the ivf journey

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Exploring the IVF Journey: What to Expect and How to Prepare

• First Steps Fertility Clinic
• August 17, 2023

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The journey toward parenthood can be filled with a mix of anticipation, excitement, and anxiety, especially for couples who find themselves considering assisted reproductive technologies (ART) like in vitro fertilization (IVF). At First Steps Fertility Clinic, our team of highly skilled professionals led by Dr. Fay Weisberg is dedicated to providing the guidance, support, and expertise necessary to help couples navigate the intricate world of fertility treatments with confidence and clarity. Our commitment to patient education and personalized care ensures that you have the resources and understanding to make well-informed decisions about your reproductive journey.

In this blog post, we will walk you through the IVF process, discussing each stage and its purpose, while providing valuable insights to help you prepare mentally, physically, and emotionally for the journey ahead. By exploring topics such as initial consultations, ovarian stimulation, egg retrieval, embryo transfer, and post-treatment care, we aim to demystify the IVF experience and empower you with the knowledge to feel confident and secure in your choice to pursue this powerful fertility treatment.

As a leading fertility clinic in the greater Toronto area, we understand the impact that infertility can have on a couple’s emotional well-being and relationships, and we are committed to offering compassionate care tailored to your unique needs at every stage of your IVF journey. Let us join you in exploring the intricacies of IVF, providing the guidance, support, and expertise necessary to make your dreams of parenthood a reality.

1. Initial Consultation: Laying the Groundwork for Your IVF Journey

The first step in your IVF journey begins with an in-depth consultation with a fertility expert, like Dr. Fay Weisberg at First Steps Fertility Clinic. This consultation provides an opportunity for you and your partner to discuss your medical history, fertility concerns, and expectations for IVF. You’ll also undergo a thorough evaluation, including diagnostic tests to assess your reproductive health and identify potential factors contributing to your fertility challenges.

To make the most of your consultation, come prepared with any questions, concerns, or documentation related to your fertility journey. This information will help your fertility specialist develop a personalized treatment plan tailored to your unique needs and circumstances.

2. Ovarian Stimulation: Maximizing Your Chances for Success

Following your initial consultation, your fertility specialist may prescribe medications to stimulate the development and growth of multiple eggs in your ovaries. These medications, known as gonadotropins, are typically administered through injections over a period of 8-14 days.

During ovarian stimulation, you’ll be monitored closely through blood tests and ultrasound exams to track the progression of your follicles (the fluid-filled sacs containing the eggs) and ensure the appropriate response to the medications. Based on your monitoring results, the fertility specialist may adjust your medication dosage to optimize egg development.

To prepare for this stage, familiarize yourself with the injection process and techniques, and create a comfortable, stress-free environment for administering the medications. Remember, it’s normal to feel a range of emotions during this period. Consider joining a support group or seeking counselling to help navigate these feelings.

3. Egg Retrieval & Fertilization: Harvesting the Building Blocks of Life

Once your follicles have reached optimal size and maturity, the next step is egg retrieval. This minimally invasive procedure involves the use of a transvaginal ultrasound probe and a thin needle to aspirate the eggs from the ovaries. Egg retrieval is typically performed under sedation, ensuring your comfort throughout the process.

Following retrieval, your eggs are combined with your partner’s sperm or donor sperm in a laboratory setting. The fertilized eggs, now called embryos, are monitored for growth and development over the next few days. A select number of healthy embryos will be chosen for transfer to your uterus.

During this stage, it’s crucial to prioritize self-care, as the procedure can cause mild cramping and discomfort. Make sure to follow your doctor’s recommendations regarding physical activity and pain management.

4. Embryo Transfer & Post-Treatment Care: Nurturing Your Future

Approximately 3-5 days after fertilization, one or more healthy embryos will be transferred to your uterus. The transfer procedure is generally straightforward and requires no anesthesia. A thin catheter is used to place the embryos in your uterine cavity, after which they will hopefully implant and result in a successful pregnancy.

Following the embryo transfer, you may be instructed to take various medications, such as progesterone supplements, to support implantation and early pregnancy. Additionally, you’ll be advised to avoid strenuous activities and monitor for any potential complications. Your fertility specialist will provide detailed guidelines for self-care during this period.

To prepare for the emotional aspect of the post-transfer wait, consider engaging in relaxing activities, such as meditation or gentle exercise, and seek the support of friends, family, or professional counsellors to help manage anxiety and stress.

The IVF process can be a complex and emotionally charged experience. Understanding each stage, knowing what to expect, and preparing appropriately can help alleviate stress and foster a sense of control over your fertility journey.

At First Steps Fertility Clinic, we are dedicated to supporting and empowering couples throughout their IVF clinic experience. We understand the emotional intricacies and personal challenges associated with infertility, and we strive to provide comprehensive and compassionate care tailored to your unique needs. Our unwavering commitment to patient education empowers you to confidently navigate the IVF journey and embrace the possibility of a brighter future as parents.

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Navigating the IVF Process: Key Insights to managing the IVF Timeline and work-life balance

by Dr. John Preston Parry | Nov 9, 2023 | Doctor's Blog

Embarking on fertility treatments can be a demanding process that requires significant emotional, financial, and time commitments.

Understanding fertility treatments is the first step in what may be one of the most important journeys you’ll take as a couple. It’s about creating life and expanding your family. We’re here to guide you through the myriad of fertility treatments available today, providing you with a clear, supportive pathway to parenthood and helping you understand the potential demands and how they might intersect with your career.

How long does the IVF process take from start to finish?

Begin by educating yourself about the IVF process. Knowing the step-by-step process, from initial consultations to procedures and follow-ups, can help you anticipate and schedule necessary time off.

The typical IVF (In Vitro Fertilization) treatment timeline is a multi-step process that usually spans several weeks. Each cycle of IVF includes multiple stages, although the exact timeline can vary based on individual circumstances and protocols of the fertility clinic.

An IVF cycle typically includes  the following steps or procedures:

• Medications to grow multiple eggs
• Retrieval of eggs from the ovary or ovaries
• Insemination of eggs with sperm
• Culture of any resulting fertilized eggs (embryos)
• Placement (“transfer”) of one or more embryo(s) into the uterus
• Support of the uterine lining with hormones to permit and sustain pregnancy

The IVF Process and Timeline

Embarking on the journey of in vitro fertilization (IVF) can be filled with hope and anticipation, yet it’s important to acknowledge that every couple’s path to parenthood is unique. The timeline we provide here outlines a typical IVF process, but it’s tailored with flexibility to meet your specific circumstances.

As you step forward, remember that each phase is approached with your individual needs in mind, ensuring that your journey is as smooth and successful as possible. While timelines may shift, our commitment to your family’s dream remains steadfast.

*Please note that all timelines are approximate and can vary based on individual health profiles and responses to treatment.

Navigating Work-Life Balance During Your IVF Journey

Embarking on in vitro fertilization (IVF) can feel like taking on a second full-time job. Balancing your career while undergoing IVF requires careful planning, open communication, and self-compassion. Here are some strategies to help you maintain equilibrium between your professional life and IVF treatment.

Communicate with Your Employer

If you feel comfortable, have a candid conversation with your employer or HR department about your IVF journey. Many are willing to offer flexibility once they understand the significance and requirements of the process. You’re not obligated to disclose all the details, but providing some insight can lead to accommodations like flexible hours or remote work opportunities.

Flexibility in Your Work Schedule

Look into flexible working arrangements. Flextime, compressed workweeks, or the possibility of working from home on certain days can reduce the stress of juggling work and IVF appointments. It’s crucial to arrange this in advance to minimize the impact on your professional responsibilities.

Prioritize and Delegate

Evaluate your work tasks and prioritize them. Consider what can be delegated or what projects can be put on hold. By focusing on critical tasks, you ensure your work quality remains high, which can relieve some of the pressure during your IVF treatment.

Protect Your Personal Time

Resist the urge to overcompensate at work for the time taken off for IVF procedures. Protect your personal time by setting boundaries and avoiding the pitfall of working late hours or during weekends. This time is vital for rest and recuperation.

Plan for the Unexpected

IVF can be unpredictable, with last-minute changes or unexpected outcomes. Have a contingency plan for work projects and deadlines in case you need to adjust your schedule suddenly.

Understanding Your Legal Rights in the IVF Process

Deciding to embark on an IVF journey is a monumental, intimate decision, often reached after considerable reflection and, in many cases, profound emotional challenges. While navigating the intense emotions and the deluge of medical details, you must not overlook another significant element: the complexities of the legal framework surrounding Assisted Reproductive Technology (ART) and IVF. To learn more, check out our blog on the  7 Fertility Legal Insights To Avoid Common Pitfalls .

Navigating the Emotional Landscape of IVF

The stress of fertility treatments can affect your emotional well-being and your performance at work. Tools for stress management, such as those recommended by ACOG, can be valuable resources to help you maintain your composure and focus.

According to  OBGYN Nazanin E. Silver , “Before starting infertility treatment, I encourage couples to discuss what they will do if initial treatments don’t work. Would you ever consider adoption? Would your partner? You can talk through scenarios together, and it may help to consider couples therapy.”

In a  recent blog , we discuss how the American College of Obstetricians and Gynecologists (ACOG) highlights that the emotional impact of infertility often mirrors that of other significant medical conditions such as cancer or heart disease. You might oscillate between feelings of denial, anger, guilt, depression, and acceptance, all of which can be overwhelming and stressful.

In a recent interview with a Positive Steps patient, the couple noted, “The most crucial advice we can offer is to remember that you are not alone. The struggle with infertility can often feel isolating, but it’s important to know that you are part of a community that understands your journey and stands with you.”

Embracing Self-Care During Your IVF Journey

Self-Care is Non-Negotiable. Amid the demands of IVF and work, self-care should be a priority. At the heart of your fertility journey is a commitment to nurturing your own well-being to enhance your fertility and increase the prospects of a successful pregnancy. Self-care in this context means taking thoughtful steps toward improving your overall health and creating the best possible environment for conception.

One of the primary self-care measures involves reviewing and potentially altering medication use, with professional guidance, to avoid substances that may hinder fertility or cause developmental issues. A healthcare provider can help determine which medications are safe to continue and which to suspend during preconception and beyond.

Maintaining a healthy body weight is also crucial, as weight can influence hormonal balance and fertility. A balanced diet and regular exercise not only support reproductive health but also improve mental well-being, a key factor in the fertility journey.

Moderation is the operative word when it comes to alcohol consumption. Reducing intake can have a positive impact on fertility, and it’s a change that partners can undertake together as part of their shared journey toward parenthood.

Furthermore, understanding the significance of timing in your sexual routine can be empowering. Aligning sexual activity with the most fertile periods can naturally increase the chances of pregnancy.

Lastly, addressing additional personal health factors, such as stress levels, sleep patterns, and other lifestyle choices, is essential. Each element of your lifestyle has the potential to affect fertility, and making positive changes can contribute to a healthier conception.

By integrating these self-care practices into your routine, you are taking control of what you can on your path to parenthood. It’s a journey that extends beyond the physical aspects of fertility to encompass the nurturing of your body, mind, and relationship.

Building a Support System: The Key to IVF Success

Navigating the complexities of fertility treatments can be emotionally taxing. During this period, a robust support system becomes invaluable. While the workplace may offer one avenue of support, expanding your search for understanding and solidarity beyond professional circles can provide comfort and connection.

