In vitro fertilisation (IVF)
IVF is a type of fertility treatment where fertilisation takes place outside the body. It’s suitable for people with a wide range of fertility issues and is one of the most commonly used and successful treatments available for many people. This page introduces you to how IVF works, the risks and success rates.
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What is IVF?
IVF is a common treatment for people who are unable to conceive naturally
Usually in IVF, the woman has medicines (fertility hormones) to stimulate the ovaries to produce several eggs. The eggs are then collected and mixed with sperm in a laboratory.
IVF is carried out when the sperm quality is considered to be ‘normal’ If there are issues with the sperm quality such as low motility or numbers, a procedure called intracytoplasmic sperm injection (ICSI) may instead be used – this is where a single sperm is injected into the egg by an embryologist
If fertilisation is successful, the embryos are allowed to develop for between two and six days. This helps the embryologist to select the strongest embryo, which is then transferred back to the woman’s womb to hopefully continue to a successful birth.
Often several good quality embryos will be created. In these cases, it’s normally best practice to freeze the remaining embryos because putting two embryos back in the womb increases your chance of having twins or triplets, which carries health risks. You can use your frozen embryos later on if your first cycle is unsuccessful or you want to try for another baby.
Find out more about embryo freezing
Who might be recommended to have IVF?
- Women with blocked or damaged fallopian tubes.
- People with unexplained fertility problems, or who have tried other treatments that were unsuccessful.
- Men with low sperm counts or who have high numbers of sperm with an abnormal shape or movement. Where these problems are serious an additional procedure (intracytoplasmic sperm injection or ICSI) may be necessary.
- Women who have difficulty with ovulation and who haven’t been successful with other treatments.
- Older women who are less likely to be successful with less invasive treatments.
- People using surrogacy.
Is there anyone IVF isn’t right for?
Not everyone needs IVF. For example, some problems with ovulation may be corrected with drug treatment alone so it’s important you understand all your options before going ahead.
Find out more about fertility drugs
IVF might not be suitable for some people because it’s very unlikely to succeed, particularly in the case of older women, or those who are at risk of premature menopause. You should talk to your doctor about your personal chances of success with IVF.
How safe is IVF?
IVF is generally very safe and most who have it experience no problems with their health or pregnancy. However, there are some risks to be aware of, which include:
- ovarian hyperstimulation syndrome(a severe reaction to fertility drugs)
- having a multiple pregnancy or birth (twins, triplets or more), which can cause serious health problems to both mum and babies
- having an ectopic pregnancy
- possible birth defects (these are rare and research is still ongoing).
It’s very important you understand all the risks of IVF and know when to spot the symptoms of something serious.
Can I have IVF on the NHS?
It depends on where you live as decisions around who can have IVF on the NHS are made locally rather than nationally. Talk to your GP about what's available in your area.
If you do need to pay for treatment, one cycle of IVF costs £5,000 on average, although this varies considerably. Bear in mind there may be additional costs such as the cost of storing your embryos or going for an initial appointment.
How long does IVF take?
Before you have IVF, you’ll need various appointments with you doctor and/or tests and investigations, so be prepared for it to take some time. It’s not something to take lightly, so take your time to think things through, ask questions and make sure you’re clear on what’s involved and what to expect.
IVF is referred to as a ‘cycle’ of treatment as it involves a number of stages: suppressing natural hormone production, hormone treatment to boost egg supply, egg collection, mixing the eggs and sperm and finally, embryo transfer (more information on the process below). How long it takes depends on your recommended treatment.
For most people, one cycle of IVF will take between four and six weeks. However, for medical reasons some women won’t have the first stage of treatment (suppressing hormone production) which brings their treatment time down to around three weeks. Your doctor will advise you on the most appropriate treatment for you.
How successful is IVF?
As with all fertility treatments, how successful IVF will be depends on the woman’s age and the cause of infertility.
For the latest statistics on IVF, visit our Research and data page.
When we had our first cycle of IVF we just assumed it would work. You read all those 'miracle baby' stories in the media but you rarely hear about the people who weren't successful.
What does IVF involve?
This process outlines a single cycle of IVF following the most commonly used procedure. You may find that your treatment is slightly different depending on your history and what your clinic thinks is best for you.
