What is In Vitro Fertilization (IVF)

IVF is one of the most effective fertility treatments available. It involves combining sperm and eggs in the laboratory to create embryos.
The full IVF–FET/ET process typically includes ovarian stimulation, egg retrieval, embryo culture, and embryo transfer.

Who May Need IVF

IVF may be recommended for:

  • Women with blocked or damaged fallopian tubes
  • Women with low ovarian reserve or diminished egg quality
  • Couples with male factor infertility (low sperm count, motility, or morphology)
  • Patients with unexplained infertility who have not succeeded with other treatments
  • Women with endometriosis
  • Individuals or couples using donor eggs, donor sperm, or gestational surrogacy
  • Same-sex couples or single individuals planning to build a family

IVF Treatment Process

Step 1 – Controlled Ovarian Stimulation

What happens:

  • Lasts about two weeks.
  • Involves injectable medications containing FSH, LH, or both, plus a GnRH antagonist to prevent premature ovulation.
  • Frequent ultrasounds and blood tests to monitor follicle development.

Special notes for different patients:

  • Low ovarian reserve: Mini Stim IVF or tailored low-dose protocols may be used.
  • PCOS or irregular cycles: Careful medication adjustment to reduce risk of ovarian hyperstimulation syndrome (OHSS).

Step 2 – Egg Retrieval

What happens:

  • Performed under sedation in an operating room.
  • Transvaginal ultrasound-guided aspiration retrieves eggs from mature follicles.

Special notes for different patients:

  • Difficult ovarian access: Advanced ultrasound guidance and fine needle aspiration techniques may be required.
  • Poor responders: Aim to retrieve fewer but higher-quality eggs.

Step 3 – Semen Collection & Preparation

What happens:

  • Partner’s semen collected same day, processed (“washed”) to select healthy, motile sperm.
  • Frozen sperm can be thawed if collected earlier.

Special notes for different patients:

  • Male factor infertility: ICSI (Intracytoplasmic Sperm Injection) is often used to improve fertilization rates.
  • Donor sperm users: Frozen donor samples are thawed and processed.

Step 4 – Fertilization

Methods:

  1. Conventional Insemination – Sperm and eggs combined and incubated overnight.
  2. ICSI – A single sperm injected into each egg; useful for poor semen quality, previous fertilization failure, or when genetic testing is planned.

Special notes:

  • Genetic disorder carriers: ICSI is usually paired with PGT-M or PGT-A for embryo testing.

Step 5 – Embryo Culture

What happens:

  • Embryos grown in a lab for 3–7 days.
  • Graded for quality before transfer or freezing.

Special notes:

  • Multiple embryos: Patients can choose fresh transfer, freeze-all, or PGT before transfer.
  • Frequent ejeculation: Improve sperm quality.
  • Specific sperm: Selection kit (zymote) to decrease sperm DNA fragmentation.

Step 6 – Embryo Transfer

What happens:

  • Best-quality embryo(s) placed into the uterus via a thin catheter.
  • May be fresh (same cycle) or frozen (in a later cycle).

Special notes:

  • Thin uterine lining: May require additional medication or endometrial preparation.
  • Surrogacy: Transfer is performed to the gestational carrier’s uterus.