At Positive Steps Fertility we are dedicated to helping individuals and couples get the support they need. These groups provide a safe space to share experiences, offer and receive advice, and foster a sense of companionship on the journey to parenthood.

It’s also important to consider the support that can come from close friends, family members, and even online forums. These personal connections can offer different perspectives and kinds of support. While friends and family provide a personal touch, online communities can offer anonymity and a broader range of experiences.

Counseling services, whether individual or as a couple, can also play a critical role in your support network. Professional therapists, particularly those specializing in fertility issues, can guide you through the emotional complexities that arise during this time, helping you to develop coping strategies and maintain mental and emotional wellness.

Remember, seeking and accepting support is not a sign of weakness; it’s a proactive step toward ensuring your emotional resilience as you navigate your fertility journey.

Preparing Financially for Your IVF Treatment

Costs associated with fertility treatments can add another layer of stress when balancing work life. At Positive Steps Fertility, our goal is to provide the highest quality fertility treatment at the most transparent and affordable cost. We understand that each fertility journey is unique, and we’re committed to getting to know you personally and designing a treatment plan that aligns with your family goals and budget. We aim to provide all the information and transparency you need to make informed decisions. So, if you have any questions, please do not hesitate to call us at 855-759-4124 or email us at [email protected] to learn more.

Embracing the IVF Journey with Confidence and Clarity

At Positive Steps Fertility, we understand that your fertility journey is just one part of your larger life tapestry, which includes your professional aspirations. As you move forward with treatments, we’re here to support you in harmonizing your career goals with the path to parenthood.

With Positive Steps Fertility, you can be assured that while you strive for success in your professional life, we are working alongside you, dedicating our expertise to help you achieve your most cherished personal goal—building a family.

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In Vitro Fertilization (IVF): The Ultimate Guide

According to the National Survey of Family Growth conducted by the Centers for Disease Control and Prevention, approximately 1 in 8 couples struggle with infertility ––an estimated 49 million couples worldwide. 

Building a family is a milestone for many people. Yet up until the 1960s, many individuals and couples across the world struggled to conceive and start a family. 

Now, modern-day fertility treatments have made families a reality for couples struggling with infertility, with thousands of global organizations helping parents conceive. Thanks to much scientific advancement in the 21st century, we now have modern-day In Vitro Fertilization (IVF) to support individuals on their path toward parenthood. 

What Is In Vitro Fertilization (IVF)? 

IVF is an advanced form of Assisted Reproductive Technology (ART) that helps infertile women and couples conceive. Through IVF, eggs are manually fertilized using a sperm sample from a woman’s partner or donor.

There are many ways to tailor the In Vitro Fertilization process to intended parents, from reciprocal IVF for lesbian couples, to mini IVF treatments for people searching for a lower-impact, less expensive approach to fertility. 

IVF has helped many couples with fertility issues successfully conceive, and may be right for you if you have or experience: 

• Damaged, blocked, or removed fallopian tubes
• Ovulation disorders, uterine fibroids, or premature ovarian failure
• Decreased sperm count or decreased sperm motility
• Unexplained infertility

Additionally, those who are in a same-sex relationships or are intended single parents can achieve their dream of building a family through IVF.

When To Use IVF As Fertility Treatment

Since the introduction of IVF into mainstream medicine in the 1980s, nearly 5 million babies have been born through assisted reproductive technology (ART).

However, it’s also important to understand that IVF does not ensure a successful pregnancy. Some patients require multiple IVF cycles to achieve a successful pregnancy, while others unfortunately never achieve pregnancy at all. 

Good candidates for IVF include: 

• Women with blocked fallopian tubes 
• Women with an infertility disorder ( Polycystic Ovarian Syndrome or Endometriosis)
• Women with irregular cycles of ovulation 
• Male factor infertility

IVF might not be as effective for: 

• Women over 37 years of age (it’s urgent you act quickly for IVF or fertility preservation)
• Women with trouble producing healthy eggs 
• Women with no interest in getting an outside donor 

Because IVF is unique to each patient’s situation, there is no “one-size-fits-all” approach to fertilization. However, medications, blood tests, vaginal ultrasounds, sperm and egg retrieval, fertilization and embryo transfer are all critical elements of the process. 

IVF Process Calendar 

The IVF treatment process can be complex and daunting as a patient. It is important that you be as informed as possible throughout the entire process.

The IVF process has many elements: 

1. Consultation and Testing 

When the IVF cycle begins, your clinic will order a number of pre-treatment tests. Some tests are mandated by state and federal law, while testing required by your clinician is customized to you. These tests often include a baseline ultrasound, bloodwork, and a semen analysis for the male partner to assess your fertility challenges and possibilities.  However, other tests may also be required.

2. Ovarian Stimulation 

Ovarian stimulation is a critical part of egg production. By using fertility medications , women can prepare for egg retrieval and increase their chances of a successful pregnancy. Oral and injectable fertility medications are often recommended in addition to hormones for optimal results. This may be conducted with a transvaginal ultrasound to determine when the eggs have matured.

3. Egg Retrieval 

During the egg retrieval process , patients will receive general anesthesia to sleep during the procedure. Next, the eggs are then retrieved by placing a needle through the vaginal wall and into the ovary––and suctioned from the growing follicles and collected into test tubes. Finally, the test tubes are passed to the waiting embryologist. Here's what the egg retrieval calendar might look like: 

4. Fertilization 

Once the eggs are in the laboratory, they will be visualized under a microscope and prepared for fertilization with either fresh or frozen sperm. A process called ICSI or Intracytoplasmic Sperm Injection is then performed to inject one healthy sperm into each of the viable eggs.

5. Embryo Freezing and Genetic Testing 

The following morning, the embryologist will be able to determine how many embryos have formed. The embryos will typically spend 5-7 days in the laboratory before they are ready to be frozen, or transferred back to the uterus. Frozen embryos tend to have better success rates. Most patients will choose to test embryos for genetic or chromosome abnormalities prior to embryo transfer through preimplantation genetic screening or preimplantation genetic diagnosis. 

6. Embryo Transfer

Preparing for your embryo transfer is one of the most important processes in your IVF journey. Patients at PFCLA may receive an IVF embryo transfer calendar that resembles the following: 

On the day of embryo transfer , the embryos will be graded based on their cell growth and development. This grading system, along with the patient’s age, will help the physician and patient to decide on the appropriate number of embryos to transfer.

An embryo transfer procedure feels similar to a pap smear and is performed while the patient is awake. To start, the cervix is visualized and cleaned. Then, a very thin catheter (tube) loaded with the embryo(s) is placed gently through the cervix and into the uterine cavity. The embryo(s) are placed near the top of the uterus using ultrasound guidance.

7. Pregnancy Test (Two Weeks After the Embryo Transfer)

Approximately ten days after the transfer, a blood pregnancy test (hCG level) is performed to determine if the patient is pregnant.

IVF vs. IUI

There are multiple available fertility treatments available today , but some are less effective than others. It’s important to talk to your doctor about what will deliver the best chances of pregnancy, so you’re not wasting precious time and money on options that may not be right for you. IUI, or intrauterine insemination, is one of these treatment options that some use because it is minimally invasive, but the success rates are usually far lower than that of IVF.  

After experiencing failed IUIs , many patients turn to IVF as a more reliable fertility treatment. IVF, or in vitro fertilization, oversees most of the stages of conception to increase the chance of a successful pregnancy. Although IUI is a viable and successful fertility treatment option, it is not uncommon for a patient’s first IUI attempt to fail. 

But for most who are experiencing infertility, IUI is an inferior option to IVF because IUI acts only as an assistant to natural conception. For many patients seeking fertility treatment, it can be impossible to achieve pregnancy through IUI, and your doctor may recommend starting with IVF. 

How To Prepare for Your IVF Journey

To prepare for IVF, intended parents will likely need various screenings --semen analysis, uterine exams, ovarian reserve testing, and even a mock embryo transfer. This is critical to your individual IVF success, and everyone’s process will look slightly different. Preparing for IVF requires consideration of your diet, blood testing, exercise, stress, and overall health. 

Before undergoing IVF, your blood work will be used to assess the level of follicle-stimulating hormone (FSH) in your system. This will give the fertility specialist an understanding of the quality and number of eggs you may have. Also, the blood work performed can help note possible incompatibilities between a mother’s blood type and father’s blood type. This blood work is also crucial in determining the presence of potential genetic disorders, viruses, and diseases that could affect the mother or baby’s health if pregnancy is achieved.

Without critical data from ultrasounds and blood work during the IVF process , the chances of a successful pregnancy are much lower, and fertility specialists can’t use the most modern techniques to truly aid patients in their journey to having a child. Additional testing may be part of the IVF process, depending on the challenges you’ve faced in getting pregnant. 

After the embryo transfer, a blood test will be used to measure the pregnancy hormone levels of human chorionic gonadotropin in a woman’s system. The presence of this hormone confirms pregnancy and is typically tested for 11-12 days after an embryo transfer has been performed. 

Fertility Medications and IVF

During IVF, it’s common for fertility doctors to prescribe various fertility medications to their female patients as part of the treatment process. 

These fertility drugs are meant to trigger the release of various hormones and to regulate ovulation. By doing this, women are in essence made more fertile during the procedure, which improves the chances of pregnancy. 

There are common fertility drugs that may be prescribed: 

• Follicle-Stimulating Hormone (FSH) - Additional FSH may be used in addition to clomiphene to help stimulate the production of eggs.
• Human Menopausal Gonadotropin (hMG) - A combination of FSH and LH, and can also be used to supplement the effects of clomiphene.
• Human Chorionic Gonadotropin (hCG) - Used to trigger a woman’s ovaries to release viable eggs.
• Clomid or Serophene (Clomiphene) - A type of estrogen-blocking medication. It triggers the release of GnRH (gonadotropin-releasing hormone), FSH (follicle-stimulating hormone), and LH (luteinizing hormone), which signal your ovaries to produce eggs.

The exact medications and types of drugs required for your treatment will be determined during the consultation process. Keep in mind that some of these medications can be taken orally while others will be administered through injections.

Whatever drugs a patient requires, the effectiveness of these medications will require precise timing. Patients should take their fertility drugs as directed by their fertility specialist. 

All fertility visits must also be attended on schedule to ensure optimal results. The improper dosage or administration of a fertility drug can result in a failed IVF cycle or reduced potential for a successful pregnancy.

Side Effects of the IVF Procedure

When a woman is undergoing IVF treatment, the required fertility drugs can increase specific hormone levels, such as progesterone, to prepare the body for pregnancy. Just as when progesterone levels rise naturally during pregnancy, a patient’s increased progesterone levels during IVF are likely to cause fatigue.

While changes in hormone levels are the most prominent cause of fatigue during IVF, the condition can be further exacerbated by stress or anxiety. 

By the time a woman undergoes IVF treatment, she has often been dealing with infertility issues for at least a year. The worry and anticipation of repeated failed pregnancy attempts can take both a physical and mental toll, so it is understandable that many patients already feel worn down when their IVF journey begins. 

Make sure to talk through all your concerns with your fertility specialist to get peace of mind during treatments and receive resources for further emotional support if needed. This will ensure you feel prepared and comfortable during your IVF treatments. Some helpful resources could be therapy for trauma-related to previous pregnancies, talking to couples who have successfully undergone IVF or joining a support group for couples going through the same process.

