In-vitro fertilization (IVF) is a common form of assisted reproductive technology (ART), accounting for over 99% of all ART procedures. It’s a complex and emotional process, but millions of people around the world have started their families in this way.
*European Society of Human Reproduction and Embryology. ScienceDaily. 3 July 2018.
IVF includes many different stages involving a range of specialists over a 4- to 6-week period. First medication will be prescribed to stimulate the woman’s ovaries in order to grow multiple eggs. Her eggs will then be retrieved and fertilized in the lab with sperm. Embryologists in the lab will monitor the embryos for a short period of time before placing the best embryo(s) back into the woman’s uterus.
IVF may be a good choice if you have:
Be sure to speak to your healthcare provider to see if IVF may be right for you and about concerns you may have.
Because IVF is a multi-step process, there’s a higher risk of side effects from treatment, including:
The chance of multiples in IVF depends on how many embryos are transferred. Most women give birth to one baby, about 25% give birth to twins, and 1% give birth to triplets or higher multiples.
*This may not represent all side effects. Please discuss with your healthcare provider.
For most people, IVF is more successful than the 20% chance a healthy 30-year-old woman has of conceiving each month. However, it’s important to remember that many factors can influence the chances of IVF working, such as your age and whether you have any other medical conditions.
Success rates are higher for younger women. For women using their own fresh eggs in 2023, the chances of having a baby on the first embryo transfer were as follows*:
| AGE OF WOMEN | LIVE BIRTHS |
|---|---|
| <35 | 35.5% |
| 35-37 | 26.4% |
| 38-40 | 17.3% |
| 41-42 | 8.8% |
| >42 | 2.8% |
Data based on SART 2023 Preliminary National Summary Report, accessed April 30, 2025.
It can be disheartening if a treatment cycle does not work on the first attempt, but cycles can vary, increasing your chance of success next time. This is because:
A large, UK-based study of more than 150,000 women who underwent more than 250,000 IVF cycles between 2003 and 2010 found that the rate of pregnancy increased with each additional round of IVF, with 30% of women conceiving after 1 cycle, and 45% conceiving after 3 cycles.†
*Cycle success is measured by the live birth rate, with a singleton delivery occurring after 37 weeks of gestation being the optimal outcome of an IVF cycle. The percentage of triplet, twin, and singleton births contributing to the live birth rate is provided in the report for each cycle group and type of transfer, along with a summation of all deliveries (singletons and multiple births).
†Smith A, Tilling K, Nelson S, et al. Live-birth rate associated with repeat in vitro fertilization treatment cycles. JAMA. 2015;314(24):2654-2662.
Before your IVF cycle begins, your doctor may start you on oral contraceptives to regulate your menstrual cycle and prevent ovarian cysts. Progesterone may also be prescribed if you don’t ovulate regularly. In some women, a mock transfer may be performed to check for problems that could affect embryo transfer.
You’ll also undergo a physical examination and sometimes, blood work, to ensure your ovaries are clear of cysts.
To stop the ovaries from releasing eggs too early, your doctor will control your menstrual cycle with fertility drugs. Depending on your situation, your doctor will recommend either:
You’ll take hormonal injections for 8 to 14 days to stimulate the ovaries to produce and mature several eggs. Regular ultrasounds or blood tests will be conducted to monitor the growth of your follicles (fluid-filled sacs containing eggs) and your hormone levels.
When the follicles reach a certain size, you’ll receive a single injection called a trigger shot, which mimics the natural luteinizing hormone (LH) surge your body experiences before ovulation. This will trigger your ovaries to fully mature and prepare to release eggs.
Around 36 hours after the ovulation “trigger shot,” your doctor will retrieve your mature eggs, along with the fluid in your follicles, using a long needle and ultrasound guidance. Anesthesia will be used during the procedure to minimize discomfort.
Ultrasound tests will give an approximation of how many eggs you might expect, but the actual number of eggs retrieved will depend on the number of follicles that have developed, as well as the accessibility of one or both ovaries. On average, 8 to 15 eggs are retrieved. Some women may have spotting or discomfort for a few days after the procedure, but injury and infection are rare.
On the same day as the egg retrieval, a semen sample will be collected. Your male partner will need to provide a semen sample (masturbation, aspiration or biopsy). For women using a donor, the sperm will be thawed at the time of egg retrieval.
In the lab, your embryologist will combine sperm and eggs in a small petri dish. Intracytoplasmic sperm injection (ICSI) or the traditional in-vitro fertilization (IVF) procedures may be conducted. The dishes will be placed into incubators that control temperature and gas, designed to mimic the natural conditions inside your body. Your eggs will be assessed after 16 to 20 hours to confirm successful fertilization and continue to be monitored.
3 to 5 days after egg retrieval, your embryologist will select the healthiest embryo(s) to transfer into the uterus. The number of embryos transferred will depend on your age and embryo quality.
The embryos are transferred through the cervix into the uterus using a thin tube. This procedure does not require anesthesia, and you’ll be able to go home after a brief recovery period.
If you have additional good quality embryos that are not transferred, they can be frozen for future use.
After transfer comes a 9- to 12-day waiting period before a pregnancy test can be taken, known as the “two-week wait.” This can be a difficult time, filled with hope and anxiety.
During this time, your doctor may prescribe a hormone called progesterone, which helps thicken the uterus lining to help the embryo attach and grow. This is given either as an injection, a tablet, or a gel inserted into the vagina.
You’ll be able to be tested for pregnancy around 9 to 12 days after transfer. If you get the joyous news of a positive pregnancy test, your clinic will closely monitor your pregnancy with scans and blood work to ensure the health of you and your baby. You’ll be referred to your OB when your pregnancy is 8 to 10 weeks along.
Know what to ask your doctor before starting fertility treatment.
It’s important that you’re happy with your clinic and the care its staff provides. Learn what to keep in mind when choosing a clinic.
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