What Is IVF? A Guide to In Vitro Fertilization

In vitro fertilization is a fertility treatment that involves combining an egg with sperm in a laboratory. Here's what you need to know about the IVF process.

Many people don't plan for in vitro fertilization (IVF) to be in their future. And yet, for many hopeful parents, having a baby is not as easy as they imagine. If you find yourself considering this option, there's no doubt that IVF feels daunting at first. Most people pursue IVF only after other fertility treatments have failed. Some people may have been trying to conceive for months or years. Other times, sometimes, doctors recommend starting with IVF treatment. 

The good news is that million of babies have been born through assisted reproductive technology so you definitely aren't alone. To help you understand the process, here's a handy guide to the IVF process.

You'll learn how long a typical IVF cycle takes, the estimated costs, success rates, and more. The more you understand about what's coming next, the more in control you'll feel. While every clinic's protocol, and every person's treatment needs, will be slightly different, this breakdown takes you through the IVF process and helps you learn where to start with IVF.

IVF Step-by-Step guide graphic

What Is IVF Treatment?

In vitro fertilization is a form of assisted reproductive technology (ART) that uses technology to help sperm fertilize an egg in a laboratory dish—in fact, in vitro means "in the lab." IVF facilitates the transfer of a fertilized egg to the uterus, with the ultimate goals of a viable pregnancy and a live birth.

Who Is a Candidate for IVF?

If you've been trying to conceive for at least six months to a year, and are over the age of 35, you may be a candidate for IVF, says Banafsheh Kashani, MD, OB-GYN, reproductive endocrinologist and infertility specialist in Laguna Hills, California. Those under 35 are typically encouraged to try for at least one year before turning to IVF.

John Zhang, MD, founder and director at New Hope Fertility in New York City, adds IVF may be an option if you are experiencing any of the following conditions: 

  • Unexplained infertility
  • Severe sperm disorders
  • Severe endometriosis
  • Recurrent miscarriages
  • Desire to screen for specific gene defects

IVF is also an option for patients who are single mothers by choice and same-sex couples. Patients may go through rounds of intrauterine insemination (IUI) first before turning to IVF. IUI is a fertility treatment that involves inserting sperm directly into the uterus, using a catheter, to increase the chances of conception.

How Long Does IVF Take?

 The entire cycle from start to finish can take four to six weeks, and the first step in the IVF process is preconception testing.

"Preconception testing for both the female and male is required as the first step of IVF,” says Dr. Kashani. “This includes laboratory testing to check for infectious diseases, hormones, and a semen analysis for the male partner. Women undergo ovarian reserve testing to determine their egg quantity and testing to see how they would respond to the hormone treatments."

A typical IVF cycle will take two to three weeks once the egg stimulation process begins. That takes place after being on birth control for about two weeks to "mimic a menstrual cycle," or, in certain cases, a patient starts "with their natural menstrual cycle," according to Dr. Kashani. 

Just keep in mind that as Dr. Zhang notes, "This process can be longer based on the patient's reaction to the medication."

How What Are the Steps in the IVF Process?

According to Dr. Zhang, there are four main steps involved in IVF:

  1. Prepping the ovaries with oral pills (such as birth control pills or estrogen). These pills control the timing of your menstrual cycle, prevents ovarian cysts, and promotes better results during egg retrieval.
  2. Administering hormone medications to stimulate your ovaries into producing mature multiple eggs at one time. Your body typically produces only one egg per menstrual cycle, but having multiple eggs provides a greater likelihood of successful fertilization. This process may also involve injecting fertility drugs stimulate the ovaries to mature a dozen or more eggs for retrieval.
  3. Harvesting the eggs through egg retrieval (which is accomplished using a transvaginal ultrasound-guided needle) for either freezing or fertilization. Fertilization involves mixing the egg with sperm in a laboratory dish to create an embryo.
  4. Embryo transfer into the uterus, which can be done in the same cycle, called a fresh transfer, or at a later date, a frozen transfer. During the embryo transfer, a thin tube, or catheter, will be passed through your cervix. You may experience very light cramping but nothing more than that.

Key Takeaway

Currently, many providers suggest transferring just one embryo and freezing the rest. This is known as elective single embryo transfer (eSET), and it can reduce your risk of a multiple pregnancy. When you get pregnant with just one healthy baby, you reduce your risks for pregnancy complications. Speak to your provider to find out if elective single embryo transfer is best for you.

