How Is IVF Done? A Step-by-Step Guide in Plain Language

By Dr. Rajendra Shitole, IVF Doctor in Pune

How is IVF done? In vitro fertilisation has five stages: hormone injections grow several eggs, a procedure under sedation collects them, the laboratory fertilises them, embryos grow for three to five days and one is placed in the uterus. A pregnancy blood test follows about two weeks later.

Most couples know the word IVF long before they know what happens during it. This guide shows how IVF is done in the order you will live it, with the timings, sensations and numbers people ask about most.

Key Takeaways

• Five core stages: ovarian stimulation, egg retrieval, fertilisation, embryo growth and embryo transfer.
• Timeline: injections run for roughly 10 to 14 days before retrieval, and the full cycle from first consultation to a pregnancy result usually takes 4 to 6 weeks.
• Comfort: egg retrieval takes about 5 to 10 minutes under sedation. Embryo transfer usually needs no anaesthesia.
• Result day: the pregnancy blood test comes 10 to 14 days after embryo transfer.
• Cost range: ₹1 lakh to ₹2.5 lakh per cycle, depending on the protocol, the medicines and add-ons such as ICSI.
• Honest numbers: per-cycle success in India is commonly quoted at 30% to 35%, and age is the biggest single factor.

How Is IVF Done? The Process at a Glance

Think of IVF as a relay, with a consultation at the start and a pregnancy test at the end.

1. Consultation and tests: your doctor reviews your history, scans and reports before planning medicines.
2. Ovarian stimulation: daily injections help several follicles grow in one cycle instead of the usual one.
3. Egg retrieval: a thin needle collects the mature eggs under ultrasound guidance.
4. Fertilisation: eggs and sperm are brought together in the laboratory, either by standard IVF or by ICSI.
5. Embryo growth: embryologists watch the embryos develop for three to five days.
6. Embryo transfer: a soft catheter places the chosen embryo into the uterus.
7. Pregnancy test: a blood test about two weeks later gives the answer.

Who Needs IVF and What Tests Come First?

Doctors usually suggest IVF when simpler options have not worked or when the cause of infertility makes them unlikely to work. Common reasons include blocked fallopian tubes, low sperm count or poor sperm movement, endometriosis, ovulation problems that did not respond to tablets, age-related decline in egg numbers and unexplained infertility after several IUI attempts.

You are in large company. The World Health Organization estimates that about 17.5% of adults, roughly 1 in 6 people worldwide, experience infertility in their lifetime. The clinic’s own website puts the figure for India at about 27.5 million couples, which is 10 to 15% of the population. Male factors contribute to 40 to 50% of cases, so both partners are tested from the start.

Before any medicine begins, expect these checks:

• Ovarian reserve: an ultrasound to count resting follicles and an AMH blood test.
• Semen analysis: count, movement and shape of sperm.
• Hormone profile: thyroid, prolactin and other cycle hormones.
• Uterus and tubes: scans, and sometimes a hysteroscopy or dye test.

Step 1: How Does Ovarian Stimulation Work?

In a natural month your body releases one egg. IVF aims for several, because not every egg fertilises and not every embryo is suitable for transfer. Hormone injections, usually follicle-stimulating hormone, nudge the ovaries to grow more follicles at once.

Stimulation typically runs 8 to 14 days. During that time you visit the clinic for vaginal ultrasound scans and blood tests every few days. These show how many follicles are growing and how fast, so the doctor can raise or lower the dose.

When the larger follicles reach the right size, you take a trigger injection. It completes the maturing of the eggs, and retrieval is scheduled about 34 to 36 hours later.

What does it feel like? Many women describe bloating, breast tenderness, mild cramps and mood swings, and most of it settles after retrieval.

Not everyone needs IVF straight away. The clinic’s female infertility treatments cover options that may come first.

Step 2: What Happens During Egg Retrieval?

Egg retrieval is a short procedure done under sedation, so you stay comfortable and do not feel the needle. Guided by a vaginal ultrasound probe, the doctor passes a fine needle through the vaginal wall into each follicle and gently draws out the fluid containing the eggs. There are no cuts and no stitches.

The procedure takes about 5 to 10 minutes. You rest for a while afterwards, and most women go home the same day with someone to accompany them. Light cramping and spotting for a day or two are common.

The number of eggs depends on age and ovarian reserve, and many cycles yield around 8 to 14. What matters is how many are mature and healthy.

On the same day, the male partner gives a fresh semen sample. A sample frozen earlier can be used if he cannot be present. If sperm quality is a concern, the clinic’s male infertility treatments cover evaluation and care before IVF.

Step 3: How Is IVF Done in the Laboratory?

In the embryology laboratory, each egg is checked for maturity. Fertilisation then happens in one of two ways.

• Standard IVF: eggs and prepared sperm are placed together in a dish and kept in an incubator set at body temperature. Sperm enter the eggs on their own.
• ICSI: an embryologist injects a single sperm directly into each mature egg under a microscope. It is used when sperm count or movement is low, or when earlier cycles had poor fertilisation. You can read more about ICSI treatment on the clinic website.

The next morning, the embryologist checks which eggs have fertilised. Not every egg does, and that is expected.

Step 4: How Do Embryos Grow Before Transfer?

Fertilised eggs stay in the incubator and are checked daily. By day 3 an embryo has roughly 8 cells. By day 5 or 6 the strongest ones reach the blastocyst stage, a ball of about 100 cells.

