In vitro fertilization or IVF is the most effective type of assisted reproductive technology
(ART) to help women become pregnant.
First, the injectable medicines are given to women. These medicines help the eggs in the
ovaries to mature and get ready for fertilization. Then a fertility doctor takes the eggs out
from the ovaries under anaesthesia and ultrasound guidance. Eggs retrieved are fertilized
with sperm in a specialized embryology lab. After fertilization is done, the eggs develop into
embryos. After 3-6 days, the doctor transfers the embryos back into the uterus. Pregnancy
happens if any of the embryos implants in the uterus.
IVF has many steps involved. It may take one to a few months to complete the whole process.
There are five basic steps in IVF and embryo transfer process:
The women receive a drug, usually in the form of an injection to suppress their natural menstrual cycle.
Fertility drugs containing the fertility hormone Follicle Stimulating Hormone (FSH) and/or
Luteinizing Hormone (LH) are given to women. These medicines stimulate the ovaries to
produce several eggs. Having several eggs available for IVF increase the chances of
pregnancy. Vaginal ultrasound scans (TVS) are carried to monitor the follicular growth in
Egg retrieval is done at the IVF clinic 34 to 36 hours after the final injection. The eggs are
removed from the follicles under ultrasound guidance through a needle connected to a
suction device. This process is repeated with each ovary. Donated or frozen eggs may also
be used in cases with poor ovarian reserve.
For fertilisation, the eggs that have been collected are mixed with the male sperm in a
laboratory petri dish and stored in a CO 2 incubator.
Sometimes the sperm is directly injected into the egg in severe cases of male infertility. This
is known as an Intracytoplasmic Sperm Injection (ICSI). Frozen sperm, which is retrieved
through testicular biopsy (TESA/TESE/MESA) can be also used. This is believed to be as
effective as fresh sperm in achieving a successful pregnancy. The Petri dishes are checked
after 12-18 hours for fertilisation. Once this occurs the fertilized eggs are considered
Embryo transfer is done at the IVF clinic and usually takes place three to six days after egg
retrieval. The transfer of the embryo is done using a thin catheter. It enters the womb
through the vagina. If successful, an embryo will implant in the lining of the uterus. Fourteen
days after embryo transfer, urine pregnancy test (UPT) or serum Beta HCG is done to
Like all other medications and medical procedures, IVF has some possible side effects.
Breast tenderness: This occurs due to the high estrogen level in the body.
Mood swings: These are likely caused due to the changing levels of hormones, demands of
motherhood or due to the reality of pregnancy ending in women.
Mild bloating: Bloating occurs due to the changes in hormonal levels which slows down the
digestion leading to gas formation.
OHSS: In some rare cases ovaries respond to fertility medicine more than usual and this
leads to ovarian hyperstimulation syndrome (OHSS). In such cases, IVF cycles may need to
be carried out in a segmented fashion.
If you experience any of the above, consult your doctor immediately.