In Vitro Fertilization (IVF)

If your doctor has suggested IVF as an option for you to conceive or you are researching it, then your first step needs to be, getting familiar with the procedures that are involved in this treatment.

What is IVF?

In vitro fertilisation, or VF, is a combination of treatments used to help you conceive. It is frequently used when a hereditary condition or other fertility issues prevent you from conceiving. Fertility preservation, same-sex relationships, and being single and wanting to start a family are just a few other circumstances in which IVF may be considered a treatment.

In a usual menstrual cycle, the ovaries typically produce one egg each month. However, in the case of IVF treatment, fertility specialists intervene by prescribing medications that stimulate the ovaries to produce multiple eggs. Throughout this process, continuous monitoring via blood tests and ultrasounds is conducted to closely observe the development of follicles.

Once the eggs have matured, they are carefully retrieved through a surgical procedure performed under anaesthesia in a controlled environment. Following retrieval, the collected eggs undergo examination by an embryologist under a microscope. From the pool of retrieved eggs, only the mature ones are selected for the next stage of fertilisation.

Fertilisation of the selected eggs usually takes place on the same day as retrieval. After fertilisation, the resulting embryos are left to develop for a period of about three to five days. At this point, a decision is made whether to proceed with immediate transfer into the uterus or to freeze the embryos for future use.
When the time comes for embryo transfer, the procedure is relatively simple and quick. It involves placing the embryo gently into the uterine cavity, similar to a pap smear test. Importantly, this step does not require anaesthesia, offering a smooth and comfortable experience for the patient.

IVF Journey : STEP-BY-STEP process explained


Step 1: Blood Tests

  • On day 1 of your period, you need to call your fertility clinic to inform them that your cycle has started to book your blood test. Usually this blood test needs to be done on DAY 1’s morning. However, if you get your periods in the afternoon, book your blood test for the following day and consider that DAY 1.

Step 2: Hormone Stimulation

  • By DAY 2 or DAY 3 of your cycle, your hormone stimulation treatment will start. This involves taking medication such as follicle-stimulating hormones (FSH) and luteinizing hormones (LH) to stimulate your follicles to produce multiple eggs. The duration of this treatment varies, with some women reaching the desired follicle size after 8 days, while others may require more time.

Step 3: Trigger shot

  • Once the eggs have reached a certain size, you will need to take a trigger shot. This contains Human Chorionic Gonadotropin (HCG hormone) which triggers your ovaries to mature and release an egg.

Step 4: Egg Retrieval

  • Approximately 34-36 hours following the trigger shot, your eggs will be collected either in a procedure room or operating theatre. This brief procedure is conducted under sedation or anaesthesia. Using a thin needle guided by ultrasound, your fertility specialist will extract the eggs by puncturing through your vaginal wall into the follicles. In cases where accessing the follicles with transvaginal ultrasound is not feasible, egg retrieval through laparoscopic surgery will be arranged.

Step 5: Semen Sample

  • If you’re using your partner’s fresh sperm, he’ll be requested to provide a semen sample on the day of egg retrieval. However, there are situations where obtaining sperm from the ejaculate isn’t feasible, prompting a surgical procedure to directly extract sperm from the testicles.
  • Alternatively, frozen donor sperm may be utilised in certain instances, such as if you’re single or in a same-sex relationship.

Step 6: Fertilisation

  • In conventional IVF, viable sperm and eggs are combined in a dish and left to incubate overnight. However, in certain situations, your fertility specialist might suggest IntraCytoplasmic Sperm Injection (ICSI) instead. This procedure involves injecting a single healthy sperm directly into each mature egg. ICSI is typically advised when sperm quality is suboptimal.

Step 7: Embryo Transfer

  • Around 3 – 5 days following egg retrieval, your fertility specialist will perform an embryo transfer into the uterine cavity. Sometimes, more than one embryo may be transferred (This is not a common occurrence). Alternatively, your fertility specialist may choose to delay the embryo transfer in some cases. Any excess high-quality embryos will be frozen and stored for future use, to be transferred in the following month or at a later time, based on your specific circumstances.

Step 8: Pregnancy Test

  • Following the embryo transfer, a two-week waiting period begins before you can undergo a pregnancy test. A blood test is preferred over a home pregnancy test due to its higher reliability.