Patient Resources

How IVF Is Done: Step by Step

In vitro fertilization is an effective infertility treatment that involves the fertilization of an egg outside a woman’s body in a specialized lab. Many people are unaware of what is involved in this process, so here’s how it works:

Testing & Ovarian Stimulation

Before IVF, you will have an evaluation of your uterus and fallopian tubes to ensure that surgical repair is not needed. Pre-cycle testing includes hormonal evaluation to assess thyroid function and ovarian reserve, screening both partners for sexually transmitted infection, and a semen analysis of the male partner.

Most women will take fertility drugs for ovarian stimulation, which is used to mature multiple eggs for egg retrieval, for 8-14 days. Even if ovulation is normal, fertility drugs are used to produce more than one egg to heighten the pregnancy rates. Typically, an average of 10-20 eggs is retrieved for IVF, but only about two-thirds have the appropriate maturity to be used.

Fertility drugs are usually injected, followed by frequent monitoring using hormonal testing and vaginal ultrasounds. You will then receive a trigger shot of hCG or other medication to replace the natural luteinizing hormone surge, which spurs the final stage of egg maturation so that eggs can be fertilized.

Egg Retrieval

34-36 hours after receiving the trigger shot and before the eggs ovulate, the eggs will be surgically removed from follicles in your ovaries. The procedure involves using an ultrasound to visually guide a small needle through the top of the vagina, into one ovary, and then the other. Follicles are entered with the needle and follicular fluid contents are removed with gentle suction, bringing the egg along with the fluid.


Experts examine the eggs to determine maturity and quality once they reach the lab. Mature eggs are transferred into a special culture medium, placed in an incubator, and fertilized with sperm within a few hours of egg retrieval. Intra-cytoplasmic injection (ICSI) can then be used to inject one sperm into the cytoplasm of the egg.

Fresh Embryo Transfer

Embryo transfer, in which fertilized eggs are placed back into the woman’s uterus, usually takes place about 3-5 days after egg retrieval.

Frozen Embryo Transfer (FET)

If genetic testing is desired, a biopsy will be taken from the embryo on culture day 5 or 6. After receiving the results, the selected embryo will be chosen, thawed, and transferred into the uterus within one to two months after egg retrieval.


The North Carolina Center for Reproductive Medicine/Talbert Fertility Institute is the premiere center for reproductive health in North Carolina and the East Coast. Our team specializes in fertility testing, diagnosis, and treatment of infertility conditions. We’re experts in IVF, Tubal Ligation Reversal, Male Infertility, Intrauterine Insemination (IUI), Gestation Surrogacy, Family Balancing, and more. Contact us today.

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