What is IVF?

IVF or in vitro fertilisation is a series of procedures to help you to conceive a baby (get pregnant). It’s when eggs are removed from your ovaries and fertilised with sperm in a laboratory.

The fertilised egg (embryo) is put back into your uterus. If the transferred embryo implants this results in pregnancy.

What does the IVF process look like?

IVF is a long process with multiple steps. Each of these steps take place within one menstrual cycle. All the steps together make up one cycle of IVF.

1. Blood test: On day one of your menstrual cycle, you will have a blood test at your fertility clinic.
2. Hormone stimulation: On day 2 or 3 of your menstrual cycle, your hormone stimulation treatment will start. You will start taking medicine to stimulate your follicles so they produce several eggs.
3. Trigger shot: Once your eggs have reached a certain size, you will give yourself an injection containing hormones. The hormones trigger your ovary to mature and release an egg.
4. Egg retrieval: About 34 to 36 hours after the trigger shot, your eggs will be retrieved (collected) in a short procedure. Your fertility specialist will use a thin needle inserted in your vagina wall into your ovaries to retrieve the eggs.
5. Semen sample: If you are using your partner's sperm, they will need to provide a semen sample on the same day as the egg collection. If this is not possible, a surgical procedure can help extract sperm directly from the testicles. You may also use frozen donor sperm.
6. Fertilisation: Healthy sperm and eggs are brought together in a dish and incubated overnight. In some situations, you may need intra cytoplasmic sperm injection (ICSI), which is a procedure where a single healthy sperm is injected into a mature egg. This may be helpful when the sperm quality is low.
7. Embryo transfer: Around 3 to 5 days after egg retrieval, your fertility specialist will place an embryo into your uterus. Usually one embryo is transferred, but sometimes more. In some cases, your fertility specialist will wait to transfer an embryo. Any good quality embryos that are not transferred might be frozen. These can be stored for future use, depending on your individual circumstances.
8. Pregnancy test: After the embryo is transferred, you will need to wait 2 weeks before you can test for pregnancy. Blood tests are more reliable than a home pregnancy test, so it's best to do this at your fertility clinic or through your doctor.

Why might I want to use IVF?

IVF is used to treat infertility and some genetic problems. It may also help people in the sexually- and gender-diverse (LGBTIAQ+) community start a family, as well as single people who would like to become parents.

You may think about using IVF for several reasons, including if you or your partner has:

• low sperm count or low sperm motility
• problems with ovulation due to conditions such as polycystic ovary syndrome
• problems with the fallopian tubes
• been sterilised (had an operation to prevent pregnancy)
• problems with endometriosis or fibroids
• wish to avoid passing on inherited genetic disorders to your children

Some people may choose to use donor sperm or eggs. For example, if a couple is at risk of passing on a serious genetic disorder to their children, they may be advised to use donor sperm or donor eggs.

Cancer treatment can harm fertility. People who have cancer can sometimes have their healthy eggs or sperm frozen before starting treatment. These eggs or sperm can be thawed later and used in IVF once the cancer treatment is over.

Sexually and gender-diverse people (LGBTIQA+) and single people may also choose to use IVF to build a family.

Should I try other fertility treatments first?

For some people, IVF is the preferred treatment right from the start. Your doctor can give you more information about your different options.

You might choose to try other fertility treatments first, such as:

• fertility drugs
• surgery
• artificial insemination

What is the success rate of IVF?

Your chance of success with IVF depends on many factors. Ask your doctor or fertility clinic about your chances of a successful pregnancy and birth.

Some important factors are:

• your age
• your partner or donor's age
• the cause of infertility

You will have a better chance of success with IVF if you are younger than 35 years old. The chance of success decreases (goes down) as you get older. By 44 years, your chance of successfully getting pregnant and having a baby through IVF is about 1 in 100.

Some women need 5 or more cycles of treatment to be successful, while others never become pregnant.

Can single or sexually- and gender-diverse people (LGBTIQA+) people use IVF?

Any Australian can use IVF whether they are single or in a partnership.

The situation for LGBTIQA+ people (who may not be infertile) seeking IVF can vary. For information about IVF that is relevant to your own situation, talk to your doctor or local fertility clinic.

How much does IVF cost?

IVF is costly and takes a lot of time to manage. Repeated cycles can be hard physically and emotionally. IVF can take a toll on the people going through it, and their family.