Because IVF requires a variety of medications throughout the treatment process, patients undergoing IVF may experience a mixture of different side effects . However, the chances of starting a family through IVF far outweigh the possible side effects. 

If you do experience one of these side effects, know that they are common and can be minimized to prevent discomfort. These side effects include:

• Mild cramping and bloating
• Breast tenderness
• Constipation
• Leaking a small amount of clear or blood-tinged fluid after the procedure
• Mood swings
• Hot flashes

However, more severe risks and complications associated with IVF can include:

• Ectopic pregnancy
• Ovarian hyper-stimulation syndrome (OHSS)
• Ovarian torsion

These complications can bring side effects that should not be ignored. If you're experiencing the following, reach out to your doctor immediately: 

• Pelvic pain
• Blood in urine
• Heavy vaginal bleeding
• A fever over 100.5° F

Your fertility doctor should address the side effects of IVF, as well as offer tips to deal with these symptoms. When experiencing fatigue, cramping and other side effects, it’s recommended you: 

• Sleep for 8-10 hours every night
• Drink plenty of water
• Maintain a healthy, balanced diet
• Use approved over-the-counter pain relievers
• Rest warm compresses on areas of discomfort
• Meditate and use other deep breathing or relaxation techniques

Although mild cramping and pelvic discomfort are common, more severe pain should not be ignored. If your side effects are 

IVF Success Rates and Outcomes

Success rates matter when it comes to the field of IVF, especially with surrogacy. Using the most experienced clinics with great success rates can provide you a better chance of having a successful pregnancy and birth, resulting in a healthy baby (or babies). You can ask any doctor or clinic for their success rates and protocols.

By having a conversation with your doctor about what you can expect, you’ll know what will and won’t be possible throughout your fertility journey. When it comes down to how many embryos will be implanted and what’s safe for you or your surrogate, trust your doctor’s counsel and let him guide you on the right path.

• Since 1985 the success rate of achieving a live birth from IVF has increased from 5% to 30% (SART). 
• The Centers for Disease Control and Prevention (CDC) recorded 231,936 fertility treatment cycles in America in 2015. Of that number, 99 percent of fertility treatments involved in vitro fertilization (IVF) . 
• The overall median age for women undergoing ART is 35.
• The CDC reports 186,157 ART cycles in which an embryo was transferred. Of these 186,175 procedures, 60,778 resulted in live births. 
• Through ART , 72,913 infants were delivered in 2015.
• When fresh non-donor eggs or embryos were used in ART procedures, the CDC noted an 81.6 percent success rate, meaning live birth of a child or multiple children; 16.3 percent of ART procedures resulted in pregnancy loss.

Out of nearly 118,000 cycle starts from intended egg retrievals including all embryo transfers record by SART performed in the United States in 2020, under 29%  (SART)  resulted in live births. By contrast, PFCLA has an over 44%   (SART)   live birth rate from cycle start per intended egg retrieval including all embryo transfers.

Bear in mind that comparing clinics to one another is rarely an ‘apples to apples’ comparison, as different clinics and the physicians therein take different profiles of patients based on age, risk factors and services offered (whether an egg donor was used etc…). The best thing you can do to understand your personal IVF profile is consult with a physician. 

Begin Your IVF Journey With Top-Rated Fertility Care

Building a family has never been more accessible and successful than ever. If you’re coping with infertility blues or looking to start your family but don’t know how, you don’t have to wait any longer to take steps toward this dream. 

The fertility specialists at Pacific Fertility Center would be happy to answer any further questions you may have regarding in vitro fertilization (IVF) and your surrogacy options. Contact us to get started today.

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Note: This is not intended to be a substitute for professional medical advice, diagnosis or treatment. Information provided is for general educational purposes only and is subject to change without notice. Speak to your doctor directly with any questions you may have regarding a medical condition. Any information contained herein does not replace any care plan as determined by a physician.

¹Birth rate percentage using aggregate data from ALL age groups on the Live Births Per Intended Egg Retrieval (ALL EMBRYO TRANSFERS) of Patient's Own Eggs chart for 2020. Reference: PFCLA SART | NATIONAL SART

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What the IVF Process Is Really Like

A mom who went through IVF explains what the journey was like from start to finish and offers advice to other hopeful parents.

I remember meeting with a reproductive specialist for the very first time. She explained to my husband and me the process of in vitro fertilization (IVF) using complicated charts and diagrams. It was shocking. Until that meeting, I had no idea how little I knew about what it takes to get pregnant. I'd never really had to think about it since I had previously conceived without medical treatment. Keyword: Had .

Now that we were trying to have another child "later in life," suddenly, all those aspects of human reproduction I'd never given a second thought to post-middle school sex-ed were my whole world.

I was 38 years old, and according to the Society for Assisted Reproductive Treatments (SART), I had about a 16.9% chance of having a live birth after undergoing IVF. Given everything I was about to go through, the percentage didn't seem too high. In fact, the IVF journey I was about to embark upon would push me beyond what I thought I was capable of.

How Long Does the IVF Process Take?

In the movies, an entire IVF cycle seems like no time. You inject yourself with a few hormones, and then—poof!—you're pregnant. In reality, our doctor talked us through all the steps involved, including the egg fertilization cycle and the transfer cycle.

If everything went perfectly, I would start my egg fertilization cycle that July and hope to be pregnant that October. That time frame felt especially brutal to me since we'd just suffered a pregnancy loss at almost six months along. So, it would take almost a year to return to where I was. That felt impossible.

The IVF Process Start to Finish

I showed up at my fertility clinic with $8,000 in cash. Talk about a leap of faith. That day, we fully committed to the IVF journey. It felt exciting, yes, because you hope so darn much it'll work. But more than that, I felt overwhelmed. Was I really going to go through with all of this? Just a few days later, I had my answer.

The beginning of an IVF cycle

Upon using oral meds to induce my period, which marks the beginning of a cycle, we were suddenly deep into hormones and monitoring. Something else that seemed insurmountable was all the injections I'd need to take to do this. Let's just say if you have a fear of shots, you'll need to get over it real quick to do IVF. I was in disbelief when my first shipment from the specialty pharmacy arrived at our home. The instructions were incredibly detailed, and, geez , we thought, we aren't doctors! Yet, there we were, mixing up meds and drawing up syringes each night.

Yup, the stomach is where you start with the shots. The hormones you inject at this stage are administered via fairly small needles. Nonetheless, I would grow terribly black and blue and get very bloated—a side effect of the egg stimulation hormones. There were other side effects, too, like extreme moodiness. That, coupled with the depression over our loss and my anxiety about whether all these injections would even succeed in getting me pregnant—well, it was a lot.

Another shocking aspect of this part of the IVF process is how often I needed blood work and ultrasounds. My hormone levels were being closely followed, as were the size of the follicles being stimulated by the drugs. Some weeks, I had blood drawn and a wand inserted in me just once. In other weeks, it was almost every day. Since our IVF clinic was 45 minutes from our house, this was a lot, especially with my husband's and my jobs and our kids, ages 9, 6, and 3.

I remember one time I went for morning monitoring at 5 a.m. These appointments always felt really heavy. I would look around at the others who were having their blood drawn in the cubicles around mine. They were as beat up as I was from the meds, the monitoring, and the worry. There was just this sense that every one of them had been through something—maybe a loss like me or previous failed IVF cycles. Disappointment, shame, and grief hung in the air like a fog.

To make this process seem less intense, the phlebotomists would always play music, and once, the song "Spirit in the Sky" came on. A phlebotomist practically tripped over patients in a rush to turn it off. That's how fragile some of us were. A lyric like, "Goin' up to the spirit in the sky / That's where I'm gonna go when I die," could do us in.

The egg retrieval process

After weeks of injections and monitoring, I was ready for my egg retrieval. This procedure is done under sedation, which felt like a really big deal. But the procedure was fine. It was waiting for the results that nearly gave me a panic attack.

You see, I was told the odds were that I would get one or two healthy eggs. Of those, perhaps only one would reach the embryo stage after fertilization using my husband's sperm. "If we were lucky" was a phrase I heard a lot. Luck? Yup, it seemed in addition to science, we'd need that, too.

The transfer cycle

Luck was on our side—we got several healthy embryos.

Nonetheless, I felt acutely aware of how many people weren't as "lucky" as I moved on to the next phase: the transfer cycle. Again, my doctor waited until I got my period to begin my next round of meds. These shots were no joke, with needles big enough to make me sweat. They would go in my rear end now. What a treat.

I also needed help to psych myself up each night. I held a baby hat and played Led Zeppelin while I bent over the sink, and my husband plunged a needle into my butt. Some spots hurt worse than others. I cried every time.

About four weeks later, my transfer was scheduled. Again, I felt so lucky to get here. This time, you are awake for the procedure. It's strange. The whole thing feels super clinical, even though you are about to—hopefully—get pregnant.

Several people are in the room, including a doctor, a nurse, and someone who brings your tiny embryo into the room in an incubator. The weirdest thing about it is how they verify it's your embryo via a series of numbers. I hope that's really mine , I remember thinking. But here we go!

The transfer itself is quick but painful. Your legs are spread with the speculum inserted like you're about to get a Pap smear as the doctor inserts this tube inside of you. I watched that embryo float up into my uterus on a screen. All my hopes and dreams were encapsulated in that microscopic dot. Would it become the child we'd been yearning for?

The waiting period

We'd have to wait 10 excruciating days to find out if it worked. During that time, I cried a lot, fearing the worst. Had I done all of this for nothing? It was tough not to go there. Finally, the day came when I went in for my blood test to determine if I was pregnant.

My nurse said I could take a home pregnancy test if I wanted, but I couldn't bring myself to do it. Instead, I decided to wait for that all-important phone call. When it came, I froze and didn't answer. In fact, I didn't listen to the voicemail for about an hour. When I'd built up the courage, I listened to the message.

And I was pregnant! I couldn't believe it.

After a positive pregnancy test

This was the best possible news, of course. But I was about to learn my IVF journey wasn't over.

To continue to support the pregnancy, I would inject myself with progesterone for the next eight weeks. I want to tell you these shots were easier since I was pregnant, but they weren't. At this point, I'd be getting jabbed with needles for six months. I was exhausted, and I still had an entire pregnancy to go through!

I think that's one of the hardest things about the IVF process. You have already been through so much by the time you get to the pregnancy test—it's daunting, no matter what happens next.

Case in point: Although I was blessed to give birth to my healthy son after that IVF cycle, we tried again a year and a half later, using an embryo we'd frozen. Amazingly, I got pregnant again. But at seven weeks, I miscarried. The loss killed me emotionally—I'd done all those injections and put my family through all that stress, plus I spent thousands of dollars and ended up with nothing.

It hurt. A lot. The most painful moment came when my doctor said I could just stop the injections. There was no reason to take them anymore. Suddenly, not needing those needles I so dreaded felt beyond sad. In fact, I'll confess that years later, I haven't been able to bring myself to throw them away since they are my only real connection to the baby we lost.

Finding Support for Your IVF Process

The good news is there are tons of resources for IVF patients—specifically, I was pointed to videos that walked us through every step of preparing and administering the injections. My fertility clinic also had an emergency line that we might have called a few times in a panic that we'd timed or mixed something wrong.

