IVF, or in vitro fertilization, is a big choice, so it’s common to have a lot of questions. If you and your infertility specialist have chosen IVF to help you have a baby, it can help to know what to expect before, during, and after.
From preparing your body for IVF to follow-up after a pregnancy test, your OB GYN can walk you through each medication, procedure, and question. Here are the basic steps you’ll want to understand as you start your IVF process.
1. Before your IVF cycle
If you’ve chosen IVF, you’ve probably already had checkups, tests, and conversations with your OB GYN to make sure it’s the best choice for you. But you’ll want to use this time before IVF to not only prepare physically but also financially and emotionally. For example, clarify any insurance or payment questions and connect with support for those going through IVF.
In the month before your IVF cycle, you may take birth control pills for a short time. Taking pills that prevent pregnancy when you want to get pregnant may seem strange. However, this short-term use might be recommended to better control your monthly cycle. Depending on your health, your OB GYN could also have you use certain injections to prepare.
2. Medication and egg stimulation
The next step in the process typically starts when you start your period. This marks the beginning of your IVF cycle month. During the first part of the month, you’ll take fertility medications through the use of injections. These can include follicle-stimulating hormone (FSH) or human menopausal gonadotropins (hMG), which is a combination of FSH and luteinizing hormone. You’ll also have a specifically timed dose of human chorionic gonadotropin (hCG).
While you typically release one egg each month, the U.S. Library of Medicine says these fertility drugs help cause “super ovulation,” where you produce multiple eggs. During this step, you’ll also have routine tests to monitor your eggs and hormones, including ultrasounds and blood work.
3. Egg retrieval and sperm collection
Once your eggs are ready, you’ll have a minor procedure to retrieve them. Most of the time, this can be done in your doctor’s office with medication to help ease any discomfort. Your infertility specialist will use a small, hollow needle guided by ultrasound images to retrieve your eggs. Your partner will also provide a sperm sample around this same time. Or, if you’re using a sperm donor, arrangements are made for this sperm sample to be sent to the lab.
4. In the embryology lab
Once in the lab, the eggs and sperm are added together into a lab dish. In some cases, The National Infertility Association says the lab may inject sperm directly into your eggs to help with fertilization. When eggs are fertilized and start cell division, they are then called embryos. The lab will carefully monitor this process to make sure you have enough healthy embryos for a transfer.
5. Embryo transfer
According to the American Pregnancy Association, the typical wait between egg retrieval and your procedure to transfer the embryos back into your uterus is 3 to 5 days. Like egg retrieval, embryo transfer is an in-office procedure. Your fertility specialist will carefully transfer your embryos using a thin tube inserted through the vagina into the uterus.
Before you start the IVF process, you and your infertility specialist will talk through the exact number of embryos to transfer. When you transfer multiple embryos, it can result in a pregnancy with twins or more, so this decision is based on many health and personal factors.
6. Medication to support implantation
After your embryo transfer procedure, you’ll likely take the hormone progesterone for several days. This helps support implantation—where an embryo attaches to the lining in your uterus. The Society for Assisted Reproductive Technology says you may use vaginal, oral, or injected forms of progesterone during a two-week period.
7. Pregnancy test and follow-up
Around the time your next period is expected, your infertility specialist will let you know the right time to take a pregnancy test. No matter the results, you’ll want to follow-up with your doctor about your care. If it’s positive, you may continue to take certain medications and have special care from your infertility specialist during the following weeks. If it’s negative, your OB GYN is there to help you determine the best next steps.
The entire IVF process can bring with it a mixture of emotions and ups and downs. A board-certified specialist in reproductive endocrinology and infertility can give you expert advice so that you know what to expect. By doing your research, asking questions, and getting the support you need, you’ll feel more prepared every step of the way.