What Is In Vitro Fertilization (IVF)?

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When it comes to options for fertility treatment, in vitro fertilization (IVF) is one of the most commonly known and effective methods of assisted reproductive technology (ART).

On the surface, IVF sounds like it should be a quick and easy procedure. The doctor takes an egg, a sperm, combines them, and implants the combination into the uterus. However, there is more to IVF than simply joining an egg and sperm.

A smiling African-American couple is having a consultation with a doctor who is also smiling.

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How Common Is Assisted Reproductive Technology (ART)?

Approximately 1.9% of all infants born in the United States every year are conceived using ART.

What to Expect

IVF is a five-step process that can take quite some time to complete, depending on your situation.

Step 1: Increase Egg Production

When starting IVF treatment, you will begin taking a medication that increases your follicle stimulation hormone (FSH). This hormone tells your body to produce more than one egg per month. The more eggs your body creates, the more likely you are to be successful in getting pregnant.

Step 2: Retrieve the Eggs

Removing the eggs is a minor surgical procedure known as follicular aspiration. Your doctor will use an ultrasound during follicular aspiration to find the ideal location; then, they insert a small needle through your vagina and into each ovary. While this needle is in your ovary, it will remove the eggs. Within 20 minutes, your doctor can collect several eggs.

This step can be pretty intimidating for many people since it is a surgical procedure and the description of the procedure sounds painful. However, it’s important to know you will have medication to help with the discomfort. And while most people experience some cramping, it’s expected to go away within a day. 

Step 3: Collect Sperm

While you are going through the follicular aspiration procedure, your partner will provide a sperm sample—unless you go with a sperm donor.

Step 4: Mix the Egg With the Sperm

During this step, your doctor combines the egg and a sperm—also known as insemination. A few days after insemination, you'll be on to the final step.

In some cases, the sperm cells need extra help with the fertilization process. ICSI, or intracytoplasmic sperm injection, may be used, which is an assisted reproductive technology that involves injecting a single sperm cell into an egg.

Step 5: Transfer the Embryos

Within a week of insemination, you will have an appointment for another procedure. During this appointment, your doctor will take a catheter and pass this clear tube through the vagina, past the cervix, and into the uterus. Your doctor will then insert the embryo into the uterus. About six to 10 days later, the embryo—if successful—will implant itself into the uterus. 

Labs and Testing

Before starting IVF, you will have some testing done to help predict the likelihood of successful implantation.

Your doctor will request some blood tests to check on a few things, including a follicle stimulation hormone (FSH) test. This test gives your doctor a clue about the quality of your eggs.

The doctor will also use an ultrasound to check on the health of your uterus and ovaries and help decide the best way to proceed with implantation. 

Risk Factors

As with any medical procedure, there are risks with IVF. These risks include: 

Multiple Births 

If there is a transfer of one or more embryos into the uterus, there is a possibility of having multiple babies. A multiple-birth pregnancy also increases the risk of premature labor and low birth weight.

Premature Delivery

Babies conceived through IVF have a slight increase in odds of premature birth.

Ovarian Hyperstimulation Syndrome

Using fertility drugs such as those prescribed during IVF can cause your ovaries to become swollen and painful. You may also find yourself bloated, nauseated, and having bouts of diarrhea. In most cases, these symptoms last only a week.

Birth Defects

Regardless of how the baby is conceived, the risk factor for birth defects seems to depend on the mother's age.

A Word From VeryWell

When you're ready to expand your family, waiting to conceive can be particularly stressful. If you are concerned about an inability to conceive and think IVF may be a good option for you, ask your primary care provider or gynecologist for a recommendation or referral to a fertility specialist.

Seeing a doctor specializing in fertility allows you to discuss all options based on your medical history and current situation. 

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Article Sources
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  1. Centers for Disease Control and Prevention. ART success rates. Updated December 31, 2020.

  2. Penn Medicine. A step-by-step look at the IVF process.

  3. MedlinePlus. Follicle-stimulation hormone levels test. Updated December 17, 2020.

  4. Sullivan-Pyke CS, Senapati S, Mainigi MA, Barnhart KT. In vitro fertilization and adverse obstetric and perinatal outcomesSemin Perinatol. 2017;41(6):345-353. doi:10.1053/j.semperi.2017.07.001

  5. Centers for Diseases Control and Prevention. ART and multiple births. Updated April 1, 2016.

  6. Cavoretto P, Candiani M, Giorgione V, et al. Risk of spontaneous preterm birth in singleton pregnancies conceived after IVF/ICSI treatment: a meta-analysis of cohort studiesUltrasound Obstet Gynecol. 2018;51(1):43-53. doi:10.1002/uog.18930

  7. Cleveland Clinic. Ovarian hyperstimulation syndrome. Updated January 10, 2020.