Infertility is more common than many people realize. In fact, it affects about 1 in 8 couples in the United States, and it’s not always easy to know why. According to the American Society for Reproductive Medicine (ASRM), roughly one-third of infertility cases are due to female factors, one-third are due to male factors, and the remaining third are caused by a combination of both partners or are classified as unexplained.
For those navigating this journey, it’s important to know you’re not alone — and that there are effective treatments available. Among these, in vitro fertilization (IVF) is one of the most powerful. IVF isn’t the right choice for everyone, but it has helped millions of families around the world achieve pregnancy when other methods failed.
If you’re considering IVF, one of the biggest questions you may have is: What exactly is IVF, and how does it work? Let’s talk through what IVF means, who it helps, and what to expect step by step.
What Does IVF Stand For?
IVF stands for in vitro fertilization. “In vivo” means inside the body, while “in vitro” means outside the body. Normally, conception occurs in the fallopian tube, not the uterus as many assume. That’s where sperm meets egg and forms an embryo, which then travels to the uterus to implant.
With IVF, this process takes place in the lab. Eggs are collected from the ovaries and combined with sperm outside the body. Not every egg will be mature, not every egg will fertilize, and not every embryo will grow. But those that do may develop into a blastocyst — an embryo at five to six days of growth with strong potential to implant.
Today, many clinics biopsy embryos at the blastocyst stage, test their DNA, and freeze them while awaiting results. Once testing is complete, embryos are thawed and transferred into the uterus. This reduces the risk of miscarriage and improves the chances of selecting the healthiest embryo for transfer.
Why Is IVF Performed?
IVF is often used when other treatments haven’t worked — but in some cases, it’s the only effective choice from the start.
If fallopian tubes are blocked, tied, or removed, sperm and egg simply can’t meet. Similarly, if sperm counts are very low (less than a few hundred thousand active sperm), even intrauterine insemination (IUI) may not work. IVF allows doctors to bypass these barriers, sometimes using a technique called intracytoplasmic sperm injection (ICSI), where a single sperm is injected directly into an egg.
IVF also helps couples who face certain genetic concerns. Conditions such as cystic fibrosis, Huntington’s disease, or Tay-Sachs disease can be passed down without intervention. Through IVF with genetic testing, embryos can be screened before transfer, lowering the risk of miscarriage or passing on serious conditions.
In short, IVF is used when sperm and egg can’t meet naturally, when less invasive treatments fail, or when genetics make natural conception risky.
The 6 Steps of an IVF Cycle
An IVF cycle can feel complicated, but it really breaks down into six main steps:
Step 1: Synchronization
Normally, one egg takes the lead each month while the others fade away. With IVF, medications help align the eggs so they develop at the same pace. This gives more eggs the chance to grow evenly, making retrieval more effective.
Step 2: Ovarian Stimulation
Once the eggs are synchronized, injectable fertility medications (gonadotropins) stimulate the ovaries to grow multiple eggs. Instead of just one or two, patients may produce 10, 15, or even 20 eggs in a cycle. Regular monitoring with ultrasounds and bloodwork ensures they’re developing safely.
Step 3: Trigger Shot and Egg Retrieval
When the eggs are ready, a precisely timed injection — often HCG or Lupron — completes their maturation. About 35–37 hours later, eggs are retrieved in a short outpatient procedure. Guided by ultrasound, a thin needle collects the eggs while the patient is under sedation. Most people return home the same day, experiencing only mild bloating or cramping.
Step 4: Sperm Retrieval
On the same day, sperm is collected. In most cases, this is through a semen sample. If sperm counts are very low, sperm can also be retrieved directly from the testicle. With ICSI, even a single healthy sperm can be used to fertilize an egg.
Step 5: Fertilization and Embryo Growth
The eggs and sperm are combined in the lab. Some eggs won’t fertilize, and not all fertilized eggs will grow normally, but the strongest may reach the blastocyst stage after five to seven days. Many clinics now freeze embryos and perform preimplantation genetic testing (PGT) to identify those most likely to succeed before transfer.
Step 6: Embryo Transfer
Finally, one embryo is placed into the uterus using a thin catheter. The procedure is simple and doesn’t require anesthesia. If the embryo implants, pregnancy begins. Because embryos have already grown several days in the lab, patients often find out results a little sooner than with natural conception — usually about 9–10 days after transfer.