Luckily, I also had a great partner who huddled in the bathroom with me each night and encouraged me to take deep breaths while he plunged needle after needle into my tummy. I always felt supported and seen—although no one can truly understand what the IVF process is like unless they themselves are going through it.

Unfortunately, I didn't know anyone else who had done IVF, so I also felt incredibly isolated. I looked online for IVF support groups, but if I'm being honest, I didn't linger too long there. It's hard not to read what others are going through and apply it to your own experience, good or bad. I found it best to focus on my own journey and used yoga and meditation to find calm amid the storm of emotions and fears I was navigating.

The Bottom Line

I'd tell anyone considering IVF that firstly, you should know beyond a shadow of a doubt you want to get pregnant; secondly, it'll test you physically, emotionally, and financially.

It was almost a blessing that I didn't know what my IVF journey would entail, or else I'm not sure I could have done it. But even though it was difficult, and even though it drained my bank account and taxed my emotions and body in ways I will never fully recover from, I am so grateful IVF exists because we wouldn't have our son without it.

Related Articles

The IVF Journey | Part One: Introduction to IVF

A primer on in vitro fertilization and important considerations before beginning treatment.

By Lauren Lisle

Medical Experts: Jordan Rush, MD, OB-GYN ; Desireé McCarthy-Keith, MD, MPH

If you’re contemplating in vitro fertilization (IVF), either with a partner or solo, you likely have questions about the process. While the amount of information available on the procedure itself is quite vast, there’s plenty to mull over before choosing to explore fertility treatments to arrive at the best decision for you. We’ll help you understand what the process entails and how to best prepare, plus give you expert advice from fertility specialists.

What is IVF and How Does it Work?

IVF stands for in vitro fertilization. It is a common type of assisted reproductive technology (ART) that can aid with fertilization, embryo development, and implantation to increase your chances of getting pregnant. 

In IVF, a combination of medications and surgical procedures are used to retrieve mature eggs from ovaries to be fertilized by sperm in a lab. These fertilized eggs (embryos) are then implanted into the uterus. This procedure can be done using a couple’s own eggs and sperm, or eggs, sperm, or embryos from a donor.

Who is a Good Candidate for IVF Treatment?

There are different reasons to consider IVF, such as cases of unexplained infertility, advanced maternal age, becoming a single parent by choice, surrogacy, or the presence of certain health conditions , including endometriosis, uterine fibroids, and fallopian tube damage.

“The best candidates for IVF are patients with tubal factor infertility (blocked tubes),” specifies Jordan Rush, MD, OB-GYN at Northside Women’s Specialists, part of Pediatrix Medical Group in Atlanta, Georgia. “These patients qualify as candidates for initial treatment with IVF/embryo transfer.”

Additionally, a good candidate for IVF success has “healthy egg quality and reserve and normal sperm from a partner or donor,” explains Desireé McCarthy-Keith, MD, MPH, medical director of Shady Grove Fertility Atlanta, specializing in obstetrics and gynecology, reproductive endocrinology, and infertility. To do this, “egg reserve is assessed by ultrasound of the ovaries and blood testing for [certain hormone] levels. Sperm function is measured by microscopic semen analysis,” she says.

Some explore IVF after less-invasive fertility methods have been unsuccessful, such as intrauterine insemination (IUI). In vitro is also a reproductive option for same-sex couples , or for anyone interested in using donor eggs, sperm, embryo(s) or employing a gestational carrier.

How Much Does IVF Cost?

It’s difficult to know how much treatment will cost beforehand, and it’s somewhat dependent on where you live or your insurance benefits. 

According to the National Conference of State Legislatures, the average cost of a single IVF cycle in the United States is between $12,000 and $17,000, but this total does not include medication or additional tests and procedures—some of which are optional, some not depending on the clinic—that can be added to the base price. A recent article in “Forbes Health” reports that medication alone can account for up to 35 percent of overall charges, and because each patient’s individual medication needs are different, the range of cost is likely closer to $15,000 to $20,000 or more per cycle.

How you approach IVF will also affect the price. For example, the cost of non-donor IVF differs from that with a donor; another example is using a frozen embryo for implantation, which comes with cryopreservation and storage fees. The best place to start planning financially for treatment is to ask your provider for facility recommendations and learn about their treatment options.

What Should I Look for in a Facility and Provider?

“ You should seek a fertility clinic with well-trained and experienced health care physicians and embryologists,” says Dr. McCarthy-Keith, while adding that individuals should research potential facilities’ treatment success rates and clinic reviews online.

“Look for a clinic that is supportive and patient-focused. While many patients focus primarily on the financial preparations for IVF treatment, it is equally important to ensure that you are physically, emotionally, and psychologically prepared. Going through fertility testing and fertility treatment (as well as the side effects) can be stressful and emotional, so ensuring that you have a good support system and effective ways to cope with the ups and downs of treatment is key,” she explains.

From a provider standpoint, Dr. Rush agrees that how often a physician is successful is also important and notes other signs to observe.

“Considerations for selecting a provider include their pregnancy success rates (live newborn births not including miscarriage), the cost of the IVF cycle and whether they reimburse for a failed cycle, whether they have a dedicated physician or a number of providers, and whether they have their own lab/embryologist,” says Dr. Rush. He adds, “The [potential] clinic should allow you to interview them prior to proceeding with treatment, so that you are familiar and comfortable with their process.”

Some common interview questions and concerns Dr. Rush receives from new patients include options for unused embryos, how many eggs will be used in the process, and whether eggs, sperm, and embryos are stored on-site or at a different location.

How Long Does Treatment Take?

“The IVF process typically lasts six to eight weeks from initial consultation to transfer of the embryo(s),” explains Dr. Rush. However, the process involves many steps that can take longer in some cases. “Week one consists of the initial visit and consults; a clinical workup is also performed, and financial information is discussed. Weeks two through four involve prep, usually including either birth control pills or Lupron [hormone injections]. Week five is stimulation [of the ovaries] and week seven involves retrieval, fertilization, and then hopefully embryo transfer.” 

Some patients are able to conceive on the first try, but many people need more than one round of IVF to get pregnant. The good news is that IVF treatments do increase your chance of pregnancy if experiencing infertility, though there’s no guarantee that treatment will work for everyone. 

How Successful is IVF?

According to the Centers for Disease Control and Prevention (CDC), ART success rates vary in the context of patient and treatment characteristics, such as age, infertility diagnosis, number of embryos transferred, type of ART procedure, use of techniques, and history of previous births, miscarriages, and ART cycles.

The CDC compiles national statistics for all ART procedures performed in the U.S., including IVF, which accounts for 99% of the procedures. The latest report from 2018 shows that 48.8% of IVF transfers in women ages 35 and under (with or without prior ART cycles) resulted in a live birth, and the rates continue to decrease with age:

• Ages 35-37: 44.1%
• Ages 38-40: 37.6%
• Ages 41-42: 26.6%
• Ages 43 and older: 12%

What Should I Do Before Starting Treatment?

IVF is both physically and emotionally demanding, but there are ways to prepare yourself to increase your chances of conception.

• Eat a healthy, well-balanced diet
• Avoid processed foods
• Maintain a healthy weight
• Take prenatal vitamins and a folic acid supplement
• Stop smoking, drinking alcohol, and using recreational drugs
• Avoid travel to any countries or regions that may put you at risk of exposure to significant infectious diseases, which could delay treatment
• Reduce or eliminate your caffeine intake
• Decrease stress and anxiety levels
• Join an infertility support group

In addition, Dr. Rush advises patients “become familiar with the required testing, medications, and other steps in the process; and to be aware of the associated risks, including multiple gestation , increased rate of prematurity, miscarriage, and ectopic pregnancy (pregnancy outside of the uterus).”

Even without complications, in vitro fertilization can be draining to your mental well-being. “ Psychological counseling is an effective way for patients to foster their mental health and receive support before, during and after treatment,” recommends Dr. McCarthy-Keith.

Ensuring you’re well supported throughout the process is crucial, even in the early days of doing your research. Share your findings with your partner or a trusted friend, and have an open conversation with your provider about considering IVF to receive their guidance before making your next move. 

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What I Wish I'd Known Before Getting IVF

By Zahra Thompson

When you're avoiding getting pregnant, it's easy to feel like one little slip-up will end with a bun in the oven. The possibility can create a lot of vigilance around taking your birth control pills , making sure you always use condoms properly, or even opting for an IUD for that extra level of protection. That's why when some women are finally ready to get pregnant and can't, it seems like an especially cruel twist of fate. Even though in vitro fertilization exists, it's usually not the one-shot, silver-bullet infertility solution it's made out to be.

" IVF is not a guaranteed pregnancy," Brian Levine, M.D., New York practice director for the Colorado Center for Reproductive Medicine , tells SELF. During each cycle of IVF, the majority of women have a success rate of 20-35 percent, according to Resolve , the National Infertility Association. (Keep in mind that a couple with no fertility issues has about a 15-20 percent chance of conceiving each month.) That doesn't mean your chances of getting pregnant with IVF are doomed, just that there's no one-size-fits-all way to go about it. "It's very rare that I have a couple I can't treat, but people have to understand what treatment involves," says Levine.

Namely, IVF may require shots to stimulate your ovaries , other medications to help the eggs mature and prevent premature ovulation, timing your medications properly, getting blood drawn or undergoing vaginal ultrasounds, and dealing with financial strain to top it all off, says Levine. While IVF has made many women's dreams come true, "people quite often don't ever think this is how they're going to start their family," he says. Here, eight women share what they wish they'd known before embarking upon the IVF journey.

1. I wish I'd known how it would change my relationship with my husband.

"My husband and I went through IVF after we tried to conceive naturally for more than three years, and we had success with our second round. I'm currently pregnant with our first child, due January 15.My husband and I have always been very, very close, but going through a major health journey like this for two years brought us even closer than I could have imagined. It turned into a wonderful experience (minus the needles and being tired all the time).

My husband actually passed away very suddenly five weeks ago, a week and a half after our egg transfer and only a few days before I found out I was pregnant. I have really wonderful memories of how incredibly supportive he was and all the hours spent talking about how we wanted to raise our little one. Infertility and IVF are such a roller coaster, but my husband and I went into the experience with a very positive attitude." —Jessica F., 29

2. I wish I'd known that for me, adoption was the answer.

"I did five intrauterine inseminations and six rounds of IVF between 2004 and 2007, including one with donor sperm. I also did a frozen embryo transfer with donor embryos. Receiving the package of IVF meds in the mail was so exciting, then we'd get to the embryo transfer and the excruciating two-week wait to see if it worked. Twice, it did and was so thrilling, but both times, something was wrong with the embryo and I lost the pregnancy.