Transfer is usually done on day 3 or day 5. Extra good-quality embryos can be frozen for later. This gives two paths:

• Fresh transfer: the embryo is placed a few days after retrieval.
• Frozen embryo transfer: the embryos are frozen and transferred in a later cycle, once the uterus has been prepared with medicines. Doctors choose this when hormone levels are very high after stimulation or when the lining needs more time.

Frozen cycles skip stimulation, retrieval and culture because the embryos already exist.

Step 5: How Is the Embryo Transfer Done?

Embryo transfer is the stage most people expect to be dramatic, and it is usually the gentlest. The embryologist loads the chosen embryo into a thin, soft catheter. The doctor guides it through the cervix into the uterus under ultrasound and releases the embryo. It takes only a few minutes and rarely needs anaesthesia.

After a short rest you can go home. Progesterone support, as tablets, gels or injections, usually starts around this time to prepare the lining.

How many embryos are transferred? Many clinics now prefer single embryo transfer because twin pregnancies raise risks for both mother and babies. Your doctor will talk this through based on your age, embryo quality and earlier attempts.

What Happens During the Two-Week Wait?

After transfer, the embryo needs a few days to attach to the uterine lining. A blood test for the pregnancy hormone hCG confirms the result. The clinic’s guidance is 10 to 12 days after transfer, and other centres quote 10 to 14 days. A home urine test taken too early can mislead, so wait for the blood test.

Meanwhile:

• Medicines: continue them exactly as prescribed.
• Activity: most doctors advise light normal activity rather than strict bed rest. Follow your own doctor’s instructions.
• Call the clinic: if you notice heavy bleeding, severe abdominal pain or fever.

What Are the Risks and Side Effects of IVF?

Most people feel only mild effects such as bloating, cramps, spotting and mood changes. A few risks deserve to be known upfront, and the first one needs urgent action.

• Ovarian hyperstimulation syndrome (OHSS): the ovaries over-respond to the medicines. Rapidly increasing abdominal swelling, passing much less urine, breathlessness or calf pain are warning signs. Do not wait for these to settle. They need same-day medical attention.
• Multiple pregnancy: more likely when more than one embryo is transferred.
• Procedure risks: small chances of infection or bleeding after egg retrieval.
• Miscarriage and ectopic pregnancy: both can occur in IVF pregnancies, as they can in natural ones.

How Much Does IVF Cost?

The clinic states that IVF typically costs between ₹1 lakh and ₹2.5 lakh per cycle. The final figure depends on the protocol, the medicines you need and extras such as ICSI or embryo testing. A detailed ivf cost breakdown is shared after the first consultation. If a second attempt or a frozen transfer might be needed, ask what that would add before you begin.

What Do IVF Success Rates Really Look Like?

Success figures confuse many couples because clinics measure different things: a positive pregnancy test, a heartbeat on scan or a baby born. The number that matters to families is live birth per cycle or per transfer.

• National range: as reported by the Hindustan Times in 2018, AIIMS places IVF success at about 30% to 35% per cycle.
• Across several cycles: Industry estimate: cumulative success over three cycles can reach 60% to 70%, because many couples need more than one attempt.
• Age: egg numbers and quality fall with age, so the same treatment gives different outcomes at 30 and at 40. A 2020 study from a South Indian teaching hospital found that a male partner aged 40 or above did not significantly change live birth rates in couples without male-factor infertility.
• Reporting: India’s Assisted Reproductive Technology (Regulation) Act, 2021 provides for a national registry so clinic data can be reported in a uniform way.

When any clinic quotes a success figure, ask what it measures and for which age group.

Frequently Asked Questions About IVF Treatment

Is IVF painful?

Daily injections cause mild discomfort. Egg retrieval is done under sedation, so you should not feel pain during it, though cramping afterwards is common.

How long does one IVF cycle take?

Stimulation to retrieval takes about 10 to 14 days. A fresh transfer follows 3 to 5 days later, and the pregnancy test comes 10 to 12 days after that. From first consultation to result, expect 4 to 6 weeks.

How is IVF done when sperm count is low?

The laboratory uses ICSI. An embryologist selects a single sperm and injects it directly into each mature egg, so fertilisation does not depend on sperm swimming into the egg.

How is IVF done with frozen embryos or sperm?

Frozen sperm can be used on the day of retrieval, and embryos frozen earlier can be thawed for a later transfer. Frozen embryo cycles skip stimulation and retrieval. The clinic also offers fertility preservation through egg freezing and sperm banking.

How is IVF different from IUI?

In IUI, prepared sperm are placed inside the uterus around ovulation and fertilisation happens in the body. In IVF, fertilisation happens in the laboratory and the embryo is placed in the uterus afterwards.

What should I bring to my first IVF consultation?

Bring earlier medical records, test results, ultrasound reports and semen analysis reports, along with any records from treatment elsewhere. Bring your questions too.

Plan Your IVF Treatment With Dr. Rajendra Shitole

Dr. Rajendra Shitole is an IVF doctor, consultant and gynaecologist in pune with more than 11 years of experience. He holds an MBBS, DGO and DNB in Obstetrics and Gynaecology, with a fellowship in IVF and endoscopy from Ruby Hall Clinic, Pune. He sees patients at IRSA Fertility – IVF & Endoscopy Clinic, Kharadi, Pune. Read more about Dr. Shitole to discuss your own plan.

You can also call 8208422881.