IVF
A fertility treatment where eggs are collected, fertilised with sperm in a laboratory, and one resulting embryo is placed back into the womb to try for a pregnancy.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- IVF collects eggs, fertilises them with sperm in a laboratory, and places one embryo back into the womb.
- No clinic can guarantee a baby; the chance of a live birth falls as a woman gets older, and many people need more than one cycle.
- One cycle usually takes about 3 to 6 weeks, with a pregnancy test around two weeks after embryo transfer.
- UK clinics are licensed by the HFEA; check verified success rates and ask for the live birth rate for someone your age, not just a 'pregnancy rate'.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your specialist will give you advice for your situation.
Can help people conceive when natural conception is difficult or not possible.
Situations where pregnancy would be dangerous for the woman's health until that risk is addressed.
Daily injections with scans every few days. You may feel bloated and emotional. Most people carry on with work and normal life with some flexibility.
A named contact and clear out-of-hours route for OHSS or other urgent concerns.
Daily injections with scans every few days. You may feel bloated and emotional. Most people carry on with work and...
A day-case procedure with sedation. Expect cramping and light bleeding afterwards, and arrange for someone to take...
A quick, awake procedure like a smear test. You can usually return to normal gentle activity straight away; strict...
You take medicine to support the womb lining and wait for a pregnancy test. Many people find this the hardest...
What is IVF?
IVF (in vitro fertilisation) is a way of helping people have a baby when getting pregnant naturally is difficult. Medicine is used to help the ovaries grow several eggs. The eggs are then collected, mixed with sperm in a laboratory, and one of the embryos that forms is placed gently into the womb.
IVF is used for many reasons, including blocked or damaged fallopian tubes, problems with sperm, ovulation problems, endometriosis, unexplained infertility, and for same-sex couples and single people using donor eggs or sperm. Sometimes the sperm is injected directly into the egg; this is called ICSI.
IVF can help, but it does not work for everyone, and no clinic can promise a baby. Success depends a lot on age and the reason for treatment, and many people need more than one cycle. It is normal to feel hopeful and anxious at the same time.
In the UK, IVF clinics are licensed and inspected by the HFEA (Human Fertilisation and Embryology Authority). The HFEA website lets you check a clinic and compare honest success rates.
Types, options & approaches
There may be different ways to do this. The right approach depends on the clinical question and your circumstances.
IVF vs ICSI
| IVF | ICSI | |
|---|---|---|
| How egg meets sperm | Sperm added to egg in a dish | One sperm injected into each egg |
| Often used for | Tubal, ovulation or unexplained problems | Sperm problems or failed fertilisation |
| Extra lab step | No | Yes |
| Higher success? | Not automatically | Not unless there is a sperm reason |
ICSI is not a routine 'upgrade'. It mainly helps when there is a sperm-related reason, and your clinic should explain why it is or isn't recommended for you.
Preparing for your treatment
- Both partners usually have tests first, such as hormone and ovarian-reserve checks, a semen analysis, and infection screening.
- Ask the clinic for its HFEA-verified live birth rate for people your age, and a realistic view of your own chances.
- Discuss how many cycles you can afford emotionally and financially before you start, and what 'add-ons' you will and won't pay for.
- You will be shown how to give yourself the injections; a nurse can talk you through timing and storage.
- Take folic acid, and try to reach a healthy weight and stop smoking, as these can affect success and safety.
- All clinics must offer counselling before treatment; using it is a sign of good care, not weakness.
- Read and complete the HFEA consent forms carefully, including consent for how embryos and eggs may be stored or used.
- Plan some flexibility around egg collection day, when you will need sedation and someone to take you home.
What happens
In a typical cycle you first take medicine (injections, and sometimes a nasal spray) for about two to three weeks to control and then stimulate your ovaries, so several eggs grow. You have scans and sometimes blood tests to check how the eggs are developing.
When the eggs are ready, a final 'trigger' injection is timed precisely. About 36 hours later the eggs are collected: a doctor passes a fine needle through the vaginal wall into the ovaries using ultrasound to guide it. This is done with sedation or a light anaesthetic, usually takes 15 to 30 minutes, and is a day-case procedure.