By Katie Camero

By Jenna Ryu

By Sarah Klein, CPT

I wish I'd known from the start how happy I would be as an adoptive mom. I adopted my son after my treatments failed, and I now have the most amazing 8-year-old boy. If the price I had to pay to be his mom was four years of treatments and two miscarriages, then so be it. He was worth the trouble." —Teena M., 48

3. I wish I'd known how often I'd fail.

"I can sum up IVF in three (overused) words: blood, sweat, and tears . You truly don't know how resilient, how strong, and how determined you are until you experience IVF and come out on the other side. But it is something you absolutely must take step by step. It's so easy to get ahead of yourself and set timelines and goals that you will almost undoubtedly fail to reach. With every procedure, every cycle, every phone call with pregnancy results, you must take a deep breath and just concentrate on the next step." — Katie A ., 34

4. I wish I'd known to get other opinions.

"My husband and I went through three cycles of IVF. The process the first time around was definitely new, but by the third time, it actually became strangely routine. I recommend people do whatever they can to stay sane during the process and be extra good to themselves! Also know that it’s OK to get a second or even third opinion. Many patients feel beholden to their doctors and don’t trust their guts. It’s vital that you feel a connection with your doctor and are enthusiastic about the protocol they are recommending. It’s an emotional and important journey, and you should feel good about who is treating you." —Jennifer P., 42

5. I wish I'd known that it doesn't always take the first time around. Or the second. Or the fourth.

"I went through five rounds of IVF and finally just had a baby. Initially, I started off hopefully. Then I would feel sad, then I would feel angry. I also felt like a total failure and would get really down on myself. I wish I'd known so much: Don't count on the first round working. Go to a counselor to help you sort through your feelings. Stick with self-preservation, avoid baby showers, and stay away from social media if you need to. Don’t tell people, or they will constantly ask you the status (if it takes, you want to be in the clear, and if it doesn’t, you won’t want to talk about it). And know your limit mentally and financially. After my fifth round, I planned on it not working and I was ready to move on with my life knowing I tried everything. Once I was getting ready to throw in the towel, IVF worked." —M. Lynn, 38

6. I wish I'd known that it helps to talk about it.

"It was a long road of trying—and losing—before we explored IVF. Most of my pregnancies (there have been many) self-terminated before the eight-week mark. After tests, we realized I carry a chromosomal abnormality, which was likely why babies we produced naturally weren't developing as they should. IVF with preimplantation genetic diagnosis (PGD) was our only option if I wanted to become pregnant with my own healthy child and carry it to term.

I’m not sure there’s anything anyone could have told me to help prepare me—there are the injections and medications, then several appointments for blood tests and ultrasounds, and it's physically exhausting and painful. But just being able to talk to someone about it is helpful. Everyone I know who's gone through IVF has had their own unique experience. I wish I’d been more open to talking about it during the first round, but I didn’t want anyone to know." —Monica H., 38

7. I'm glad I knew that different clinics do things differently.

"I had several pre-existing health conditions that made it unsafe to carry my own child. We went through IVF so we could have a gestational surrogate carry our child. My husband and I were very hopeful. We knew this was our family's story and that made it special.

I did a ton of research on clinics before moving forward with IVF because my doctors only approved me for one round due to my other health conditions. We had to nail it. My research uncovered that IVF philosophies differ from clinic to clinic. Some of the more well known clinics in my area put every patient on the same cycle, and every patient would have their procedures done on the same day, and never on weekends or holidays. But every woman is different. When one woman may be ready for the extraction, another woman could go another day or two on hormone shots in order to get more eggs. The clinic I ended up choosing did cycles and procedures according to when MY body was ready. Our IVF doctor and nurses came in on the July 4th holiday for our transfer! Now we have 15-month old twins, one boy and one girl." —Rachel K., 38

Quotes have been edited and condensed for clarity.

Watch: Women Openly Share What It Feels Like To Be Told You Can't Have Kids

Photo Credit: Illustration by Jocelyn Runice

SELF does not provide medical advice, diagnosis, or treatment. Any information published on this website or by this brand is not intended as a substitute for medical advice, and you should not take any action before consulting with a healthcare professional.

Home > Blog > The IVF journey and what to expect

The IVF journey and what to expect

IVF is often referred to as a journey. It’s not just a single procedure, but a process, involving multiple hospital visits, a variety of medication, physical and emotional challenges and a lot of waiting. 

It’s therefore important to be mentally and physically prepared before you begin your IVF cycle, as feeling informed about what you can expect is a great way to start.

Is IVF the right treatment for me?

Your GP may have referred you to a fertility specialist, if you have been trying unsuccessfully to conceive or there are reasons why conceiving naturally is not an option for you. 

You may have tried IUI already, without success, or you may have damaged or blocked fallopian tubes, making IVF your best option.

Your specialist will conduct a variety of tests and assessments of you (and your partner if heterosexual) which may include blood tests, an ultrasound to assess your ovaries and a semen analysis. They will also ask about your family history and any known genetic problems or fertility issues.

What can I do before I start my IVF cycle?

Counselling may be recommended before you start. You should also consider your lifestyle, as having a healthy diet and a healthy lifestyle in general, can have a positive impact on your fertility and the future health of your child. We have blog posts on our site which provide useful information about fertility diets and guidelines on what to do and what not to do for your best chance of conceiving.

You will also need to make sure that you are available to attend all appointments, often at relatively short notice. As IVF treatment depends very much on how and when your body reacts to the drugs, the timetable is individual to you and flexibility is important.

When will my treatment start? 

Your IVF cycle will start on the first day of your period. 

How does the IVF process start?

Usually, the process starts with fertility drugs to stimulate your ovaries to release more eggs. The medication will be administered by self-injection at home. Your fertility specialist will show you how to do the injections.

You will be asked to have scans and possibly blood tests during the stimulation stage, to observe how the follicles are responding to the medication. 

When your follicles are ready, you will have an injection to mature the eggs, so they will be ready for collection.

What happens during egg collection?

Egg collection takes place 36-40 hours after the trigger injection. You will be given a light sedative to make you sleepy during the egg removal procedure, which will take around half an hour.

Eggs are collected using a fine needle, which is passed through the vaginal wall, with the help of a scanning probe. 

Due to the sedation, you will need to rest after the procedure and have someone with you. Your clinic will advise you on any other possible precautions, which include not driving and not operating machinery for 24 hours.

What happens with sperm collection?

If you are using a sperm donor, the sample will have been produced much earlier and frozen, to allow time to assess for any genetic abnormalities or infections.

If you are using your partner’s sperm, a sample will need to be produced at the clinic on the same day as egg collection and a private room will be provided to do this.

After egg collection, you may be advised to take medication, to help to prepare the lining of your uterus ready for potential embryo transfer, if viable embryos are produced.

What happens in the insemination process? 

The best sperm are selected and added to the eggs in a special dish. If you are having ICSI, the sperm will be injected into each egg.  The dishes are then put into an incubator to enable fertilisation.

What happens next?

In the laboratory, experts will check to see if fertilisation has taken place and how any embryos are developing. 

Your fertility clinic will keep you informed on the development of any embryos.

What happens during embryo transfer?

If any of the embryos are viable, five days after egg collection, you will need to go to the clinic for embryo transfer.

A catheter will be used to transfer either one or two embryos into your uterus. Only one or two embryos are transferred, to reduce the risk of multiple births. You may choose to have any other viable embryos stored to use in a later IVF cycle.   

When will I know if the IVF has worked?

Your clinic will invite you in for a pregnancy test, at least 7 days after embryo transfer. It is advisable to wait for the clinic to do a test, rather than being tempted to do a test at home, as due to the medication and the timing, you may otherwise get either a false positive, or a false negative.

Pregnancy test results 

The clinic will tell you whether or not the treatment has resulted in pregnancy. 

If the test is positive, you will be told when to attend the clinic for a scan and given any further advice that you need for your pregnancy.

If you have a negative test, your clinic will be able to support you and talk about what your next steps may be.

Here at the IVF network, we know how challenging the IVF process can be, so we provide information and advice through our dedicated channel, blog posts and website, to help you to make informed choices throughout your fertility journey. 

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A typical IVF journey

A typical IVF journey, whether it is for the first time or trying again, can also be called a ‘stimulated cycle’. This is because your treatment will involve taking drugs that stimulate your body so we can collect a number of eggs for fertilisation.

If you’re not sure which options are best for you, you can attend one of our FREE information events or contact your local clinic to understand your options.

1. Referrals

Your referral may come from your GP or hospital doctor, or you can self-refer. Learn more about the referrals process .

2. Pre-treatment

Preliminary fertility assessment tests and screening

To make the best decision about your treatment in the consultation, your doctor needs the results of some tests. There may be a combination of blood tests and a vaginal ultrasound scan to assess your ovaries, and a semen assessment where appropriate. Learn more about TFP fertility assessment packages .

Initial consultation

At your first consultation with a TFP fertility specialist, they will cover your medical history and explain your test results. You and your doctor will then discuss their recommended programme of treatment based on your personal results and circumstances.

3. Counselling

Counselling is available at any stage of your treatment pathway. Fertility treatment is a significant emotional journey for all patients, and counselling provides extra emotional support.

It is completely confidential. If you are going to be using donated eggs or sperm for your treatment, then you’ll be recommended to see the counsellor before starting treatment to discuss the implications for both you and any children that may be born. Learn more about fertility counselling .

4.Treatment planning appointment

At your treatment planning appointment one of our specialist fertility nurses will explain your treatment in full. You will be taken through your regime of drugs and shown how to use them.

You will have the opportunity to ask questions regarding your forthcoming treatment. It’s also the time when you officially consent to undergo fertility treatment , and we go over the legal side of things.

This is an important part of the process which ensures that your parenthood will be recognised legally after treatment. We require that everyone involved in the treatment comes to the treatment planning appointment. It generally takes 60 minutes. We use an online consent platform where you will be able to watch videos prior to electronically signing your consent. If you are funding your own treatment, you will need to pay for your treatment programme at this point. Once all the tests, consent forms and payment are completed, you are ready to start your IVF cycle. Learn more about the treatment planning appointment . 

5. Starting treatment

Your treatment will start on the first day of your period. You will need to call the clinic to let us know and to receive the instruction to start the treatment plan, as explained by your fertility specialist in your consultation and nurse in your planning appointment. As you’re not undergoing ovarian stimulation, you may or may not have drugs to take in this cycle; this will be agreed upon with your doctor at your consultation. If you have a regular menstrual cycle, we will monitor you so that we can transfer the embryo(s) at the best point in your ‘natural cycle’.

6. Ovarian stimulation and monitoring

In general, treatment starts with drugs that stimulate your ovaries. This enables us to collect a number of eggs for insemination, rather than the usual single egg. The drugs are injections that can be taken at home – you’ll be shown how to do this.

Over a period of around two weeks of stimulation, you’re likely to have one to three scans and possibly blood tests, to monitor the development of the egg-producing follicles.

These are short appointments that last around 20 minutes, and the results are available later the same day. The timings are different for everyone, because treatment is tailored to suit each patient individually.

7. Trigger injection

Once your follicles are ready, the stimulation period ends with an injection that matures the eggs in the follicles to get them ready for egg collection.

8. Egg collection

The appointment to collect the eggs will take place 36-40 hours after the trigger injection. The procedure takes about half an hour, and you will be given drugs to make you sleepy during the procedure.

With the help of a scanning probe, a very fine needle is passed through the vaginal wall and into the ovary to collect the eggs. Usually, around 80% of follicles contain an egg. As you will have had sedation you cannot drive or operate machinery for 24 hours and you will need someone to stay with you.

9. Providing sperm

If your treatment uses a fresh sperm sample, it will be provided on the same day as the eggs. You provide the sample at the clinic, in one of our andrology (men’s) rooms. If you’re providing the sample via a surgical procedure, this will take place before the egg collection day, and the sample will be be frozen.

