IVF Procedure Step by Step, 2025: What Every Hopeful Parent Should Know

Celebrated as one of the most groundbreaking innovations in reproductive medicine over the last few decades, in vitro fertilization (IVF) is a boon to couples struggling to conceive naturally.

The resulting embryo is then implanted into the mother’s uterus, where it undergoes natural development.

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In Latin, In vivo means ‘within the living’, referring to the experiments conducted inside a whole, living organism.

In vitro translates to ‘in glass’, describing experiments performed outside a living organism, often in test tubes or petri dishes.

Since the first IVF birth in 1978, more than 12 million babies have been born worldwide with the help of Assisted Reproductive Technology (ART).

Although fertility treatments have become increasingly common in India, some confusion and hesitation around them still exist. So, let us break down the IVF procedure step by step for you.

IVF Procedure Step by Step Breakdown

Pre-IVF Prep

The first step of IVF is, of course, consultation with a reputable IVF specialist in Mumbai. During this visit, the doctor may prescribe hormone tests, ultrasounds, semen analysis, and infectious disease screenings.

Based on these results, a personalized treatment plan is created. The doctor may recommend lifestyle changes such as quitting smoking and alcohol, adopting a balanced diet, and managing stress.

Some women may be advised to take antioxidants and omega-3 fatty acids to help reduce oxidative stress and inflammation, potentially enhancing endometrial receptivity and supporting overall reproductive health.

This important step prepares both your body and mind for the IVF journey ahead, increasing the chances of a successful pregnancy.

Also Read:

Important Questions You Must Ask On Your 1st IVF Consultation

1. Ovarian Stimulation

A woman’s ovaries prepare to produce a bunch of eggs each month. Out of this harvest of eggs, only one lucky egg is naturally selected for ovulation, while the rest degenerate.

For IVF, doctors need to collect multiple eggs to increase the chance of success. To do this, they give fertility medicines that help more eggs mature at the same time.

The doctor decides the type and amount of these medicines based on your age, health, and other important factors. When the eggs are ready, you’ll get a “trigger” injection to help them fully mature, and the eggs will be collected about 36 hours later.

2. Egg Retrieval

Egg retrieval is a minimally invasive procedure performed under sedation. An ultra-thin needle is introduced through the vagina into the ovaries to collect the follicular fluid.

This whole process takes no more than 20 minutes. The mature eggs are extracted from the fluid and incubated in a controlled environment in a lab.

3. Sperm Collection

This happens at the same time as egg retrieval. The male partner provides a semen sample in a private room. In the lab, sperm are separated from the seminal fluid.

Sometimes, the sperm sample may be frozen (cryopreserved) for future use, especially if collection on the day of egg retrieval is not possible or if fertility preservation is planned.

In some cases, ejaculation is not possible, or the sperm count is very low. In such situations, sperm can be surgically retrieved using techniques like TESA (Testicular Sperm Aspiration) or PESA (Percutaneous Epididymal Sperm Aspiration). The healthiest and most viable sperm are then selected for fertilization.

4. Fertilization

 The isolated eggs and sperm are placed together in a lab dish or test tube to allow fertilization. Fertilization occurs through conventional IVF, where sperm and eggs are incubated together and sperm fertilizes the egg on its own.

Alternatively, fertilization can be done by intracytoplasmic sperm injection (ICSI), where a single sperm is directly injected into each egg.

Not all retrieved eggs end up being fertilized; generally, only 1 in 2 eggs do. Once fertilization occurs, the resulting zygote begins cell division to develop into an embryo.

5. Embryo Development

After fertilization, embryos are carefully nurtured in the lab under controlled conditions. They are usually monitored up to Day 3 (the cleavage stage) or allowed to develop further until Day 5 or 6, when they reach the more advanced blastocyst stage.

Doctors observe embryo development without disturbing them, using time-lapse imaging and advanced culture systems like the EmbryoScope — a recent innovation that continuously monitors embryo growth in a stable environment. This helps in selecting the healthiest embryos for transfer.

Only about 1 in 2 embryos typically reach the blastocyst stage, which is considered the optimal time for implantation. The viable embryos are then frozen and stored for future transfer.

At this stage, an optional technique called Assisted Hatching may be performed. It involves making a tiny incision in the outer shell of the embryo to help it “hatch” and attach more easily to the uterine lining.

In some cases, Preimplantation Genetic Testing (PGT) — previously known as PGS — may also be recommended. This test screens embryos for genetic or chromosomal abnormalities to improve the chances of a healthy pregnancy.

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STAGES OF AN EMBRYO

Cleavage Stage (Day 3):

The embryo divides into 6 to 10 cells without increasing in overall size.

Blastocyst Stage (Day 5–6):

The embryo develops into a blastocyst with 100 to 200 cells, a fluid-filled cavity, and begins to form distinct cell layers.

6. Embryo Transfer

This is a quick and simple procedure that usually takes place on Day 3 or Day 5 after fertilization. A soft catheter is used to transfer one or more embryos through the vagina into the uterus. If the embryo successfully implants in the uterine lining, it can lead to a pregnancy.

The number of embryos transferred depends on several factors, including the patient’s age, embryo quality, and medical history. The procedure is mostly painless, requires no sedation, and is typically completed in less than 20 minutes.

7. Pregnancy

After the embryo transfer, signs of pregnancy are closely monitored. A blood test is performed 9 to 14 days after the transfer to check for the hormone human chorionic gonadotropin (hCG), which is produced during pregnancy. A positive result indicates that implantation has occurred.

If the test is positive, follow-up ultrasounds are done in the coming weeks to confirm the location of the embryo and track the early development of the pregnancy.

If the result is negative, the couple can consult their IVF doctor to discuss the next steps. This often involves using frozen embryos for another transfer cycle.

Who Needs IVF?

Wondering if IVF is the right choice for you. The answer is yes, if any of this applies to you:

• You’ve been trying to conceive for over a year without success.
• You’re a woman over the age of 35 and have been trying to get pregnant for more than six months to a year.
• You’ve had repeated miscarriages.
• You’ve been diagnosed with conditions like endometriosis, PCOS, or have poor egg quality.
• You’re a male with low sperm count or poor sperm motility.
• You’re a single parent planning to conceive with the help of donor sperm or donor eggs.

Frequently Asked Questions