In the laboratory the eggs are mixed with sperm (IVF) or injected with a single sperm (ICSI), then watched over the next few days to see which fertilise and grow into embryos. One good embryo is usually placed into the womb through a thin tube (embryo transfer), which feels similar to a smear test and does not need anaesthetic. Spare suitable embryos can be frozen.
After transfer you take medicine to support the womb lining and wait about two weeks before a pregnancy test.
Is this treatment right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- Situations where pregnancy would be dangerous for the woman's health until that risk is addressed.
- When the realistic chance of success is extremely low, for example using your own eggs at an older age, and donor options have not been discussed.
- Active, untreated medical or pelvic conditions that should be managed first.
- When a treatable cause of infertility could be addressed more simply or safely before IVF.
- When neither partner has been properly investigated, so IVF may be the wrong or premature step.
Delay or rearrange if…
- There is an active infection or an untreated sexually transmitted infection.
- Important tests, such as ovarian reserve, semen analysis or infection screening, are missing.
- Weight, smoking or alcohol use could be improved first to lower risk and improve the chance of success.
- You feel rushed, unsupported or have not had the counselling all clinics must offer.
- There is a high risk of OHSS this cycle, when a 'freeze-all' approach may be safer.
Alternatives to discuss
- Further investigation and treatment of a specific cause before assisted conception.
- Simpler treatments such as ovulation induction or intrauterine insemination (IUI) where appropriate.
- Using donor eggs, sperm or embryos when the chance with your own is very low.
- Taking a planned break, or deciding not to pursue treatment, with counselling support.
- The NHS pathway if you may be eligible, rather than self-funding straight away.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Benefits
- Can help people conceive when natural conception is difficult or not possible.
- Allows treatment of specific problems, such as blocked tubes, sperm problems or ovulation failure.
- Lets a single healthy embryo be chosen and transferred, lowering the chance of risky multiple pregnancy.
- Spare embryos can be frozen for future attempts without repeating egg collection.
- Makes parenthood possible using donor eggs, sperm or embryos, including for same-sex couples and single people.
Risks & complications
- Side effects from the medicines, such as bloating, headaches, mood changes and bruising at injection sites
- Emotional strain, anxiety and disappointment, especially if a cycle does not work
- Mild ovarian hyperstimulation (bloating and discomfort) as the ovaries respond
- Cramping and light bleeding after egg collection or embryo transfer
- A cycle being cancelled if too few or too many eggs develop
- Moderate OHSS needing closer monitoring
- Pelvic infection after egg collection
- Failure to collect eggs, fertilise, or have an embryo suitable to transfer
- Ectopic pregnancy, where a pregnancy implants outside the womb
- Multiple pregnancy if more than one embryo is transferred
- Severe OHSS, which can be serious and occasionally needs hospital treatment
- Bleeding or damage to the bowel, bladder or blood vessels from the collection needle
- A reaction to the sedation or anaesthetic
The two safety risks the HFEA highlights most are OHSS (an over-response to the stimulating medicines) and multiple pregnancy (twins or more), which is riskier for mother and babies. Good clinics lower these by tailoring your medicine dose and usually transferring a single embryo. Tell your clinic at once about severe bloating, breathlessness, severe pain or much-reduced urine, as these can be signs of severe OHSS.
Published figures to discuss
Success and risk in IVF vary a great deal from person to person. The biggest factor is the woman's age, followed by the reason for infertility, ovarian reserve and sperm quality. Because of this, headline 'success rates' can mislead, and a clinic's average says little about your own chance. The figures below are cautious and indicative; ask your clinic for HFEA-verified rates for someone in your situation.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Live birth per embryo transferred, by age | Around 30% under 35, falling through the late 30s to roughly 10% at 40 to 42 and under 5% at 43 and over, using own eggs (HFEA national data) | These are national averages, not a promise; your own chance depends on your individual situation. | HFEA — Risks of fertility treatmenthfea.gov.ukPublished figure |
| Mild to moderate OHSS | About 1 in 100 people in one NHS service; up to around a third have some degree of mild ovarian over-response | Usually managed at home; tailoring the medicine dose reduces it. | NHS — IVFnhs.ukPublished figure |
| Severe OHSS | Less than 1 in 1,000 people in one NHS service | Can be serious and occasionally needs hospital care; a 'freeze-all' cycle lowers the risk. | NHS — IVFnhs.ukPublished figure |
| Pelvic infection after egg collection | Less than 1 in 100 people in one NHS service | Treated with antibiotics; report fever, pain or smelly discharge promptly. | NHS — IVFnhs.ukPublished figure |
| Multiple pregnancy | UK clinics aim to keep multiple births below 10% of IVF births | Single embryo transfer is the main way this is kept low because twins are riskier for mother and babies. | HFEA — Risks of fertility treatmenthfea.gov.ukPublished figure |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
What happens afterwards
There is no major physical recovery from IVF itself, but a cycle is a marathon of appointments, injections and waiting. Egg collection is the main procedure: most people feel sore and tired for a day or two afterwards.