If you already have sperm in storage , or have been matched to a sperm donor, the sample will be thawed on the same day that the eggs are collected.

10. Insemination of the eggs

The sperm sample provided is prepared to ensure that the very best sperm are being used for insemination.

IVF – Prepared sperm will be added to the eggs in a culture dish.

ICSI – A single sperm will be selected and injected into each egg then put into a culture dish.

The culture dishes are placed in the incubator to allow fertilisation to take place.

11. Embryo development

The embryos are carefully monitored in the period after insemination, first to check for fertilisation, then for signs for development which indicate the embryo is growing. Time-lapse monitoring allows us to carefully monitor embryo development. Click here to learn more about time-lapse monitoring . The clinic will be able to update you on embryo development.

Shortly after egg collection, you may also start taking drugs to help prepare your uterus lining to receive an embryo (this is known as Luteal Phase Support).

If your treatment plan includes genetic testing, then this will happen during this phase.

12. Embryo transfer

The frozen embryo transfer takes place 5 days after egg collection. The embryos are monitored carefully in the Embryoscope by our Embryologists. The procedure can feel like a smear test, but it takes longer: around 15 minutes. A tiny drop of culture medium containing one or two embryos is carefully deposited in the uterus using a thin catheter.

If you decided before treatment to store any further good quality embryos for further cycles, you’ll be consulted again, and it will happen at this stage.

13. The wait

At TFP fertility clinic we appreciate how difficult this two-week wait can be. Please call us at any time if you are concerned; no worry is too small. It’s a good idea to make plans for after embryo transfer to help you feel more in control. Try to live life as normally as possible.

14. The outcome

Positive test.

If you’re pregnant, we schedule a scan in the clinic at around six to eight weeks. If everything looks good, then you’re discharged to your GP.

Negative test

If your period arrives before the test is due or if the test is negative, rest assured you are not alone.

We can meet to talk, review your treatment, and consider what the next step will be on your IVF journey. IVF conception often takes place over a number of cycles. You could be ready for a new cycle within a short time, even a couple of months if you have frozen embryos, but this is completely up to you.

Watch these 2 videos about:

What happens when a patient first starts their fertility journey with TFP?

What are the most challenging parts of the IVF journey for patients?

This service is offered in the following clinics:

TFP Belfast Fertility

BT3 9JQ Belfast

028 9009 7315

TFP 92 Harley Street

W1G 7HU London

0207 160 6379

TFP Boston Place Fertility

NW1 6ER London

0203 131 2152

TFP Wessex Fertility

SO15 5QS Southampton

0203 1318630

TFP Thames Valley Fertility

SL6 4BY Maidenhead

01628 702632

TFP Simply Fertility

CM2 8HN Chelmsford

01245 371849

TFP Oxford Fertility

OX4 2HW Oxford

01865 224819

TFP Nurture Fertility

NG10 5QG Nottingham

+44 0115 828 0246

TFP GCRM Fertility

G51 4FD Glasgow

0141 413 0715

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Navigating the IVF Journey: A Step-by-Step Guide for Couples

Introduction

The journey of infertility can be emotionally and physically draining for couples longing to start a family. In recent years, In Vitro Fertilization (IVF) has offered renewed hope to many struggling with infertility. While IVF can be a complex and daunting process, understanding each step can empower couples and make the journey more manageable. In this comprehensive guide, we will walk you through the IVF process step by step, helping you navigate this transformative journey towards parenthood.

Step 1: Consultation and Evaluation

The first crucial step in the IVF journey is seeking a consultation with a reproductive specialist. During this initial meeting, you and your partner will discuss your medical history, any previous fertility treatments, and undergo a series of tests to assess your overall health and fertility. These tests may include blood work, ultrasound scans, and semen analysis. The results will help your doctor determine the most suitable treatment plan for your unique situation.

Step 2: Ovarian Stimulation

Once your doctor has gathered all the necessary information, the next phase is ovarian stimulation. This step involves the use of medication to stimulate your ovaries to produce multiple eggs. The goal is to retrieve a sufficient number of mature eggs for fertilization. The process is closely monitored through ultrasounds and blood tests to ensure the optimal timing for egg retrieval.

Step 3: Egg Retrieval

When the eggs are deemed mature, a minor surgical procedure known as egg retrieval is performed. Under light anesthesia, your doctor will use a thin needle to extract the eggs from your ovaries. This is typically an outpatient procedure, and you will recover within a few hours.

Step 4: Fertilization

After egg retrieval, your partner will provide a semen sample, or if needed, donor sperm can be used. The eggs and sperm are then combined in a laboratory dish for fertilization through traditional IVF or Intracytoplasmic Sperm Injection (ICSI). ICSI involves injecting a single sperm directly into an egg. The fertilized eggs, now called embryos, are closely monitored for development.

Step 5: Embryo Culture and Selection

The embryos are cultured in a controlled environment for several days, typically five or six. During this time, they undergo various developmental stages. Your doctor will assess their quality and select the healthiest embryos for transfer. The remaining viable embryos can be cryopreserved (frozen) for future use.

Step 6: Embryo Transfer

One of the most anticipated moments of the IVF journey is the embryo transfer. This is a relatively simple and painless procedure where selected embryos are placed into the uterus through a thin catheter. Your doctor will guide the catheter using ultrasound for precision. After the transfer, you will rest for a short time before going home.

Step 7: The Two-Week Wait

Following the embryo transfer, couples enter the “two-week wait” period. This is when patience is essential, as you eagerly await the results of a pregnancy test. It’s essential to follow your doctor’s post-transfer guidelines and take any prescribed medications to support the process.

Step 8: Pregnancy Test and Beyond

Approximately two weeks after the embryo transfer, you will undergo a blood test to determine if pregnancy has occurred. If the test is positive, congratulations! You will continue working with your fertility specialist for ongoing prenatal care. If the result is negative, your doctor will discuss next steps and potential options.

The IVF journey is a remarkable path to parenthood, offering hope and possibilities to couples facing infertility challenges. While it can be a challenging process, understanding each step can alleviate some of the anxiety associated with it. Remember that you are not alone on this journey, and there is a supportive community of medical professionals, counselors, and fellow couples who have walked the same path. Stay hopeful, stay informed, and know that many couples have successfully navigated the IVF journey to welcome the family they’ve always dreamed of.

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Navigating the Emotional Journey of Infertility: Coping Strategies and Support

The emotional journey of infertility can be complex and challenging for individuals and couples struggling to conceive. Often involving a wide range of overlapping and sometimes conflicting emotions, facing fertility issues can make people feel like they’re all alone in their struggle.

However, every cloud has a silver lining. While infertility is undeniably one of the most difficult diagnoses to receive, you’re never truly alone. The Prelude Network® was created for patients, by patients – this personal connection to the struggle of infertility and the world of fertility care serves as our guiding light. We know what you’re going through because many of the people behind Prelude have been there themselves. In this blog post, we’ve provided an overview of some of the emotions that commonly come up when facing infertility, as well as some helpful coping and support strategies to help make your journey a little easier.

Emotions Linked with Infertility

The following emotions can occur before, during, and after an infertility diagnosis.

Shock and Disbelief: Even when a person suspects there may be some problems with infertility, getting a diagnosis often results in an initial feeling of shock and disbelief. 

Anger and Resentment: As the reality of an infertility diagnosis sets in, anger and resentment are common emotions. The anger may be targeted toward oneself or others, such as family or friends who have had no problem getting pregnant.

Depression and Anxiety: Experiencing infertility, even before you are officially diagnosed, can be a real struggle as you deal with medical interventions, ongoing uncertainty, and getting your hopes up, only to become disappointed. Sometimes these experiences can lead to anxiety and/or depression.

Grief and Loss : Many people with infertility experience grief and loss because they are mourning the loss of their dream of being a parent. The grief is often as intense as the feelings experienced in any other type of significant loss.

Isolation and Shame: Surprisingly, people with infertility can experience a sense of isolation from experiencing themselves as being different from others who are successful in their family planning efforts. Shame can result from feeling one is unable to fulfill the expectations of becoming a parent. 

Acceptance and Adaptability: After integrating positive coping strategies, many people find themselves able to reach a stage of acceptance, eventually adapting their family planning goals, expectations, and plans.

Hope and Optimism: Despite the many challenges of dealing with infertility, people often find hope in exploring the many fertility treatment options available. Adopting some positive coping tools and finding support can also make a huge difference.

Coping with Infertility

Coping with infertility and its accompanying emotions can be challenging, but learning about your options and integrating coping strategies can help. Each person’s experience is unique, so you can adopt the tips and suggestions that work best for you.

Seek Support: Many people find it helpful to reach out to friends and family members to discuss their feelings and struggles with infertility. Others seek out support from support groups; connecting with others who have experienced infertility can provide a sense of acceptance and shared empathy.

Communicate Openly: Infertility is known to strain relationships. If you have a partner, it’s crucial to maintain open, honest communication, which will help you process feelings of anger, resentment, guilt, or other emotions. 

Practice Yoga, Mindfulness, or Meditation : Practicing mindfulness or meditation can help you manage emotions such as racing thoughts, anxiety, and stress.

Seek Help When Needed: When dealing with infertility causes your emotions to become unmanageable, it may be time to seek mental health treatment. A therapist can offer a safe space to process your emotions and develop healthy coping strategies.

Take Up Journaling: Journaling helps many people get a sense of clarity about life events they are going through. Writing in a journal can help you process your emotions and reflect on your infertility journey. 

Practice Self-care: Avoid self-blame, remember that infertility is not your fault. Replace negative thoughts with those that are positive and empowering. Employing mindfulness and other empowering techniques can help you transform your thinking patterns. And remember, you are not defined solely by your fertility.

Prelude Resources

As part of our commitment to helping people navigate through infertility and fertility care, no matter where they are in their journey, The Prelude Network offers educational and support resources, including monthly on-demand webcasts. Hosted by Prelude’s Chief Compassion Officer, Dr. Alice Dormer, these sessions offer indispensable tools and information to manage stress and nurture emotional well-being. To sign up for upcoming sessions, click here .

Here are some recordings from past sessions:

• Stress and Fertility
• Coping with Pregnancy Loss
• Lifestyle and Fertility
• Telling your child they are donor conceived
• Impact of Infertility on Romantic Relationships
• Coping through the Holidays

The Next Steps 

Many individuals and couples have discovered how to use coping strategies and ask for support to advocate for themselves and navigate the complexities of dealing with infertility. The clinics within The Prelude’s Network are committed to providing compassionate fertility care while supporting your emotional needs during every step of the family planning journey. Contact The Prelude Network® to learn about the next steps in your fertility journey.

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THE IN FERTILITY JOURNEY

"Go confidently in the direction of your dreams.  Live the life you have imagined."

                                                                                                   ~henry david thoreau, board-certified fertility specialist & professor at, northwestern medicine, the infertility journey, available on amazon, recent blog posts.

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FERTILITY EXPERT

Dr. Jain is an expert in all aspects of fertility treatment including ovulation induction, IUI, in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), fertility preservation, pre-implantation genetic screening (PGS), hysteroscopy & laparoscopy.

INFERTILITY BOOK

'The Infertility Journey' is a unique, comprehensive & best fertility book to help anybody dealing with infertility.  

By being empowered with the right information, this book will lead you to the most efficient path to success. 

