IVF is a form of assisted reproductive technology (ART) and involves several steps:

• Ovarian Stimulation: In this step, fertility medicines are given to the woman to boost egg production. Usually, a woman produces one egg per month. Fertility medicines help the ovaries to produce several eggs. During this, the woman will have regular transvaginal ultrasounds which will help in examining the ovaries and blood tests to check the hormone levels.

• Egg retrieval: Follicular aspiration, a minor surgery is performed to remove the eggs from the woman’s body. In this, the woman will be given medicines so she does not feel any pain during the procedure. Using ultrasound images, the specialist inserts a thin needle through the vagina into the ovary and sacs containing the eggs. The needle is connected to a suction device that pulls the eggs and fluid out of each follicle, one at a time. The same procedure is done for the other ovary. The eggs are then placed in a dish containing a special solution and put in an incubator. The patient may feel some cramping after the procedure, but it will go away within a day. Egg retrieval is done 36 hours after the last hormone injection “trigger shot”. 

In some cases, a pelvic laparoscopy may be required to remove the eggs. If a woman does not or cannot produce any eggs, donated eggs may be used. 

• Insemination and Fertilization: Post the egg retrieval procedure, the embryologist will try to fertilize all mature eggs using intracytoplasmic sperm injection or ICSI. The sperm is then placed together with the best quality eggs. Immature eggs cannot have ICSI performed on them. Eggs and sperm are stored in an environmentally controlled chamber, where fertilization typically occurs a few hours after insemination. On an average, 70% of mature eggs will fertilize.
• Embryo culture: Over the next five to six days, the development of the embryo is carefully monitored. Within about 5 days, a normal embryo has several cells that are actively dividing. About 50% of fertilized embryos progress to the blastocyst stage. All embryos suitable for transfer will be frozen on day five or six of fertilization to be used for future embryo transfers.
• Embryo transfer: Embryos are placed into the woman’s womb 3 to 5 days after the egg retrieval and fertilization. This simple procedure does not require anesthesia and involves inserting a thin tube containing the embryos into the uterus. There are two kinds of embryo transfer i.e., fresh embryo transfer and frozen embryo transfer. Both the embryo transfers follow the same transfer process. A fresh embryo transfer means your embryo is inserted into the uterus between three and seven days after the egg retrieval procedure. A frozen embryo transfer means that the frozen embryo (from the previous IVF cycle) are thawed and inserted into the uterus. The embryo transfer procedure is a simple procedure which doesn’t require anesthesia. The doctor will insert a thin tube (catheter) containing the embryos into the woman’s vagina, through cervix and up into the womb. If the embryo implants in the lining of the womb and grows, it results in pregnancy. More than one embryo is placed into the womb at the same time, which can lead to twins, triplets or more. The procedure usually takes less than 10 minutes.

Pregnancy usually occurs when the embryo implants itself into the lining of the uterus. After 9 to 14 days of embryo transfer, it is suggested to take a pregnancy test.