IVF process explained: steps, IUI vs IVF and what to expect

In short: IVF (in vitro fertilisation) means joining an egg and sperm in a laboratory, then placing the embryo in the womb. The IVF process has a few main steps: tests, hormone treatment to help eggs grow, egg collection, fertilisation in the lab, embryo transfer and a pregnancy test about 2 weeks later. It is different from IUI, where sperm is placed in the womb. Talk to a gynaecologist if you have been trying for a year, or 6 months if you are 35 or older.

If someone has suggested IVF to you, it can feel like a lot to take in, new words, many visits and big hopes. Many couples in India go through it, and it is nothing to feel shy or ashamed about.

Here is the whole journey in simple words, so you know what to expect and what to ask.

What is IVF? (IVF kya hota hai)

IVF stands for in vitro fertilisation. "In vitro" means "in glass", that is, outside the body. In normal conception, sperm meets the egg inside the fallopian tube. In IVF, eggs are taken out of the ovaries and joined with sperm in a laboratory. The embryo that forms is then placed in the womb to grow.

People sometimes call a baby born this way an "IVF baby" or "test tube baby". The pregnancy itself, once it begins, grows like any other.

Who might need IVF?

A gynaecologist may suggest IVF when:

• Both fallopian tubes are blocked or damaged.
• There is a problem with sperm count or movement.
• Ovulation problems, such as with PCOS, have not improved with simpler treatment. Read PCOD vs PCOS to learn more.
• There is endometriosis.
• Simpler treatments like IUI have not worked.
• No cause has been found after full tests, which is called unexplained infertility.

The IVF process, step by step

1. Tests for both partners. Blood tests for hormones and infections, an ultrasound of the womb and ovaries, a test to check your tubes and a semen test.
2. Hormone treatment to help eggs grow. Usually, the ovaries release one egg a month. In IVF, hormone treatment helps several eggs grow at once. You will have regular ultrasound scans and blood tests to see how the eggs are growing.
3. Egg collection. When the eggs are ready, they are collected with a thin needle passed through the vagina, guided by ultrasound. You are given sedation or anaesthesia so you do not feel pain. It takes a short time and you usually go home the same day.
4. Fertilisation in the lab. The eggs are mixed with your partner's or a donor's sperm. Sometimes a single sperm is placed directly into each egg; this is called ICSI.
5. Embryo growth. The embryos grow in the lab for a few days while the team watches their development.
6. Embryo transfer. One embryo, sometimes more, is placed into the womb through a thin, soft tube. It feels like a Pap smear and usually needs no anaesthesia. Extra good-quality embryos can be frozen for later.
7. Pregnancy test. A blood test is done about 2 weeks after the transfer. Your clinic may give hormone support during this wait.

IVF and IUI: what is the difference?

• IUI (intrauterine insemination): Washed sperm is placed directly into the womb around the time of ovulation. Fertilisation happens inside your body, so at least one fallopian tube must be open. It is simpler and quicker, and is often tried first.
• IVF: Eggs are collected and fertilised outside the body, and the embryo is placed in the womb. It works even when the tubes are blocked and is used for more complex problems.

Your gynaecologist will suggest which one suits you based on your age, tests and how long you have been trying.

Is there an age limit for IVF in India?

Yes. India has a law on assisted reproduction (the ART Act) that sets legal age limits for women and men who use IVF and other fertility treatments. Any registered clinic must follow it and will explain the limits to you at your first visit.

Age also affects how well IVF works, because egg number and quality fall with age. This is why it helps not to wait too long before asking for advice, especially after 35.

Caring for your feelings during IVF

IVF can be tiring for the body and the heart. The waiting, the scans and the hope can bring anxiety, and a negative result can feel like real grief. All of this is normal.

• Share the load with your partner and decide together whom to tell.
• Ask your clinic every question you have; no question is silly.
• Rest, eat well and keep up gentle activities you enjoy.
• Talking to a counsellor helps many couples.

You can read more in Managing anxiety during fertility treatments.

When to see a gynaecologist

See a gynaecologist about fertility if you are under 35 and have tried for a year, are 35 or older and have tried for 6 months, are over 40, or have irregular periods, known PCOS, endometriosis or a past pelvic infection.

Go to a doctor the same day if, during or after IVF:

• Your tummy becomes very swollen or painful, or you feel breathless.
• You have repeated vomiting or are passing very little urine.
• You have fever, or foul-smelling discharge with fever.
• You have severe or one-sided tummy pain.
• You have heavy bleeding, soaking a pad every hour for 2 hours or more.
• You have a positive pregnancy test with pain or bleeding.
• You feel faint or dizzy.

Questions women ask

What does IVF mean?

IVF means in vitro fertilisation. Eggs are taken from the ovaries and joined with sperm in a laboratory, and the embryo is placed in the womb. Many people in India also call it "test tube baby" treatment.

What is the difference between IVF and IUI?

In IUI, washed sperm is placed in the womb and fertilisation happens inside your body, so at least one tube must be open. In IVF, fertilisation happens in a lab and the embryo is then placed in the womb. IUI is simpler; IVF is used for more complex problems.

Is there an IVF age limit in India?

Yes. India's ART law sets legal age limits for both women and men who use IVF. A registered clinic must follow these rules and will explain them to you. Your doctor will also talk about how age affects your own chances.

Is IVF treatment painful?

Most steps cause only mild discomfort. Egg collection is done under sedation or anaesthesia, and you may feel crampy or bloated for a day or two afterwards. Embryo transfer usually feels like a Pap smear. Tell your team about any strong pain.

How long does the IVF process take?

One cycle, from starting hormone treatment to the pregnancy test, usually takes several weeks. Tests before you start can add more time. Your clinic will give you a calendar for your own plan, as it differs for each couple.