INFERTILITY BLOG

Dr. Jain is internationally known for his research contributions to the field of infertility.

Read his frequently updated infertility blog postings.  Gain insight on the last fertility news and studies.

ABOUT DR. JAIN

Dr. Tarun Jain is a Board Certified Reproductive Endocrinology & Infertility (REI) Physician.  He is a Professor at Northwestern University Feinberg School of Medicine .

Dr. Jain is the Medical Director of Northwestern Medicine Fertility & Reproductive Medicine - West Region .

Dr. Jain is Chair of the Practice Committee for the Society for Assisted Reproductive Technology (SART) .

Dr. Jain is the Section Editor & Social Media Editor of Reproductive Biology & Endocrinology Journal.

Dr. Jain is on the Editorial Board of Fertility & Sterility Reviews Journal.

Dr. Jain has received numerous clinical awards including selection to Castle Connolly Top Infertility Doctors  in America.

Dr. Jain completed his fellowship at Brigham & Women's Hospital / Harvard Medical School in Boston, MA and his residency at the University of Washington in Seattle, WA.

Dr. Jain holds dual Bachelor of Science degrees in Biomedical & Electrical Engineering from the University of Southern California , a Master of Science in Biomedical Engineering from the University of Texas at Austin , and an MD with Highest Distinction from the University of Southern California Keck School of Medicine .

Dr. Jain is also an accomplished researcher who is recognized internationally for his work on mandated insurance coverage for IVF, and reducing disparities in access to infertility care.

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Woman Turns IVF Needles into Art During Infertility Journey, Now Empowers Others Through Her Paintings (Exclusive)

During her fertility journey, Jamie Kushner Blicher underwent two IVF retrievals, four IVF transfers and experienced two miscarriages

Courtesy of Jamie Blicher

Jamie Kushner Blicher has always been creative.

The Bethesda, Md. local began painting as a child, a passion that persisted through high school, where she delved into various mixed media projects.

In 2015, art took on a newfound significance in her life. During that time, she and her husband, Brian, embarked on their fertility journey. But after trying naturally for a year without success, she underwent two IVF retrievals, four IVF transfers — two of which were unsuccessful — and experienced two miscarriages.

"I really started to paint a lot because that was getting me through all of the pain, stress, frustration, anger, all of these emotions," Kushner Blicher shares exclusively with PEOPLE in an interview. "I was kind of venting through the work."

Ashley Fisher

After her second miscarriage in 2015, Kushner Blicher found herself in her art studio, feeling helpless. It was there, amidst a pile of her IVF needles, that inspiration struck. She wondered, "What would happen if I paint with the needle? What would come out?"

So, she picked up a sterile needle and began to experiment.

"All of a sudden, I was like, 'Oh my God, this is a living metaphor that I'm trying to control the uncontrollable, creating beauty out of the chaos,'" she adds. "What was coming out was just so beautiful."

From that moment on, Kushner Blicher dedicated herself to painting every day with her needles. She eventually created an Instagram and TikTok account, Glitter Enthusiast , to share her work and tell her infertility story.

"When I first posted, I got 40 messages of people going through the same thing," she says. "It was so fulfilling to me that other people would find what I find beautiful and would find shared experience and what I was doing."

In March 2016, Kushner Blicher turned her social media account into an official business. Last year, she quit her job in marketing to pursue painting full-time.

Each year, she says she completes around 60 commissions using other people's sterile, unused IVF needles. Additionally, she produces prints of her artwork for fertility clinics and transforms them into fabric for headbands and towels.

She adds how a portion of the profits to various fertility organizations, including ones that provide grants to people who can't afford IVF.

"I've had people will walk into a house and see a Glitter Enthusiast piece on their wall, and ask the owner how the art was made," she says. "The owner will share and [the] person that's coming into their house will tell them that I went through IVF also."

"Then they talk and share their stories and comfort each other. And that conversation that would not have happened if they hadn't looked at the art," she continues.

One particularly meaningful piece Kushner Blicher created was for a couple in Arizona who struggled with infertility for five years. When she first connected with the couple they sat on the phone together crying for 45 minutes.

"She told me she saw my art online and it made her feel like she was a part of something," she recalls. "I painted for her, and I gave her the painting for free because she needed a lifeline."

"They got the painting, and then two months later they got pregnant and now they have two kids," she adds.

In 2018, Kushner Blicher and Brian welcomed their own miracle when they became parents to two boys, Ethan and Bennett, using the remaining embryos from their IVF treatments.

She says how she's passed her love for art on to her twins, incorporating them into her work and teaching them about her creative process.

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"If you ask the boys 'What's IVF?' they say, it's just a different way to make a baby," Kushner Blicher says. "They don't understand the scientific concept of it because they're only five."

She continues, "But they would tell you that mommy has always wanted to be a mommy. She had a doctor's help, and now she helps other people become mommies through her art."

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On Father's Day, a dad cherishes the child he feared infertility would prevent

Courtney Freeman first met her husband, Jake, when he visited her mom’s house for a holiday gathering in 2020. Their moms were friends, and all she knew about her future spouse was that Jake Freeman was a welder whose work took him constantly on the road.

The two clicked almost immediately and married the following year, making a home near The Woodlands, a leafy, master-planned community in the north Houston suburbs. They were ready to build a family. But after a year of unsuccessful attempts , the couple learned Jake struggled with male infertility , a diagnosis medical professionals say has become increasingly common.

The couple is now overjoyed to mark Jake’s first Father's Day as a dad. After pursuing fertility treatment, they'll be celebrating the gift they thought they might never have: their son, Walker, who was born in April.

“It’s amazing,” said Courtney, a 27-year-old ICU nurse. “I can’t even put into words how lucky and blessed we are. We’re so thankful for him every day.”

Infertility is a global health issue, according to the World Health Organization, thought to affect at least one in six people during their lives.

Couples are generally deemed infertile after they've tried for a year without success to conceive, said Jason Griffith, a reproductive endocrinologist in Houston and board member of RESOLVE: The National Infertility Association.

About 80% of infertility cases can be pegged to an identifiable diagnosis, Griffith said, and men's health accounts for or contributes to roughly half of cases. One study published by Canadian researchers in 2019 found that 1 in 20 men worldwide faced reduced fertility.

Causes of male fertility tend to fall into two categories, according to Griffith – it's either a problem with sperm production or obstruction of the reproductive tract. Diagnoses are determined through bloodwork, imaging or exploratory medical procedures.

For some men, learning they have a low sperm count or they’re unlikely to be able to father biological children prompts self-doubt and questions about their manhood.

“It is a direct challenge to how they view themselves, and that can be difficult,” Griffith said.

However, the conversations that follow the diagnosis have evolved in recent years. The medical profession increasingly views infertility as a disease, and a growing willingness to discuss the issue, aided by personal testimonies on social media , has nudged it out of the shadows, gradually erasing the stigma the issue once had.

Earlier this year, former “Bachelor” star Colton Underwood opened up about his struggles with low sperm counts as he and husband Jordan Brown looked to become fathers. Similar issues plagued chef Gordon Ramsay and wife Tana, who eventually turned to in vitro fertilization (IVF) to become parents.

Other celebrities who have gone public with their infertility challenges include actor Tom Arnold, whose struggles with low sperm counts date back to his college days; and British speedster Toby Trice , who now fights to decrease the stigma of male fertility by driving race cars featuring the logo of fertility organization TestHim.

“A lot has changed for the better when it comes to perception of infertility,” Griffith said. “It’s less of a private issue. People realize they’re not struggling alone with this.”

Sharing his story to 'pay it forward'

Jake Freeman, 34, is a man of few words but hasn’t shied away from discussing his experience. “It is what it is,” he said.

He hopes his story will inspire other men struggling with male infertility.

“His exact words were ‘to pay it forward,’” said his wife, Courtney. “He’s always been very open about it, as in it’s just our journey and that’s how we got our gift.”

When they first started trying to get pregnant, Courtney, who is a nurse, tracked everything closely – circling dates on calendars, noting peak times to have sex or not to have sex.

Jake had already started to feel resigned to not having kids; fatherhood had never really been a priority for him, he said, and it wasn’t until marriage that he began to consider it seriously.

When they disclosed what they'd learned to Jake’s parents, they discovered something Jake never knew about himself: Around the time he was finishing high school, he developed a painful kidney stone requiring surgery. In the process, doctors noticed he had a varicocele, in which veins swell around a testicle and block proper blood drainage, a condition that can hamper sperm production.

Jake describes it simply as “there’s too much heat for the sperm.”

Doctors had told his parents the condition might cause fertility issues later, but they never shared that news with him. Still, the couple had suspected something was wrong.

“Really, we knew,” Courtney said. “You can tell his testicle is different. It feels like a ball of veins.”

The growing causes of male infertility

Varioceles are one of the more common causes of male infertility, said Laura Detti, chief of fertility services at the Family Fertility Center operated by Texas Children’s Hospital in Houston, where the Freemans found help. Other causes include retrograde ejaculation, in which semen travels backward into the body, and rarer conditions linked to cystic fibrosis.

Low sperm counts are another cause, the condition that can result from long-term illness, chromosome issues or childhood infections such as mumps, according to the Urology Care Foundation.

Doctors have also begun to see more sperm abnormalities caused by testosterone products men use to build muscle or treat sexual dysfunction, Detti said.

“These products cause testes to function less, and they will not produce good quality sperm for as long as the products are taken,” she said.

The first step in diagnosing infertility is doing a semen analysis that looks at the volume of the ejaculate and concentration of sperm, as well as their structure and mobility, Griffith said. If irregularities appear in successive tests, providers can do additional testing depending on the severity of the abnormality.

Across the board, sperm counts have been dropping over the generations , a phenomenon researchers can’t fully explain. In 2022, epidemiologist Hagai Levine of Hadassah University Medical Center in Jerusalem found that counts dropped by more than 1% annually from 1973 to 2000 and 2.6% between 2000 and 2018, which he characterized as “an amazing pace.”

The underlying reasons for this phenomenon, Griffith said, could involve a combination of environmental pollutants, hormone-treated food products or struggles with obesity and chronic disease. But no one is really sure.

Deciding to see a fertility specialist

In late 2022, after a year of trying, the Freemans decided it was time to see a fertility specialist. Tests confirmed that Jake’s sperm count was severely low.

The first doctor they saw said they had little chance of conceiving naturally and that their only option was IVF, a procedure they preferred to avoid.

For Courtney, in her mid-20s, the diagnosis hit hard, and she knew Jake felt bad for her as well.

“From the time I was a little kid, I always wanted to be a mom,” she said. “I was hopeful, but there was also this feeling of, ‘Is this ever going to happen?’ I kind of doubted it.”

Ultimately, the Freemans learned that Texas Children’s, the sprawling medical system where Courtney worked, also had a fertility center.

A new set of lab tests showed that Jake’s sperm count was just high enough to pursue intrauterine insemination, or IUI. The procedure involves a health care provider inserting sperm directly into the uterus, reducing the obstacles it would normally have to overcome to reach ovulating eggs through the fallopian tubes.

“The cervix is a great filter mechanism,” Griffith said. “Only thousands of sperm make it to the uterus, and only hundreds make it to the tubes. With IUI, you’re getting millions of sperm into the uterus so that thousands make it into the tubes.”

