Sometimes, getting pregnant naturally doesn’t happen—even after several months of trying. Other times, you may want to delay family planning. In either case, understanding your options and knowing when to seek medical advice is essential.
If you’re planning to postpone pregnancy, egg freezing is a proactive option that allows you to preserve your fertility and use your eggs later for IVF.
If you’ve already been trying to conceive without success, it’s important to consult a specialist.
- Women under 35 should seek help after 12 months of trying.
- Women over 35 should do so after 6 months.
How IVF Can Help
In vitro fertilization (IVF) can help many couples with fertility challenges achieve pregnancy and fulfill their dream of having a child.
Step 1: Consultation with Your Gynecologist
The fertility journey starts with a detailed consultation. Your doctor will review your medical history and lifestyle. Initial tests, such as progesterone level checks, will be done. Based on the findings, a personalized treatment plan will be created to maximize your chances of success.
Common fertility challenges may include:
- Endometriosis
- Male infertility (low sperm count or motility)
- Blocked fallopian tubes
- Erectile dysfunction
- Unexplained infertility
- Previous unsuccessful treatments (ovulation induction, IUI)
- Pelvic inflammatory disease, fibroids, polyps
- Irregular menstrual cycles
- Sexually transmitted infections
- Polycystic ovary syndrome (PCOS)
- Advanced maternal age
In some cases, options like egg donation or surrogacy may be discussed.
Step 2: Monitoring Your Cycle
If proceeding with your own eggs, your menstrual cycle will be closely monitored. Sometimes, medications are used to regulate the cycle. For example, treatment may be needed to induce menstruation and ensure the ovaries begin at a consistent baseline.
Step 3: Ovarian Stimulation
The next phase is ovarian stimulation, which encourages the development of multiple eggs.
- Most women receive gonadotropin injections for 10–12 days.
- Monitoring includes regular ultrasounds and hormone tests.
- When a sufficient number of mature follicles develop and the endometrial lining reaches 17–18 mm, an hCG injection is given to trigger ovulation.
- Egg retrieval follows 35–36 hours later.
- Egg retrieval follows 35–36 hours later.
For women at risk of ovarian hyperstimulation (e.g., with PCOS), an antagonist protocol with an agonist trigger is used. In such cases, embryo transfer is done in a future cycle to reduce risk.
If stimulation is not used (natural cycle IVF), the single egg produced naturally is tracked through ultrasounds and hormone tests, and retrieved at the appropriate time.
In women with low ovarian reserve or poor response, mild stimulation (mini IVF) or natural IVF may be the best approach.
Step 4: Egg Retrieval
Egg collection is performed in the IVF unit and takes about 15–30 minutes under light sedation. Patients arrive early in the morning after fasting for at least half an hour.
- Eggs are collected using an ultrasound-guided needle.
- Retrieved eggs are placed in a culture medium.
- A sperm sample is provided by the partner or donor on the same day.
- Fertilization occurs in the lab, and patients can return home later that day.
Step 5: Fertilization and Embryo Development
Eggs are either:
- Combined with sperm for standard IVF, or
- Fertilized via ICSI (intracytoplasmic sperm injection), especially in cases of low sperm count or azoospermia.
In some cases, sperm is retrieved directly from the:
- Epididymis (PESA)
- Testicle (TESA)
- Testicular tissue (TESE)
Techniques like assisted hatching may also be used to help the embryo implant more easily.
Step 6: Embryo Transfer
Embryo transfer takes place 3 or 5 days after egg retrieval.
- A thin catheter is used to place the embryo(s) into the uterus—no anesthesia required.
- Usually 1 or 2 embryos are transferred, depending on your age and medical history.
Remaining embryos can be frozen for future use.
Step 7: Pregnancy Test
Two weeks after egg retrieval, an hCG blood test is done.
- If positive, the test is repeated after 48 hours.
- An ultrasound is performed two weeks later to confirm embryo development and detect the heartbeat.
If Pregnancy Is Not Achieved
If the IVF cycle is unsuccessful—or before your first attempt—additional testing may be needed, especially in cases of recurrent miscarriages or implantation failure.
These may include:
- Karyotyping (chromosomal analysis of both partners)
- Thrombophilia and immune testing
- Endometrial microbiome testing
- Hysteroscopy, to check for uterine issues such as adhesions, polyps, fibroids, or chronic inflammation
An endometrial biopsy can also be taken to check for lining abnormalities.
Preimplantation Genetic Testing (PGT)
In cases of:
- Advanced maternal age
- Recurrent miscarriages
- Known genetic conditions (e.g., thalassemia, cystic fibrosis)
PGT may be recommended. This involves:
- Biopsy of the embryo at the blastocyst stage (day 5)
- Embryo freezing while awaiting test results
- Transfer of only genetically healthy embryos in a future cycle