- Bloating, tender ovaries and a feeling of fullness during and just after stimulation
- Cramping and light bleeding for a day or two after egg collection
- Tiredness, tearfulness and mood swings from the medicines and the stress of treatment
- A few days of feeling 'in limbo' during the two-week wait
- Spotting around the time of the pregnancy test, which does not always mean the cycle has failed
Aftercare
- Use simple pain relief such as paracetamol for cramping after egg collection if your clinic agrees.
- Take the womb-lining support medicines exactly as prescribed during the two-week wait.
- Watch for OHSS symptoms after egg collection and contact the clinic urgently if they appear.
- Avoid alcohol and smoking, and keep caffeine modest, while trying to conceive.
- Keep gently active rather than resting in bed; normal daily activity is fine after transfer.
- Do the pregnancy test on the date the clinic gives you, not earlier, as testing too soon can mislead.
- Use the clinic's counselling and support, whatever the result.
- Keep the clinic's emergency or out-of-hours number to hand.
- Clinic and out-of-hours phone numbers saved
- Injection medicines stored correctly and in date
- Womb-lining support medicines collected
- Someone to take you home after egg collection
- Pregnancy test date written down
- Counselling or support contact noted
- A plan agreed for what happens after a positive or negative result
⚠ Get urgent help if…
- Severe or rapidly worsening bloating or tummy swelling after egg collection
- Breathlessness or difficulty breathing
- Severe tummy or pelvic pain not eased by simple painkillers
- Passing much less urine than usual, or feeling very thirsty and unwell
- Heavy vaginal bleeding
- Fever, smelly discharge or feeling generally very unwell (possible infection)
- Severe one-sided pain, shoulder-tip pain or faintness in early pregnancy (possible ectopic pregnancy)
Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your specialist gives you.
Results & realistic expectations
A 'good' result from a cycle is a healthy single pregnancy that continues, but this is never guaranteed. A positive pregnancy test about two weeks after transfer is the first step, and an early scan a few weeks later checks that the pregnancy is in the womb and developing.
It is important to separate a 'pregnancy rate' from a 'live birth rate': some pregnancies sadly miscarry, so the live birth rate is the more honest figure to ask about. Even with good embryos, many cycles do not succeed, and a negative result is common rather than a sign that treatment can never work for you.
IVF treats a single attempt at pregnancy; it does not change your underlying fertility, which continues to decline with age. Frozen eggs or embryos can extend your options for later, within the storage limits and consent you agree with the clinic and the HFEA. If a cycle does not work, the clinic should review what was learned and discuss whether and how to try again.
Related tests, treatments or support
IVF is often combined with ICSI (for sperm problems), with genetic testing of embryos (PGT) in selected situations, and with freezing of spare embryos for later transfer. Many of these are offered as paid 'add-ons'. The HFEA rates most add-ons and warns that few have strong evidence of improving the chance of a baby, so ask what evidence supports any extra you are offered.
Follow-up & long-term care
After a positive test you will usually have an early pregnancy scan at the clinic at around 6 to 7 weeks, then be transferred to normal maternity care. After a negative test, a follow-up appointment should review the cycle, explain what happened, and discuss options, including a break, another cycle, or different approaches.
- Frozen eggs and embryos need ongoing storage, with renewal and consent within HFEA time limits.
- Keep your contact and consent details up to date with the clinic so stored embryos are not lost.
