What are the 5 stages of in vitro fertilization?

In vitro fertilization (IVF) is one of the most effective forms of assisted reproductive technology (ART) for helping couples and individuals who cannot conceive a child through traditional pregnancy. The procedure can use the couple’s sperm and eggs or embryos, eggs or sperm from anonymous or known donors.

While some may think of IVF as a one-time procedure, it is actually a complex series of procedures occurring over about three weeks. However, depending upon various factors, the process can take longer. If you are considering initiating a pregnancy via IVF as a surrogate or intended parent, here is what you can expect.

The five steps for an IVF cycle

On average, one IVF cycle takes two to three weeks, but more than one cycle is needed in some cases before pregnancy occurs. The steps include:

  • Ovulation induction: Synthetic hormones stimulate the woman’s ovaries to produce several eggs instead of a single egg that normally develops each month. Several are needed because some eggs won’t fertilize while others won’t develop after fertilization. Several medications may be necessary for this process, which usually takes up to two weeks. Doctors use ultrasound and blood tests to determine when the eggs are ready for retrieval.
  • Egg retrieval: This step is done in a doctor’s office or clinic before ovulation occurs. The woman is sedated and given pain medication, and the eggs are removed during a procedure called “transvaginal ultrasound aspiration.” The woman may feel pressure or cramping after the procedure.
  • Sperm retrieval: The partner or donor’s sperm is typically collected at the same doctor’s office or clinic when egg retrieval happens.
  • Fertilization: Doctors use two common methods for this step. During conventional insemination, the sperm and eggs are mixed and incubated overnight. Under intracytoplasmic injection (ICSI), sperm is injected directly into each egg. ICSI usually occurs after conventional insemination is not successful either prior to or at the same time as the egg retrieval.
  • Embryo transfer: This final step and is also done in the doctor’s office or clinic and typically occurs two to five days after egg retrieval.  It is also possible the resulting embryos may be cryopreserved for transfer at a later date. The woman may receive a mild sedative while a doctor, using a syringe, transfers the embryo or embryos into the uterus

If the transfer is successful, the embryo will implant in the lining of the uterus about six to 10 days after the eggs were retrieved.

When should we know if pregnancy occurred?

After the embryo transfer is complete, most women can return to their normal daily lives. However, you’ll likely want to avoid strenuous activities as discomfort and other side effects can develop. Your doctor will explain these in greater detail.

Within two weeks of egg retrieval, your doctor will do a blood test to gauge whether you are pregnant. If you are, you can begin prenatal care. If you are not pregnant, your doctor will discuss whether you are interested in another IVF cycle and may suggest steps you can take to improve your chances.