HOW IVF WORKS: A STEP-BY-STEP GUIDE
Are you considering IVF as part of your family building process? Maybe you feel a little lost and uncertain about what it entails, specifically. As a reproductive therapist, a good percentage of my clients come to me during their process of family planning and fertility concerns. Many feel VERY anxious about the thought of undergoing an IVF process and don’t feel like they get clear guidelines on exactly what the process entails. This post is intended to provide a clear outline of the IVF process. Most clients find it to be much less intimidating once they get clear information and begin the process. In fact, many walk away feeling relieved they took the risk, despite their fears. Please note, I am a therapist, not a doctor. This information is merely a rough outline. Talk with your fertility provider for specifics about your body and medical care.
12 Steps Through IVF
Step 1: Establish Care
Make sure you are established with a fertility clinic or board-certified reproductive endocrinologist. If you are at the step of considering IVF, you likely have already explored other options with a fertility clinic, but if you haven’t yet, get established fertility care. You can read more about how and where to do that here.
Step 2: Bloodwork
Your doctor will order bloodwork for you and your partner, if you have one. Scans are often ordered at this time as well to look at your ovaries, endometrium (lining of your uterus), and fallopian tubes. This is standard and is meant to rule out or address any problems that may inhibit successful IVF before you go through the process.
Step 3: Semen Analysis
If you have a male partner, they will schedule a time to give the clinic a sample that will be analyzed for quality. If you are using donor sperm, this will already be complete.
Step 4: Ovulation Stimulation
You will be prescribed a series of injections that you take from home to stimulate your ovaries to produce follicles. These are the first round of shots you often hear about. The timing and length of shots depends on each unique body. You can expect to be visiting your clinic every few days for transvaginal ultrasounds to keep an eye on how quickly you are developing follicles and how long you need to take injections before a retrieval. Typically, injections last between 8-14 days.
Step 5: Trigger Shot
When it has been determined that your body has responded to injections adequately, your doctor will instruct you to take a trigger shot (often Lupron) to inform your follicles to release eggs. This happens 1-2 days prior to your egg retrieval.
Step 6: Egg Retrieval and Sperm Collection
You will very likely be lightly sedated during your egg retrieval. A needle will pass through your vagina to your ovaries to collect the eggs that have been released by your follicles. Meanwhile, if you have a male partner, they will collect sperm at this time, generally manually but sometimes surgically if there is an underlying need. If you used donor sperm, it will be prepared at this time.
Step 7: Wait
They don’t say that waiting is the hardest part for no reason. This is often where people struggle mentally the most. The 2-week clock starts at your retrieval, when your collected eggs and sperm begin incubation. You can get updates along the way about how many eggs have matured but honestly, I advise most people to wait until the two-week mark if at all possible. It can get really discouraging to see your numbers diminishing through the process and the number you get in the initial stages will almost always be higher than your ultimate outcome. When incubation is complete, you will get a call about how many embryos have fully and healthfully developed. This is the actual number you are working with.
A note: Every body is different and every body responds differently to each round of IVF. I am not going to offer stats on how many eggs or embryos are likely at this phase of the process because it’s just not helpful. Your body is going to do the very best it can do. Most people are surprised one way or another and it’s healthier to try to focus on acknowledging your unique experience rather than comparing it to someone else’s or a generalized average.
Step 8: Schedule Your Transfer
After you create embryos, they will likely get frozen while you and your physician decide when to do a transfer. This will depend on the timing of your cycle.
Step 9: Medications and Lining Check
You will work with your doctor regarding what exact medications are needed before your transfer. At this point in your process, you are working to reduce ovarian activity and prepare the lining of the uterus for an embryo. You will have more blood work and lining checks to make sure your hormones and uterus look as good as possible before your embryo transfer.
Step 10: Embryo Transfer
When everything looks good, you’ll go in for your embryo transfer. This procedure is usually done without sedation as it’s much more simple and less painful than an egg retrieval. It’s a very quick procedure.
Step 11: Wait Again
You are going to wait another 10-14 days before going in to the clinic to get a blood test to establish if you are pregnant. Again, some people take pregnancy tests at home during this waiting period but most people do better to wait and get a fully confirmed test result around 2 weeks after your transfer.
Step 12: Get Final Results
Your results will produce contradictory emotions. If you are celebrating, enjoy! You get to be happy, even if people around you don’t get the same great news. If you are grieving, let yourself feel whatever comes up…. anger, sadness, disappointment, etc. You get to have whatever experience feels right for you, no matter who wants you to “look on the bright side” and “just try again”. Acknowledging your experience is the healthiest way through it.
These are the steps of an IVF process. As mentioned, there will be variations for each body and unique experience, but this is generally consistent as a guide for the process of undergoing IVF. Some people find it really difficult and others feel it wasn’t as bad as they anticipated. Every body is different and ever person responds individually to the process. Please be gentle with yourself and stay present to your own experience as you navigate this process. You and your body are doing the best that you can to build a family.
Here are some links to additional information regarding the IVF process if you’d like a deeper dive:
It is my great passion to support people in the reproductive season of life. If you could use support for your particular process, reach out here. I’d love to be of service or point you in the direction of someone who can serve you best.
With care!
Rachael