Taking the first steps on your IVF journey can feel overwhelming. As is getting to grips with the IVF process from start to finish. From your initial tests and consultation to finding out if a round has been successful, we know there’s a lot to get your head around.
To help you understand exactly what happens during IVF treatment, we’ve created a simple step-by-step guide to explain the IVF process for a fresh round.
How long does IVF treatment take?
A fresh round of IVF typically takes around five weeks.
Other IVF routes can take more or less time. For example, if you’re using a frozen embryo or eggs the round will be shorter, and if you’re using a donor egg it could be longer.
More often than not, you’ll go through several rounds of IVF before having a child. So your overall IVF journey could take a number of months.
Preparing for your treatment process
If you’re entering into your IVF journey as a couple, where either one or both of you are using your own eggs and/or sperm, there are a number of tests you’ll need to do before starting a round. These tests are also necessary if you’re going through IVF as a single person.
These often include:
- Blood tests - These will give a clearer picture of <z tooltip="Ovarian reserve is the number of healthy, immature eggs in the ovaries.">ovarian reserve</z> and overall hormonal health.
- Semen analysis - This measures the concentration, movement, and shape of sperm.
- Ultrasound examination - A pelvic ultrasound scan is done to assess the health of the female reproductive organs.
Once these tests are complete, you’ll have a consultation with your doctor to go through your results. This is a good time to ask questions and raise any concerns you might have about your upcoming IVF round.
Stage 1: Ovarian stimulation
The first step of an IVF round is a process called stimulation. This stage can take two to three weeks.
For women going through IVF, your natural reproductive cycle will be put on pause, and will instead be controlled by hormone injections.
Every day you’ll inject yourself with a hormone called gonadotrophin-releasing hormone (GnRH) analogues. This blocks the natural production of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) to make sure your eggs don’t mature and aren’t released. This is so they can be collected in the next phase of the IVF process.
You’ll also inject yourself every day, with higher than normal levels of FSH. This ‘tricks’ the ovaries into growing follicles and creating eggs.
Injecting yourself with hormones every day can feel intimidating. If you find it difficult, it might be helpful for you to ask someone you trust to inject you instead.
In most cases, you’ll have regular blood tests at your clinic to see how well you’re responding to the stimulation. After a week or so you’ll have a vaginal ultrasound examination to check on your follicle growth.
When your eggs are ready, you’ll have an injection of human chorionic gonadotrophin (hCG). This is 10 times stronger than natural LH and is used to make the egg mature. This will take place 34 to 37 hours before egg retrieval.
All of these injections can cause abdominal swelling, skin irritation and mood swings – making this a particularly tough stage in the process. Having your support network around you, whether that be a partner, family or friends, can help you feel like you're all going through these important first weeks together.
Stage 2: Egg retrieval and sperm collection
The next step of the IVF process is fairly quick – egg and sperm retrieval!
The egg retrieval procedure usually takes around 15 to 20 minutes. You’ll be sedated throughout so you won’t feel a thing.
Here’s how the procedure will go:
- Your doctor will start the retrieval by inserting an ultrasound probe into your vagina to locate the follicles in your ovaries.
- When they’ve found a follicle, they’ll puncture it with a needle and collect the follicular fluid into a test tube.
- They’ll repeat this process with all follicles they can clearly see.
- The test tubes of follicular fluid are passed to the lab for an embryologist to look for the eggs under a microscope.
The more eggs retrieved, the better your chance of having a child. On average, around nine eggs are collected, but you can still move on to the next stage of IVF if you only collect one or two good-quality eggs.
If no eggs are retrieved, this is where this round of IVF finishes. If this happens, you can speak to your doctor about your chances of success if you decide to try another round.
If your doctor can see that no follicles are growing they may cancel the round before this stage to save you from going through an unsuccessful egg collection.
If you have viable sperm, this will be collected on the same day as egg retrieval. There are a few ways you can collect a sperm sample:
- At the clinic – You’ll be shown to a private room where you can collect your sample in a small plastic jar.
- At home – If you collect your sperm at home you must bring it to the clinic within one hour.
- Surgical – If you have no sperm in your <z tooltip="Ejaculate is the fluid that contains sperm that's released through the penis as a result of orgasm.">ejaculate</z>, it can be collected via a surgical procedure under local or general anaesthesia.
Helpful to know:
If you’ve frozen your eggs or sperm in the past, or are using a donor, you don’t need to go through stimulation and retrieval/collection. Your IVF round would begin at stage three – egg fertilisation.
Stage 3: Egg fertilisation
First, an embryologist will separate the mature eggs into individual dishes. They will then add a droplet of thousands of sperm to each one to start the fertilisation process.
If the sperm is of low quality, your doctor may recommend intracytoplasmic sperm injection (ICSI). This is when a single sperm is injected directly into each egg to increase the chances of fertilisation. It’s important to know that ICSI is often treated as an ‘add-on’ by most clinics so there will be an additional cost.
Of the embryos that are successfully fertilised only one will be transferred in any round of IVF.
Helpful to know:
Any remaining embryos that are healthy five after fertilisation can be frozen at this stage, to be used in future transfers. Successfully freezing your embryos means you’ll be able to skip stages one to three if you need to start a new IVF round.
Stage 4: Embryo transfer
The end of your round is now in sight. The final stage is to transfer an embryo into the womb on either three or five days after successful fertilisation.
Day 3 transfer
If an embryo is of lower quality it may be transferred to the womb on day three to decrease the ‘stress’ of it being in lab conditions.
Day 5 transfer
A five-day-old embryo is called a blastocyst. If an embryo has survived for five days in the lab it will be more developed. This makes it easier for the embryologist to choose an embryo that’s more likely to implant in the womb, increasing your chances of success.
The transfer process
Embryo transfer is a simple procedure that only takes a few minutes.
- Your doctor will insert a speculum into your vagina and clean your <z tooltip="The cervix is the lowest part of the uterus that forms a canal between the uterus and vagina.">cervix</z>.
- The embryologist draws the embryo into a thin catheter.
- Your doctor inserts the catheter through your cervix and into your uterus.
- The embryo is injected into your uterus and the catheter is removed.
Your progesterone levels need to remain high for two weeks after embryo transfer to stop you from having a period and allow the embryo to implant. You’ll either be given hCG injections or vaginal progesterone gel or <z tooltip="A pessary is a device that is inserted into the vagina to administer medicine directly to the area.">pessaries</z>.
Phase 5: Pregnancy test and follow-up
After what will feel like the longest wait, you’re finally ready to find out if your round of IVF has been successful.
Depending on the tests offered by your clinic, you can take a urine test at home, or go in for a blood test to find out if you’re pregnant.
Two weeks after a positive pregnancy test you’ll be invited to your clinic for an ultrasound scan. This will check that everything is as it should be and that there’s a foetal heartbeat. All being well, your IVF clinic will then refer you to the antenatal clinic.
Watch out for hidden costs
“I can’t think of anything worse than finding out a round has failed and then having to whip out my credit card”. – Emma, BFN podcast host
The true cost of IVF isn’t always clear, with hidden costs often popping up at each stage of an IVF round.
As well as the shock of having to pay for unexpected add-ons, it can be heartbreaking to find out that a round has been unsuccessful, only to be asked to hand over more money to continue your IVF journey.
Gaia is the world's first IVF insurance. We help you plan, pay for and protect your IVF journey. We cover all essential treatments from the stimulation phase onwards, so you never have to use your credit card at your clinic once your IVF treatment has begun. This includes blood tests, scans, sedation, blastocyst culture and more. We also cover the important medicines you’ll need throughout your treatment – something that's an extra cost at many clinics!