The financial costs vary, but each cycle of IVF may cost several thousand dollars. You can get a rebate on some IVF items from Medicare, if they are medically necessary for you to get pregnant.

Your private health fund may pay for some aspects of treatment. There are also the costs of medicines, tests, counselling, storage and day surgery. You may also need to take time off work while you have treatment.

If you are considering IVF, it is important to talk to your doctor, the IVF clinic and your private health fund (if you have one) to understand what is covered and any out-of-pocket costs.

How long does IVF take?

IVF takes time. When you are first considering it, you will need to talk to your doctor and get a referral to an IVF clinic or fertility specialist.

You (and your partner) will need to have a number of physical examinations and tests such as ultrasounds, sperm analysis and blood tests before starting any treatment.

Even once you start IVF, you will go through a lot of steps involving visits to clinics and laboratories.

If the first cycle is successful, you are on your way. But if not, you may decide to try again with one or more additional cycles. You may be advised to wait a while between cycles, so speak with your fertility specialist and discuss what is best in your circumstances.

What are the risks of IVF?

It's important to remember that with IVF there is a risk of not getting pregnant, which can be upsetting and emotionally painful.

Medical risks include that the ovaries may be stimulated too much, which can be serious. This is known as ‘ovarian hyperstimulation syndrome' or OHSS.

Does an IVF pregnancy have different risks?

All pregnancies carry a risk of complications. There are many factors that may increase the risk of having a pregnancy complication, including older age (over 38 years), obesity and smoking.

Females who become pregnant through IVF are more likely to experience these complications during their pregnancy:

• vaginal bleeding
• blood clots in early pregnancy
• high blood pressure
• premature birth
• birth by caesarean section
• having a child with a congenital disorder

The risk of complications will depend on your own situation. You should discuss the risks and benefits of having IVF with your doctor or fertility clinic before you start treatment.

How can I cope if having IVF makes me stressed and emotional?

Many couples are not successful in their first IVF cycle — you may need a few cycles of treatment, and some couples do not become pregnant at all.

This can be an emotional process, especially if you have already been trying to have a baby for a few years. You or your partner may also be receiving hormone medications that can affect your mood, potentially impacting on your emotional and sexual relationship.

You will be offered counselling before you begin treatment. You should also consider ongoing counselling to help cope with any emotional or relationship issues that you or your partner may experience.

Joining a fertility support group can also help you cope with any challenges you may experience during IVF treatment.

How can I find an IVF doctor?

Your doctor can refer you to a fertility specialist, IVF clinic or special hospital unit for treatment. Some public hospital units work in partnership with private clinics.

The Fertility Society of Australia has a list of accredited assisted reproduction treatment units for different states.

You should discuss treatment options with your doctor or fertility specialist. However, deciding whether to use IVF is a very personal choice. You will need to consider the financial costs as well as the physical and emotional pressures involved.

FIND A HEALTH SERVICE — The Service Finder can help you find doctors, pharmacies, hospitals and other health services.

What questions should I ask my IVF doctor?

It's a good idea to think about any questions you have about the IVF process and write them down before your appointment.

Here are some questions you might like to ask at your appointment:

• What treatment options are available to me?
• What are the risks and benefits of the treatment plans available?
• Would all IVF procedures be done by my own specialist?
• What IVF success rate do you have for people of my age and with my condition?
• What tests, treatments and medicines are covered by Medicare or private insurance? Which are not?
• How many cycles of IVF treatment a year are funded by Medicare? Does the practice or clinic manage the claim?
• Do you have a gap agreement with my health fund?

ASK YOUR DOCTOR — Preparing for an appointment? Use the Question Builder for general tips on what to ask your GP or specialist.

What are the alternatives to IVF?

IVF is a long process that is costly, and a big investment of physical and emotional energy.

Some people may find that other options, such as fostering or adopting a child, can help them grow their family. This can be meaningful and rewarding for both the parents and the child.

Resources and Support?

For more information about IVF, you can visit:

• Visit Your IVF Success for information about IVF treatment and success rates in clinics across Australia, and to find an IVF clinic in your area.
• Visit the Fertility Society of Australia and New Zealand (FSANZ) website for information about fertility treatments, and to find accredited IVF clinics in Australia.
• Visit the University of Melbourne for information for patients about IVF optional extras.

The Centre of Perinatal Excellence (COPE) provides useful resources about emotions and feelings when you are going through IVF.