Understanding the IVF Process

The IVF procedure is not as complicated as it looks. We help you to break it down in this easy to understand guide.

Your Step-by-step IVF Guide

For couples who are considering IVF, the thought of starting can be overwhelming. We aim to help you understand what to expect throughout the entire IVF process. This helps you and your partner to prepare better, both mentally and emotionally.

Step 1: Initital Assessment

The initial assessment is done to understand both you and your partner’s condition, and to determine the best next course of action. Should you require IVF, the fertility specialist will also plan your medication regimen and dosage, to tailor to your needs. The aim of this is to maximize the number of eggs that you will get during the retrieval process. The dose will be balanced to ensure your eggs are not overstimulated.

Several tests will usually be conducted during your initial assessment. It may differ between doctors and clinics, but they generally involve semen analysis (or sperm test) for the husband, ultrasound (usually through the vagina) for the wife, and blood tests for both. In most clinics, the results are usually ready within the same consultation day.

Once the results are ready, and your fertility specialist feels that there is a good chance of getting pregnant via IVF, you will both then embark on your journey.

The IVF medication is usually administered via the subcutaneous route (injected at your tummy area, similar to how people use insulin). It is usually very simple to grasp, and is not painful for most women. Hence most clinics will usually have their nurses to guide you step-by-step on how to inject. You would then bring back the medication with instructions on when to begin injecting.

Most clinics provide comprehensive guidance and support to couples. However, you should always ask if you are not sure.

Step 2: Ovarian Stimulation

The medication provided to you to inject on your tummy area is actually used to stimulate your eggs to grow. The moment you begin your first injection (usually at home), you are considered to have started your ovarian stimulation process.

The injection process can be a daunting experience for most women. Who does not fear needles anyway? Rest assured that most women, despite their initial fears, are able to do it. And we are sure you would be able too. However if at any point of time you feel that something is not right, always feel free to contact your clinic.

How do I know if my eggs are growing well? Are they too small, or are they growing too fast? This is where a second visit to the fertility clinic is necessary. Your fertility specialist would usually schedule an appointment to perform an ultrasound to observe the growth of your eggs. Sometimes, a second ultrasound scan will be required.

If I require a second ultrasound, does that mean that my eggs are not growing according to plan? Not necessarily. At the end of the day, it depends on your doctor’s preference as well. All doctors would want their couples to do well and get pregnant.

Step 3: Egg Collection, also known as Oocyte Pickup (OPU)

The ovarian stimulation process will conclude with an injection, known as the “trigger shot”. This specific medication helps your eggs to start “hatching”, to allow your fertility specialist to collect them approximately two days later. When administering the “trigger shot”, it is important to adhere strictly to the time as ordered by your doctor.

Approximately two days later, you will be required to be at the fertility clinic for the egg collection procedure, known to your doctors as oocyte pickup or OPU. The husband will be required to be present during the OPU procedure too, in order to provide fresh sperm for fertilization to happen.

Step 4: Fertilization, followed by Embryo Development in the Laboratory

Fertilization is the process where the sperm meets the egg, and combines to form an embryo. This entire process is done entirely outside your body, in the laboratory. Embryos are left to develop in an incubator. Some clinics develop the embryos for 3 days, but most clinics these days allow the embryos to mature for 5 - 6 days, to form what is called a blastocyst.

If everything goes smoothly, you would have several healthy embryos that can be used to be implanted into your womb. Each one of these embryos are magical and precious life, as any one of them has a chance to develop into a little baby. For some couples, getting even one healthy embryo can be challenging. Hence, let us appreciate the life in each of these little embryos.

If you have managed to get healthy embryos, then congratulations! You and your partner are now officially halfway through your IVF journey.

Step 5: Preparation for Embryo Transfer

Depending on your condition, your clinic and fertility specialist, you may be offered two options for the embryo transfer: fresh embryo transfer or a frozen embryo transfer.

A fresh embryo transfer basically refers to the process of transferring your embryo into your womb upon knowing the results. A frozen embryo transfer involves freezing the embryos, usually for at least a month, to help your womb prepare better for the implantation process. Both methods of transfers have their own advantages and disadvantages. They also differ in cost. Hence it is important to discuss with your doctor on the recommended choice, based on your condition and desired outcome.

Step 6: Embryo Transfer

The embryo transfer (or ET) process involves putting an embryo back into your womb, for it to implant and grow into a healthy baby. There are some preparations involved on the day of your ET. Everything would usually be done within half a day in the fertility clinic.

After the ET procedure, both you and your partner would be able to go home, on the same day.

Step 7: Pregnancy Blood Test

The final step of your IVF journey, is to perform a blood test to check whether you are pregnant. There is usually a 2 week gap between the day of your ET and the blood test. These 2 weeks are known to many as the two weeks wait (or 2WW).

There would be a temptation to test yourself with urine pregnancy test kits during your 2 weeks wait. However it would be advisable to refrain from doing so, as the results are not as accurate as the blood test. It could lead to more undesired anxiety.

If your blood test results are positive, then congratulations!! Your hard work has paid off, and you and your partner are now going to be parents. We hope and pray that all of you reading this would be able to get pregnant.

How long is the IVF process?

The main IVF cycle takes about 4 weeks, which equals the length of a normal ovulation cycle. However, the whole process from consultation to transfer can be anywhere between 6 to 8 weeks. The following is an estimated breakdown of time needed for each step:

  • Initial assessment: Week 1 - 2
  • Ovarian stimulation: Week 3 - 5
  • Egg Collection, fertilization & Embryo development: Week 6
  • Embryo transfer: 3 - 6 days after fertilization 
  • Pregnancy blood test: 2 weeks after embryo transfer

While the IVF process can usually be completed in 8 weeks, the timeline for each person may vary, according to the issues that may arise during the treatment. Always speak to your doctor if you feel uncertain during any part of the IVF process. 

Now that you have understood the general IVF process, the next question is which fertility clinic to go to. We will help you explore that in the next section.

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