Are There Tests Before IVF?
Yes — testing is an important step in preparing for IVF. The goal is to understand the eggs, sperm, and uterus so the treatment plan can be tailored to your situation. Some clinics perform months’ worth of testing, which can add expense without always changing the approach. At Positive Steps Fertility, I often use the Parryscope® approach, which evaluates the ovaries, tubes, and uterus in a single office visit.
That said, most clinics will recommend a few baseline tests before IVF, including:
- Ovarian reserve testing – Blood tests such as anti-Müllerian hormone (AMH) and follicle-stimulating hormone (FSH) give an estimate of how many eggs remain and how the ovaries might respond to stimulation.
- Semen analysis – A semen sample is checked for sperm count, movement (motility), and shape (morphology). This helps determine whether procedures like ICSI may be needed.
- Infectious disease screening – Both partners are usually screened for infections such as HIV, hepatitis B and C, and syphilis. This protects both patients and lab staff and ensures safe handling of eggs and sperm.
- Uterine exam – An ultrasound or hysteroscopy is used to look for fibroids, polyps, or scarring that could interfere with embryo implantation.
In some cases, additional testing may be needed, particularly if endometriosis, autoimmune conditions, or tubal disease are suspected. But the key is balance: gather enough information to make IVF effective while avoiding unnecessary costs or delays.
Is IVF Painful?
Most patients are surprised to find that the egg retrieval procedure itself is not painful, since it’s done under sedation. The discomfort comes afterward, usually from bloating or soreness in the ovaries. Each egg retrieved leaves a tiny bruise, so women who produce 20 eggs may feel more sore than those who produce three.
Recovery usually takes a few days to a week. While the physical discomfort is manageable for most, it’s the emotional side — the waiting, the hormone shifts, the uncertainty — that often feels hardest.
How Successful Is IVF?
Success depends on many factors — age, ovarian reserve, sperm quality, and uterine health all play a role. According to the Centers for Disease Control and Prevention (CDC), women under 35 have about a 50% live birth rate per IVF cycle.
But those numbers can be misleading, because IVF isn’t always just one attempt. When patients use more than one embryo from the same retrieval, the odds improve significantly. The Society for Assisted Reproductive Technology (SART) reports that cumulative pregnancy rates often exceed 70% after accounting for multiple embryo transfers from a single cycle.
So while no clinic can guarantee success, IVF remains the most effective fertility treatment available today — and it helps overcome most causes of both male and female infertility.
What Are the Risks and Side Effects of IVF?
Like all medical treatments, IVF carries risks, but serious complications are rare. The ASRM fact sheet on IVF risks notes that side effects from fertility medications may include mild bruising, nausea, breast tenderness, mood swings, and fatigue. A small percentage of patients may develop ovarian hyperstimulation syndrome (OHSS), which usually causes mild bloating but can rarely become severe.
Egg retrieval carries a small risk of bleeding, infection, or injury to nearby organs, though these are very uncommon. Most patients experience only mild cramping for a day or two.
Pregnancy itself carries risks, too. IVF increases the chance of multiple pregnancies if more than one embryo is transferred, which raises the risk of premature delivery, high blood pressure, gestational diabetes, and cesarean section. That’s why many clinics now recommend single embryo transfer whenever possible.
The risk of miscarriage after IVF is similar to natural conception and largely depends on maternal age. Ectopic pregnancies (where an embryo implants outside the uterus) occur in about 1% of IVF cases, which is similar to or lower than women with infertility in general.
Concerns about birth defects or cancer risks have been studied extensively. Current evidence shows that most risks are related to the underlying causes of infertility — such as age, PCOS, or endometriosis — rather than IVF itself.
Final Thoughts
IVF isn’t the right option for everyone, but it has given millions of families the chance to grow when other paths have not worked. The process involves science, precision, and hope — and while success isn’t guaranteed, IVF remains one of the most effective infertility treatments.
If you’re considering IVF, the best step is to meet with a fertility specialist who can explain how these steps apply to your situation. Don’t suffer in silence — get answers, ask questions, and take control of your fertility journey. Schedule your appointment today.
