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What are the stages of IVF treatment?
IVF treatment, in its broadest sense, is the process of fertilizing female and male reproductive cells outside the body in a laboratory environment. Following the first successful IVF birth in England in 1978, this field developed rapidly; today, 1.6% of all live births in the United States and 4.5% in Europe occur through IVF [1].
A treatment process consisting of 5 stages is applied. Although these procedures are standard, the treatment plan is customized according to the couple’s infertility condition. Even though the stages are the same, the medications, applications, or procedures used may differ from one another [1, 2].
“ ”IVF treatment is an effective treatment option for infertility related to many causes, including endometriosis, male-factor infertility, and unexplained infertility. With individualized protocols, the chance of success can be increased significantly.
Additional Methods That Can Be Applied Within IVF Treatment
In addition to the main 5 stages, the following advanced techniques may be applied depending on the couple’s condition [1, 3]:
- Micro-TESE: Testicular biopsy performed under a microscope
- PGD/PGT (Preimplantation Genetic Diagnosis/Testing): Examination of the couple’s embryos and selection of healthy ones when genetic problems are involved
- Assisted Hatching: Thinning of the embryo shell using laser assistance
- Freezing (Frozen/Cryopreservation): Freezing embryos, sperm, and eggs for future use — live birth has been reported even nearly 30 years after frozen embryo preservation [2]
- Embryoscope: Methods used to monitor embryo development under camera observation and select those developing in a healthy way
- ICSI (Intracytoplasmic Sperm Injection): Injecting sperm directly into the egg one by one — especially used in severe male infertility cases [1]
What Are the Steps of the IVF Method?
Stage 1: Initial examination and couple evaluation
The couple’s history of previous treatments, pregnancy, miscarriage, and similar conditions is reviewed. The results of the examinations and tests performed are analyzed [1]. The requested examinations and tests include:
- Semen analysis and, when necessary, ICSI evaluation
- Blood tests for both the woman and the man (FSH, estradiol, AMH, antral follicle count)
- Hysterosalpingography and uterine cavity imaging
- Reports related to previous treatments
- Chromosome analysis and thrombophilia panel (when necessary)
- Reports related to other diseases, if any
According to the results, an individualized treatment plan suitable for the couple is prepared.
Stage 2: Ovarian stimulation and egg development
Through ovarian stimulation, multiple eggs can be obtained from the prospective mother. For this purpose, egg-developing medications and injections are administered. The dosage of the medications and the treatment process vary according to the patient’s age and ovarian reserve (AMH, antral follicle count) [1]. This process takes approximately 8–12 days.
Stage 3: Egg retrieval
The developed eggs are collected under general anesthesia. They are then taken to the laboratory to be fertilized with sperm cells. In cases where no sperm cells are present, a sperm sample can be obtained from the testis through Micro-TESE surgery [1].
Stage 4: IVF or ICSI (microinjection) procedure
Depending on the couple’s infertility condition, either the conventional IVF method or the microinjection method may be applied. In conventional IVF, the sperm and egg are expected to fertilize naturally in the laboratory environment. In microinjection, sperm is injected directly into the egg one by one; this method is especially preferred in severe male infertility [1].
Stage 5: Embryo transfer
The fertilized eggs, which are kept in the laboratory for two to six days, are placed into the uterus with a catheter. It is a completely painless procedure and is completed within 5–10 minutes. Most commonly, day-3 or day-5 embryos are preferred. Twelve days after the transfer procedure, a blood test is performed to determine whether pregnancy has occurred [2].
For detailed information about IVF treatment methods, you can review our page on what are IVF treatment methods.
Frequently Asked Questions (FAQ)
How long does IVF treatment take?
A single IVF cycle takes an average of 4–6 weeks. Ovarian stimulation lasts 8–12 days, egg retrieval takes 1 day, and embryo transfer takes place 2–6 days later. A pregnancy test is performed 12 days after the transfer.
What is the difference between IVF and ICSI (microinjection)?
In conventional IVF, the sperm and egg meet spontaneously in the laboratory environment. In ICSI, a single sperm cell is injected directly into the egg. ICSI is especially preferred in male-factor infertility cases such as low sperm count, poor motility, or abnormal morphology.
Is frozen embryo transfer (FET) more successful than fresh transfer?
Recent data suggest that frozen embryo transfer may provide outcomes equal to or better than fresh transfer, especially in terms of implantation rates and obstetric outcomes. ASRM supports frozen transfer as a standard care approach.
Is PGD/PGT testing necessary?
It is not mandatory for everyone. However, in cases of recurrent miscarriage, advanced maternal age, known genetic disease carrier status, or previous failed IVF attempts, PGD/PGT may increase the chance of success by selecting healthy embryos.
Is there a risk of OHSS (ovarian hyperstimulation syndrome) in IVF?
Yes; although mild symptoms such as nausea and bloating are common, severe OHSS is seen in less than 0.2–1% of all stimulation cycles. The risk is higher in patients with PCOS; therefore, the risk can be reduced with a GnRH antagonist protocol and a freeze-all strategy.
References
- Showell, M. G., et al. (2023). In Vitro Fertilization. StatPearls — NCBI Bookshelf. NBK562266. (https://www.ncbi.nlm.nih.gov/books/NBK562266/)
- American Society for Reproductive Medicine (ASRM). In Vitro Fertilization Treatment Journey. ReproductiveFacts.org. (https://www.reproductivefacts.org/patient-journeys/in-vitro-fertilization-treatment/)
- Singh, A., et al. (2022). Recent Advancements in In Vitro Fertilisation. Cureus. PMC9644046. (https://pmc.ncbi.nlm.nih.gov/articles/PMC9644046/)
- Malizia, B. A., et al. (2009). Live-birth rate associated with repeat in vitro fertilisation treatment cycles. New England Journal of Medicine. PMC4934614. (https://pmc.ncbi.nlm.nih.gov/articles/PMC4934614/)