: what the process is actually like

IVF (in vitro fertilisation) is the most common form of assisted reproduction, but most people's understanding of it is sketchy until they're actually going through it. This is a general overview of what the process typically involves — not a substitute for guidance from your own clinic.

Before IVF starts: testing

Before a clinic will begin IVF, both partners (if applicable) undergo a series of tests. For women, this typically includes an antral follicle count (an ultrasound counting small follicles on the ovaries), AMH (anti-Müllerian hormone, a marker of ovarian reserve), and blood tests for hormonal baseline. For men, a semen analysis. These results shape the treatment protocol — specifically how much stimulation medication is needed.

Ovarian stimulation

IVF begins with hormonal injections to stimulate the ovaries to produce multiple eggs rather than the single egg of a natural cycle. This phase lasts around 10–14 days. Monitoring ultrasounds (usually every 2–3 days) track follicle growth, and medication doses are adjusted accordingly.

Side effects during stimulation vary widely. Some people feel minimal effects; others experience bloating, mood swings, discomfort, and fatigue. Ovarian hyperstimulation syndrome (OHSS) is a potential complication when the ovaries over-respond — mild OHSS is fairly common; severe OHSS is rare but serious. Clinics monitor for this throughout stimulation.

Egg retrieval

When follicles reach the right size, a trigger injection is given — precisely timed to mature the eggs. Egg retrieval happens 35–36 hours later. It's done under sedation or anaesthesia, using a needle passed through the vaginal wall into the ovaries under ultrasound guidance. The procedure takes about 20–30 minutes. Recovery varies — some people feel fine the same day; others feel sore and bloated for a few days.

Fertilisation and embryo development

Retrieved eggs are assessed and those that are mature are fertilised — either by mixing with sperm (conventional IVF) or by injecting a single sperm directly into each egg (ICSI, intracytoplasmic sperm injection, used when sperm factors are involved). Fertilisation results are usually communicated the next day. Embryos are monitored as they develop over 3–6 days.

Not all fertilised eggs develop into viable embryos. It's normal to start with, say, 10 eggs retrieved, have 7 mature, 5 fertilise, and end up with 2 or 3 blastocysts (day-5 embryos). Each stage involves some attrition.

Transfer and the two-week wait

One or two embryos are transferred into the uterus in a brief, usually painless procedure similar to a smear test. Any remaining good-quality embryos can be frozen for future cycles. After transfer, there's a waiting period of about 10–14 days before a pregnancy test. This is universally described as one of the hardest parts — the anxious waiting with no way to know what's happening.

Success rates depend on multiple factors — age, embryo quality, diagnosis, clinic — and vary significantly. Your clinic will give you realistic rates based on your specific situation.