IVF Guide
Everything you need to know about in vitro fertilization.
IVF Quick Facts
- What it is: Eggs retrieved, fertilized in lab, embryos transferred to uterus
- Timeline: ~2-4 weeks from start of medications to embryo transfer
- Success rate: ~40-60% live birth rate per transfer (under 35)
- Cost: $15,000-$25,000 per cycle (plus meds)
What Is IVF?
In vitro fertilization (IVF) is an assisted reproductive technology where eggs are retrieved from the ovaries, fertilized with sperm in a laboratory, and resulting embryos are transferred to the uterus.
"In vitro" means "in glass"—referring to the lab dishes where fertilization occurs. IVF bypasses many causes of infertility by taking the critical steps of fertilization and early embryo development outside the body.
đź“Š IVF By the Numbers
• First successful IVF baby: Louise Brown, born 1978
• Over 8 million babies born via IVF worldwide
• ~2% of US births involve IVF
• Technology has improved dramatically—success rates have roughly doubled since 2000
Who Needs IVF?
Common Indications
- Blocked or damaged fallopian tubes: Sperm can't reach egg
- Severe male factor infertility: Very low count, motility, or morphology
- Advanced maternal age: Reduced ovarian reserve, declining egg quality
- Endometriosis: Especially moderate to severe
- Unexplained infertility: After other treatments have failed
- Failed IUI cycles: Usually 3-4+ unsuccessful attempts
- Genetic concerns: Need for preimplantation genetic testing (PGT)
- Same-sex male couples: Using donor eggs and gestational carrier
- Single men: Using donor eggs and gestational carrier
- Using frozen eggs: From previous egg freezing
The IVF Process Step by Step
1 Ovarian Stimulation
Timeline: 8-14 days
Daily injectable medications stimulate multiple eggs to develop (instead of the usual one per cycle). You'll have frequent monitoring appointments (blood tests + ultrasounds) to track follicle growth and adjust medications.
Common medications: FSH (Gonal-F, Follistim), LH/hMG (Menopur), GnRH antagonist (Ganirelix, Cetrotide) to prevent early ovulation.
2 Trigger Shot
Timeline: 36 hours before retrieval
When follicles are mature (18-22mm), you take a "trigger shot" (hCG or GnRH agonist) to finalize egg maturation and schedule retrieval precisely.
3 Egg Retrieval
Timeline: ~20-30 minutes
A minor surgical procedure under sedation. A needle guided by ultrasound retrieves eggs from follicles through the vaginal wall. You'll rest for 1-2 hours afterward and need someone to drive you home.
What to expect: Cramping and bloating for a few days. Take the day off; most resume normal activities the next day.
4 Fertilization
Timeline: Day 0-1
Eggs are fertilized in the lab. Two methods:
- Conventional IVF: Sperm and eggs placed together; sperm fertilize eggs naturally
- ICSI: Single sperm injected directly into each egg (used for male factor or previous fertilization failure)
About 70-80% of mature eggs typically fertilize.
5 Embryo Development
Timeline: Days 1-5/6
Fertilized eggs (zygotes) develop into embryos in the lab. Embryologists monitor development:
- Day 3: Cleavage stage (6-8 cells)
- Day 5-6: Blastocyst stage (~100+ cells)
Not all fertilized eggs become viable embryos. Attrition is normal.
6 Embryo Transfer (Fresh or Frozen)
Timeline: Day 3 or Day 5-6 (fresh), or later cycle (frozen)
One or more embryos are placed in the uterus via a thin catheter—similar to IUI. The procedure is quick (~5-10 minutes) and usually painless.
Fresh vs. Frozen Transfer:
- Fresh: Transfer same cycle as retrieval
- Frozen (FET): Embryos frozen, transferred in a later cycle. Increasingly common; may have slightly better success rates in some cases.
7 Pregnancy Test
Timeline: 9-14 days after transfer
A blood test (beta hCG) confirms pregnancy. If positive, you'll continue monitoring with repeat betas and an early ultrasound around 6-7 weeks.
Optional Add-Ons
Preimplantation Genetic Testing (PGT)
Embryos can be biopsied and tested for:
- PGT-A: Chromosomal abnormalities (aneuploidy)—most common; selects embryos with correct chromosome number
- PGT-M: Specific genetic diseases (cystic fibrosis, sickle cell, etc.)
- PGT-SR: Structural chromosomal rearrangements
Cost: $3,000-$6,000 additional
ICSI
Intracytoplasmic sperm injection—single sperm injected into each egg. Standard for male factor; some clinics use routinely.
Cost: $1,000-$2,500 additional
Assisted Hatching
Laser creates a small opening in the embryo's outer shell to help implantation. Evidence is mixed; may help certain cases.
IVF Success Rates
Success varies significantly by age and diagnosis:
| Age | Live Birth Rate Per Transfer |
|---|---|
| Under 35 | 50-55% |
| 35-37 | 40-45% |
| 38-40 | 25-35% |
| 41-42 | 15-20% |
| Over 42 | 5-10% |
Cumulative success: Over multiple cycles, success rates compound. Many couples who don't succeed on the first transfer do succeed on subsequent attempts.
đź’ˇ Check CDC/SART Data
Look up your specific clinic's success rates on the CDC or SART website. Rates vary significantly between clinics. But compare carefully—some clinics are more selective about which patients they accept.
IVF Costs
Typical Costs (2025-2026)
- IVF cycle (clinic fees): $12,000-$17,000
- Medications: $3,000-$7,000
- ICSI: $1,000-$2,500
- PGT-A: $3,000-$6,000
- Embryo freezing: $1,000-$2,000
- Frozen embryo transfer (FET): $3,000-$5,000
- Annual embryo storage: $500-$1,000
Total per fresh cycle: $15,000-$25,000+ (varies by location and add-ons)
Insurance & Financial Options
- Insurance: Coverage varies widely; some states mandate coverage
- Employer benefits: Many large companies offer fertility benefits
- Financing: Many clinics offer payment plans or work with fertility financing companies
- Grants: Several organizations offer fertility grants
- Shared risk programs: Pay more upfront; refund if no live birth (not for everyone)
The Emotional Side
IVF is physically and emotionally demanding. Common experiences:
- Hormonal effects: Mood swings, anxiety, irritability from medications
- Hope and fear: The emotional rollercoaster of each stage
- Relationship stress: Financial pressure, different coping styles
- Social isolation: Difficulty relating to friends with easy pregnancies
- Decision fatigue: Many choices throughout the process
Coping Strategies
- Consider therapy with a fertility specialist
- Join a support group (in-person or online)
- Communicate openly with your partner
- Set boundaries around what you share with others
- Plan activities and distractions during the wait
- Practice self-compassion—this is hard
The Bottom Line
IVF is the most effective fertility treatment available, with success rates that continue to improve. It's a significant investment of time, money, and emotional energy—but for many couples, it's the path to parenthood.
Work with your reproductive endocrinologist to understand your specific prognosis, explore financial options, and prepare for the journey ahead. You're not alone. đź’š