If you have trouble getting pregnant, in vitro fertilization (IVF) may enable you to start a family. Using IVF, doctors can help people achieve pregnancy by combining an egg and sperm in a laboratory. The resulting embryo gets returned to the person's uterus.
At UPMC, our fertility centers have years of success in helping people achieve pregnancy and build families through IVF.
IVF is the most common type of assisted reproductive technology (ART).
Normally, an egg is fertilized in the fallopian tube by a sperm. When the embryo (fertilized egg) implants (attaches) to the uterine lining, pregnancy occurs. If the embryo grows, a baby is born about nine months later.
When people experience male or female infertility, it may be difficult to conceive naturally. Many people choose to seek fertility treatments to help get pregnant.
In IVF, doctors remove eggs from the ovaries and combine them with sperm in a lab in hopes of forming an embryo. Then, they return the embryo to the woman’s uterus. If the embryo implants in the lining of the uterus and grows, pregnancy results.
IVF began in 1978 but is now a common practice for couples facing infertility and same-sex couples who want to have children. Doctors usually recommend IVF after trying other, less costly methods of boosting fertility. More than 2% of all babies born in the U.S. are now conceived through IVF.
IVF also serves another purpose. It allows people to use fertility-preservation services to save eggs or sperm to have children later. People undergoing fertility-harming treatments for cancer, sickle cell anemia, or lupus may opt for fertility preservation.
There are two main types of IVF:
IVF can get you pregnant. However, there’s no guarantee of pregnancy with IVF. Your results can vary based on many factors, including your overall health, the cause of your infertility, and your age.
About 50% of IVF procedures in women aged 35 and younger result in a live birth. The number drops to about 25% for those aged 38 to 40. For women 42 and older, only about 4% of IVF procedures result in a live birth.
It’s important to talk to your doctor about your chances of achieving pregnancy through IVF.
If you’ve tried other fertility treatments without success, you might be a good candidate for IVF.
Common reasons doctors recommend IVF include:
In general, if you’re under 35, you should see a fertility specialist if you’ve been trying to get pregnant for more than 12 months. For women over 35, wait only six months. If you’re over 40, you should seek immediate evaluation and treatment for infertility.
You might be a good candidate for IVF if you:
IVF involves large amounts of time, money, and energy. IVF can be both a difficult physical and emotional journey and has no guarantee of success. There are other factors to consider as well.
Some of the risks and complications of IVF include:
Doctors call each attempt at IVF a cycle. Each cycle takes about six to eight weeks to start and can last two to three weeks from the start of medication to the conclusion, depending on various treatment plans. If a cycle doesn’t produce a pregnancy, the patient and their doctor can discuss whether another cycle should be started.
IVF is a complex procedure with several steps. You’ll need to visit the doctor’s office or fertility clinic several times.
At the beginning of your IVF cycle, you should come to the doctor's office around the third day of your menstrual cycle. Doctors will do baseline bloodwork and an ultrasound. Then, they'll give you fertility drugs to boost egg production.
Normally, your ovaries produce one egg (oocyte) per month. But fertility drugs activate the ovaries to produce several eggs.
You may get different types of medications. In general, IVF fertility-boosting treatments can include:
During ovarian stimulation, doctors will check on the progress of developing follicles via ultrasound. Follicles are the fluid-filled cavities that contain the eggs. They'll continue to do bloodwork to see how the eggs are developing.
Once mature follicles are present, you'll receive a trigger shot (ovulation hormone) to finish maturing the eggs).
About 36 hours after you receive a trigger shot, doctors will retrieve your eggs. They'll place you under conscious sedation (sometimes called twilight sedation) through an IV.
First, doctors will pass an ultrasound with a small needle into your vagina. The ultrasound pictures help doctors guide the needle through the vagina to remove the fluid and eggs with the follicles in the ovaries.
The whole process usually takes less than 30 minutes, depending on how many follicles you have.
A specialist called an embryologist will examine your collected eggs to determine their maturity. They will combine mature eggs with semen from your partner or a sperm donor in a culture dish. The dish is then stored in an environmentally controlled chamber.
The sperm usually enters the egg a few hours after insemination. If your doctor thinks the chance of fertilization is low, they'll inject the sperm directly into the egg through ICSI.
About 18 hours later, doctors will examine the eggs to see if fertilization has taken place. When the fertilized egg divides, it becomes an embryo.
You’ll return for embryo transfer about five days after egg retrieval if you are having a fresh transfer. By that time, a normal embryo will have several cells actively dividing.
Before transferring the embryos to the uterus, doctors will grade them and choose the ones that look the healthiest for transfer.
At this stage of embryo development, doctors at UPMC may also perform preimplantation genetic testing (PGT). Genetic testing has evolved to the point where doctors can test an IVF embryo before placing it in the uterus. They can conduct the biopsy starting on the fifth day of development without any harm to the embryo. Typically, embryos are frozen if doing PGT and transferred in another cycle called frozen embryo transfer.
Doctors use genetic testing for couples where one or both carries a known disease that can be passed on to their children. They can screen for hereditary diseases like cystic fibrosis, sickle cell disease, hemophilia, Huntingdon’s disease, and muscular dystrophy. Many people worry about passing these genes on to their children.
Here’s how preimplantation genetic testing works: By the fifth day of development, embryos are hundreds of cells called a blastocyst. Doctors can remove five to ten cells for genetic testing without compromising the developing embryo.
This knowledge helps you and your doctor determine which embryos are safe to transfer to the uterus on day five of development. The goal is to help you achieve a healthy pregnancy and a healthy baby.
Whether or not they perform genetic testing, doctors transfer the embryos by placing a small flexible tube into the uterus. They inject the embryo or embryos through it, guided by ultrasound. The procedure doesn’t hurt, and you don’t need to undergo sedation or anesthesia.
If an embryo or embryos implant in the lining of the uterus, pregnancy occurs.
Your doctor will talk to you about the number of embryos to transfer. They determine the number based on the guidelines of the American Society for Reproductive Medicine.
More and more IVF clinics are encouraging single embryo transfers to reduce the risk of twins and other multiple births. Pregnancies with multiples have higher risk factors for complications — premature birth, low birth weight babies, and preeclampsia (high blood pressure) in the mother.
If you have multiple healthy embryos, UPMC offers cryopreservation (freezing) of embryos. You can use the embryos for future IVF cycles without having to undergo ovarian stimulation.
After the embryo transfer, your doctor will begin giving you progesterone— a hormone that helps maintain early pregnancies — by injection or vaginal suppositories.
You'll have a pregnancy test two weeks after your embryo transfer. If it's negative, the progesterone supplements will be stopped. But if it’s positive, you’ll continue taking progesterone for the first 10 to 12 weeks of pregnancy.
To make sure the pregnancy is developing normally, you’ll have an ultrasound within three to four weeks of the embryo transfer.
After you have an embryo transfer, your doctor may provide instructions for activity following this procedure. Patients often can return to work the same or next day.
You should contact your doctor immediately if you've had IVF and develop:
At UPMC, we provide the latest in fertility services in a warm, welcoming environment. We understand the physical and emotional toll that infertility can take on couples. Our cutting-edge technology plus compassionate care can give you the best chance to build your family.
Last reviewed by a UPMC medical professional on 2024-09-05.