The treatment is recommended for couples if the man's sperm count is high enough for insemination and the woman is under 35 with no obstacles to fertility. For men with extremely low sperm counts, IUI is unlikely to overcome that deficit.

“Sperm quality is enhanced, but the sperm still needs to do its job,” Detti said. “It needs to activate once it finds the egg and it has to penetrate the shell surrounding the egg.”

Courtney took Clomid and Ovidrel, medications designed to induce and boost ovulation. A doctor later inserted Jake’s sperm into her cervix using a catheter. Then the couple went home and waited.

When Courtney got her period as scheduled, the two repeated the process the next month. Again, it didn’t take.

A third attempt was delayed because Courtney developed a cyst on her ovary. Nearly five months after they'd begun the process, the Freemans decided if Courtney didn't get pregnant after the third attempt, they’d take a break.

Despite the couple's growing dismay, Courtney said the experience strengthened her relationship with Jake.

“I could see he cared about me,” she said. “He was doing everything he could to make our dream come true.”

'You don't really want to get your hopes up'

In July 2023, Courtney's period failed to come on time. As she prepared to administer a home pregnancy test, she tried not to get excited.

Jake was at work when the test read positive. She called the fertility center, where staff immediately summoned her to the lab for bloodwork. She didn’t want to say anything to Jake until she knew for sure.

The confirmation came back an hour later. The third time had worked.

“I was freaking out,” she recalled. “But until we saw the ultrasound, you don’t really know, you don’t really want to get your hopes up. That’s when it hit us – that we were really pregnant.”

Seeing those images was life-altering, Jake said. “I was like, this is for real now.”

While their journey was physically and emotionally difficult, Courtney said they’d do it all again for the incomparable reward.

Having an infant son, Jake said, makes it even harder to be away at work 10 to 12 hours, but he’s looking forward to celebrating his first Father’s Day as a parent.

“We’ll probably have the family over and cook some ribs or brisket and hang out,” he said. “It feels good. It’s like, ‘Yeah. I’m a dad.’”

How Can You Part With the Embryo That Could Have Been Your Child?

Some IVF patients are turning to a niche medical procedure to find peace.

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One of the first documents patients sign when starting in vitro fertilization asks them to consider the very end of their treatment: What would they like to do with extra embryos, if they have any? The options generally include disposing of them, donating them to science, giving them to another patient, or keeping them in storage, for a cost.

The idea that one might end up with surplus embryos can seem like a distant wish for those just beginning IVF. During treatment, eggs are removed from a woman’s body and fertilized with sperm in the lab to make embryos. These will then be transferred to her uterus, typically one by one, until she gets pregnant. But with advances in reproductive technology, many patients end up with extra embryos after this process is over. Deciding what to do with the leftovers can be surprisingly emotional and morally thorny; even those who are not religious or who support reproductive autonomy might still feel a sense of responsibility for their embryos. So some patients are turning to a lesser-known alternative: a method called “compassionate transfer.” The procedure is essentially an elaborate form of medical make-believe, in which clinicians place a spare embryo in a patient’s body at a time in her menstrual cycle when she is unlikely to get pregnant. It mimics the steps of a traditional embryo transfer, but here, it’s designed to fail; the embryo will naturally flush out.

No one I spoke with in my reporting was sure of compassionate transfer’s origins. One essay published in the South Atlantic Quarterly speculated that the procedure came about to circumvent restrictive IVF laws in countries where clinicians were required to transfer all embryos created via IVF into a patient’s body. Here in the United States, where there are few regulatory limits on fertility treatment , the demand for compassionate transfer speaks to something different: the intense relationship some patients have with leftover embryos, and the lengths they will go to to make peace with their disposal—a peace that, for many other IVF patients, can be elusive.

Read: America’s IVF failure

For the past few years, I’ve lurked on IVF message boards and support groups while going through fertility treatments myself. I’ve observed that although most patients flatly reject the idea that embryos have legal rights—a concept that the Alabama Supreme Court endorsed in February, when it ruled that embryos were children under state law and that people could be held liable for disposing of them—they also don’t see embryos in the same clinical way as they do other by-products of IVF, such as sperm and unfertilized eggs. Online, women share photos of their embryos and refer to them as “embabies.” I’ve seen patients get tattoos of their embryos and hang watercolor paintings of them in their nursery. They dream that these embryos will become their children, and begin to plot them into family trees. But that hope can morph into grief when embryos fail to implant, when a pregnancy ends in miscarriage, or when patients must determine how to part ways with leftover embryos.

Research shows that many patients feel dissatisfied with the traditional options for dealing with these extra embryos. Thawing and throwing them away can feel inhumane to some. As one woman put it in a 2006 paper on the topic, “If you ask ten women in my situation they probably would tell you the same thing: they don’t want them flushed down the toilet.” Others interviewed said they were distrustful of donating embryos to research, in part because of a fear that the embryos would somehow become children. (There is no evidence to support this.) Giving them to infertile couples also left some patients uneasy about their embryos’ ultimate fate. As the paper found, “For many participants, responsibility entailed that the embryo not ever be allowed to develop into a human being.”

Read: The risk and opportunity of online fertility groups

That’s why many simply defer the inevitable and pay to store them. I’ve seen rates ranging from $400 to $1,200 annually, and prices are on the rise . (For reference, my fertility clinic in New York City charges $920 a year.) Today, there may be as many as 1.5 million or more cryopreserved embryos in the United States. About 40 percent will not be used for reproduction. Some people may keep embryos because they’re still trying to have kids, or are unsure if they are completely done, or want to have a backup in case of tragedy. But others know they don’t want more children; a survey conducted in 2006 and 2007 found that 20 percent of that group said they were likely to never take their embryos out of storage . Some of these patients may end up simply abandoning their embryos , failing to pay fees or communicate with clinics. Centers, many of which are already overcrowded due to the rising number of embryos in storage, must then decide by themselves what to do with the embryos, leading to a bureaucratic and ethical mess.

What many seem to desire—and struggle to find—is a way to relinquish their embryos that reflects their significance. To fill this gap, some have created their own makeshift rites. An anonymous questionnaire completed by 703 clinical embryologists around the world found that nearly 18 percent said they’d had patients who wanted some kind of a ceremony for the disposal of their embryos, including reading a prayer, placing a prayer book near the incubator, blessing the embryos, allowing patients to have a moment with them, singing a song to the embryos, and even allowing the embryos to be released to the couple for burial.

Compassionate transfer has much the same purpose. “The point … is the ritual,” explains Megan Allyse, an associate professor of biomedical ethics at Mayo Clinic in Florida, who co-authored a paper arguing that the procedure can be an “ethical extension” of fertility care. As IVF patients go through the process, which follows many of the same steps as a traditional embryo transfer, they may feel that “ I’m saying goodbye to this embryo. The embryo is going back into my body where it came from, and everything’s gonna be fine ,” Allyse told me.

Research on the procedure—and on embryo disposal as a whole—is scant. One small study of fertility doctors in 2018 found that less than half of doctors who’d heard of compassionate transfer had offered it to a patient. In 2020, the American Society for Reproductive Medicine advised that physicians can honor or decline requests for it as long as they don’t discriminate. The group noted that although the procedure can ease some patients’ “moral distress,” it provides no medical benefit and can be seen as an inefficient use of resources. There’s also a chance, however slight, of infections and unintended pregnancies . “Some clinics feel that it’s out of scope for what they are there to do. Their goal is a pregnancy and managing that pregnancy and supporting it, not what happens afterwards,” Allyse said. Plus, it can be expensive. The 2018 study found that 29 percent of doctors who reported their prices for the procedure charged about the same amount for compassionate transfer as for a traditional frozen-embryo transfer. Insurance doesn’t routinely cover IVF, so most patients have to pay out of pocket. Although some policies do have a fertility benefit, it’s unclear if it would apply to compassionate transfer.

Still, though the costs can be high, they’ll likely be lower than storing embryos for years on end. And the risks associated with the procedure are minimal, Allyse told me, especially when weighed against the psychological stress of not knowing what to do with extra embryos. Sigal Klipstein, a physician at InVia Fertility Specialists, in Illinois, and the chair of the American Society for Reproductive Medicine’s ethics committee, told me she gets a handful of requests for compassionate transfer every year, which she provides. “Whatever we can do to help our patients feel good about their decisions and complete their families and move ahead … within the limits of science,” she said.

For some, the procedure can be a balm. Klipstein told me about one IVF couple she worked with who tried to create the precise number of embryos for their ideal family size, which was three children. It almost worked. After many cycles, they had two children and one embryo remaining. But before they had the chance to transfer the final embryo, the couple got pregnant on their own. They didn’t want to have a fourth baby, so, after much discussion, they opted for a compassionate transfer. Shortly after Klipstein performed the procedure, she bumped into the couple at a toy store, looking “kind of sad but happy,” walking through the aisles and picking out gifts for their children. Klipstein wondered if they were commemorating their decision to let go of the final embryo, honoring the baby they didn’t have by celebrating the ones they did.

Unicorns and other mythical creatures IVF Out Loud

• Kids & Family

Listen on Apple Podcasts Requires macOS 11.4 or higher

Welcome to IVF Out Loud, I’m Alison and I’m sharing the humorous and heartbreaking conversations and stories from my infertility journey. Infertility is a deeply personal journey, but no one should journey alone and by speaking about my family’s experience I hope I can provide someone with a laugh, a cry and a community. I am not a medical professional, just a woman who’s been there. This podcast is not a substitute for a conversation with your medical professional. In this episode I'll discuss an unexpected discovery in our IVF Journey. Spoiler alert, I’m a unicorn. Hosted on Acast. See acast.com/privacy for more information.

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Francesca Farago: We didn't just have sex and get pregnant. I've used over a thousand needles, I've put my body through all this stress, you put your body through stress. Eight months of our lives, eight months of not being able to live normally, to get this far - there's so much riding on everything going smoothly.

Jesse Sullivan: Although we intentionally did this and we put so much blood, sweat, and tears into making this happen, once I started seeing the heartbeats on the screen and everything, it felt so real. It sounds so real, because obviously I knew this was going to happen, but it hits you so hard: it's like, we're bringing human beings into this world together.

FF: For me, creating a community of women who have gone through the same thing has been really lovely. I've been really active on Snapchat, and I post how I'm feeling that day or what I'm going through, and I'll get hundreds of reassuring comments from women who have gone through the same thing. And I think it's important to share it because our journey hasn't been shared before. A queer couple doing IVF and being so public about it - I've never seen someone do that. I think it's important for awareness and acceptance and for people to see that we had to go through some extra steps, but we're a regular family as well. It's really important. And also for younger queer kids to know that they can have a life like us. People don't think that it's possible.

JS: Yeah, what Francesca said, as a queer couple telling this story - but more specifically, a trans couple. These sorts of things are so specific to us, and I've never seen a story told like this. Especially right now in the political climate, trans people are so targeted, so I think it's really important. The kinds of messages I've gotten are, like, from a 15-year-old saying, "I didn't ever think I could have a family. You've shown me I can have a family." It's like those simple things that you think all kids should be able to think growing up, and they don't get that.

FF: We're obviously going to be very protective when the babies get here. You want to protect your family, but you also want to be advocating for families like ours. It's a thin line of what to show and what not to show, because it's vulnerable moments that you're sharing.

Jump back to the Radical Honesty issue .

- As told to Lena Felton