- Usually, the first step is to use medication to stimulate the ovaries to produce eggs. There are different ways this can be done. One way is to suppress natural hormones before taking hormone medication to stimulate the ovaries. This treatment, often called a long protocol, involves taking a daily injection or nasal spray to suppress hormone production. A scan checks the woman’s natural cycle is fully suppressed. If it is, hormone treatment (usually gonadotrophin) is started to boost the number of eggs the body produces.
- Some clinics may use the ‘antagonist protocol’. This involves taking medication (an antagonist) to suppress your hormones for a few days after you have taken the hormone medication (usually gonadotrophin) to boost the number of eggs the body produces.
- Whichever way the ovaries are stimulated to produce eggs, you will be closely monitored for a few days by the clinic. This may involve having blood tests or ultrasound scans.
- The eggs will be collected whilst under sedation or general anaesthetic. The procedure takes around half an hour and you may feel a little sore or bruised.
- Whilst the eggs are being collected, the man will be asked to come to the clinic to produce a sperm sample, or your donor sperm will be taken from the freezer, for mixing with your eggs.
- Medication will help to prepare the lining of the womb. This is usually taken as a pessary or gel which you can insert yourself into the vagina / rectum.
- The eggs will be mixed with the sperm in a laboratory. The aim is for the eggs and sperm to fertilise to create an embryo.
- If fertilisation happens, the resulting embryo(s), will be monitored to check how it’s/they’re developing. Find out more about the decisions you and your clinic will need to make about your embryos.
- Two to five days after fertilisation, the embryo(s) will be transferred to the womb. You won’t need any kind of anaesthetic for this unless you have a condition that would make the procedure painful. You’ll be given a date to do a pregnancy test. Although you’ll understandably be excited at this stage, try not to do this early as you may get a false result.
What if I can’t/don’t want to take fertility drugs?
It’s possible to have IVF with no fertility drugs at all (natural cycle IVF) or with fewer drugs (mild stimulation IVF and in vitro maturation [IVM]).
These may be appropriate for women who can’t take drugs because of an existing medical condition or who prefer not to for personal reasons. Success rates tend to be lower when you don’t use fertility drugs and, in the case of natural IVF are significantly lower.
What can I do to boost my chances of successful IVF?
Lifestyle factors can affect your chances of getting pregnant and having a healthy pregnancy. Making small changes may boost your chances of success.
What else do I need to bear in mind?
Before treatment can take place, you are required by law to give your informed consent to ensure your sperm, eggs, embryos and personal information are used in a way that you’re happy with.
Read more about consent to treatment
There’s also a high emotional toll with IVF treatment – that’s why it’s so important you get support from people who can relate to what you’re going through.
Find out more about getting emotional support
You may be offered ‘treatment add-ons’ which are optional extras, often charged at an extra cost. To help you ask the right questions and make the right choices for you, visit our treatment add-ons page to get the latest information about the evidence for the most commonly offered. Our traffic light rating system helps you to easily identify which add-ons have been shown to be effective.
Where can I find an IVF clinic?
We have details of every licensed IVF clinic on our website, including their opening times, donor waiting times, success rates and ratings from both patients and our inspectors. It's a great place to start browsing for clinics or to find out a bit more about a clinic you've been referred to.
"We were thrilled to find we were pregnant when the first blastocyst was put back in but then I miscarried at 9 weeks, which was heart-breaking."
I’ve had IVF and it didn’t work – what next?
Many experts recommend that you wait for a couple of months after treatment before trying again. This gives you a break from the stress of treatment and a chance for your body to recover.
It can also be an important time to think about your options and decide whether to continue treatment.
Coping if treatment doesn't work
If you’re planning on trying again after unsuccessful treatment, you will understandably want to feel that you’re doing everything you can to get pregnant. We know that this can be a situation in which some patients and clinics may discuss additional treatments, known as treatment add-ons, which often cost more.
The fact is, there is no conclusive evidence that any of the commonly offered add-ons increase the chance of a pregnancy.
From our partners
IVF funding on the NHS (Fertility Fairness)
Support for everyone struggling to conceive (Fertility Network UK)
Review date: 5 October 2024