What Does IVF Cost?

All things considered, from health care visits to medications, the cost of IVF in America is usually between $15,000 and $30,000 as of 2023, according to Forbes. The medications needed are a big chunk of that cost. So yes, it's expensive, and many people have to undergo multiple cycles of IVF to get pregnant. Studies have found that only one in four couples who need IVF to conceive can actually get the treatment they need.

Making matters more challenging is that many insurance companies do not cover IVF costs. One study found that the average couple paid $19,234 for their initial IVF cycle, with an additional $6,955 for each additional cycle. Why such a difference between the first and subsequent? Partially because some of those second and third cycles are frozen embryo transfers.

Other than the physical and emotional challenges that can come when going through IVF, the costs involved are certainly the most daunting for many. Many fertility specialists will have a financial coordinator who can walk you through what your monetary commitment would be, and potentially help you plan for how to best satisfy that.

What Are IVF Success Rates?

Fertility experts will tell you that a patient’s age is the most important factor in determining the live birth success rate of an IVF cycle.

"Success rates are higher for women in their early thirties at about 50 to 60%. By the time a female is age 40, success rates are about 20 to 25% and by age 42, success rates drop to 5 to 10%,” says Dr. Kashani. “If genetic testing of an embryo is done and the embryo is genetically normal, then the success rate after transferring a genetically normal embryo is about 60 to 70%."

In addition, according to a study of approximately 156,000 women, the average live-birth rate for the first cycle was 29.5%. The same study found that after six IVF cycles, which took place over the course of two years, the cumulative live-birth rate was 65.3%. 

Are There Any Side Effects From IVF?

Although IVF is generally considered safe, symptoms that you might experience during an IVF cycle include:

  • Pain or cramping at the injection site
  • Moodiness
  • Emotional distress

Finding support is important. A support team often includes an in-office counselor, social worker, and/or clinical psychologist/therapist to help with the emotional issues that commonly arise before, during, and after IVF. Joining an IVF support group may also be invaluable, as can having a friend or family member you feel comfortable talking to about what you're going through.

"The main risk is when you produce too many eggs, called ovarian hyperstimulation syndrome (OHSS), and it can cause heavy bloating, difficulty breathing, and nausea," Dr. Zhang warns. "This can also impact the live birth rate for that cycle. OHSS occurs in less than 5% of women, and severe cases account for less than 1%, so it is not very common."

What Happens If IVF Treatment Fails?

If the pregnancy test is still negative 12 to 14 days post-transfer, your healthcare provider will ask you to stop taking the progesterone. Then, you'll wait for your period to start.

It will be up to you, your partner, and your provider to determine next steps. If this was your first cycle, another cycle may be recommended. Remember that your best chances for success are after doing several cycles.

Having a treatment cycle fail is never easy. It's heartbreaking. It's important, however, to keep in mind that having one cycle fail doesn't mean you won't be successful if you try again. There are many steps you can take after a treatment cycle fail.

What To Know Before Starting an IVF Cycle

It's normal to feel quite a bit of trepidation before starting IVF, but Dr. Zhang says that while starting IVF is going to cause emotional turmoil, there's less reason to be stressed about it thanks to mdoern technology.

Banafsheh Kashani, MD, OB-GYN

"You should feel comfortable with your provider and the office you choose as the process in itself can be overwhelming. It's best to have a team that supports you."

— Banafsheh Kashani, MD, OB-GYN

"IVF in modern times is significantly less painful and uncomfortable than you might think," he says. Some clinics even offer more natural protocols involving fewer injections, so be sure to do your research before choosing a reproductive specialist.

"It's also so important to have a list of questions handy for your doctor to discuss the steps involved with IVF, so you can best be prepared," Dr. Kashani advises. "You should feel comfortable with your provider and the office you choose as the process in itself can be overwhelming. It's best to have a team that supports you."

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Sources
Parents uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Families formed through assisted reproductive technology: Causes, experiences, and consequences in an international context. Reprod Biomed Soc Online. 2022.

  2. Fact Sheet: In Vitro Fertilization (IVF) Use Across the United States. U.S. Department of Health and Human Services. 2024.

  3. Out-of-pocket fertility patient expense: Data from a multicenter prospective infertility cohortThe Journal of Urology. 2014

  4. Live-birth rate associated with repeat in vitro fertilization treatment cyclesJAMA. 2015

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