- Review your plan with the clinic between cycles, as age and test results may change advice.
- Continue folic acid and healthy-weight, non-smoking measures between attempts.
Repeat, follow-on and what comes next
- Many people need more than one cycle; a single failed cycle does not mean treatment cannot work.
- Cycles can be cancelled before egg collection if the ovaries respond poorly or dangerously well.
- Sometimes no egg fertilises, or no embryo is suitable to transfer, even after egg collection.
- Plans often change between cycles as age and results give more information.
Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.
What good aftercare looks like
- A named contact and clear out-of-hours route for OHSS or other urgent concerns.
- Counselling offered and genuinely available, whatever the result of the cycle.
- A follow-up appointment to review the cycle and discuss honest next steps.
- Clear early-pregnancy care, including an early scan, after a positive test.
- Proper handling, storage and consent records for any frozen eggs or embryos.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- The type of cycle (standard IVF, ICSI, mild, or donor treatment).
- The fertility medicines, which vary in dose and brand and are often charged separately.
- Laboratory techniques such as ICSI, blastocyst culture and genetic testing.
- Freezing and ongoing storage of eggs or embryos.
- Scans, blood tests and consultations during the cycle.
- Counselling, donor services and any legal steps for donor or surrogacy treatment.
- 'Add-ons' that may be offered on top of the basic cycle.
- Exactly what the quoted 'cycle' price does and does not include.
- The cost of fertility medicines, which are often not in the headline price.
- Charges for egg collection sedation, the laboratory steps and embryo transfer.
- Freezing and yearly storage fees for any spare eggs or embryos.
- The cost of each add-on and the evidence behind it.
- What happens to the cost if a cycle is cancelled before egg collection or transfer.
- Follow-up consultation and counselling costs after a positive or negative result.
On the NHS? IVF is funded on the NHS for some people, but the clinical guidance and the actual funding rules are not the same thing. NICE guidance (NG257) sets out the recommendations for England, while Scotland, Wales and Northern Ireland each have their own national or HSC criteria, and rules can differ between local areas and change over time. Because of this, no one can promise you a fixed number of funded cycles from NICE alone; ask your GP, the relevant NHS or HSC fertility commissioner, or the clinic to confirm your current eligibility. Many people pay privately for speed, more cycles or choice of clinic.
You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Being shown a 'pregnancy rate' rather than the more honest live birth rate for someone your age.
- Paying for add-ons without being told how weak the evidence for them is.
- Not having the risks of OHSS and multiple pregnancy clearly explained.
- Not understanding the consent and storage rules for eggs and embryos.
- Feeling pressured to start, or to keep going, without proper counselling.
Marketing red flags
- Any promise or strong implication of a guaranteed baby or 'guaranteed success'.
- Success rates quoted without saying the age group, or per pregnancy rather than per live birth.
- Heavy promotion of expensive add-ons as if they reliably improve your chances.
- Pressure to decide quickly or to buy multi-cycle packages on the spot.
- No mention of OHSS, multiple-pregnancy risk, or the emotional toll of treatment.
Choosing a specialist safely
- Check the specialist is on the GMC Specialist Register for this area.
- Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
- You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
- Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including any follow-up — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good specialist will welcome every one of these.
- What is your HFEA-verified live birth rate for someone my age and situation?
- Why are you recommending IVF rather than ICSI, or the other way round, for me?
- How will you reduce my risk of OHSS and of a multiple pregnancy?
- How many embryos will you transfer, and why?
- Which add-ons are you suggesting, what does the evidence say, and what do they cost?
- What counselling and emotional support is included, and how do I access it?
- What happens, and what will it cost, if this cycle does not work or has to be cancelled?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the specialist who carries out my treatment, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this treatment not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Can I get IVF on the NHS?
What are my chances of success?
How many cycles will I need?
Does IVF hurt?
Is IVF safe?
Should I pay for add-ons?
What is the difference between IVF and ICSI?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: HFEA — Risks of fertility treatment HFEA — Explore all treatments (IVF) HFEA — Treatment add-ons NHS — IVF NICE NG257 — Fertility problems: assessment and treatment Guy's and St Thomas' NHS — Risks of IVF NICE NG257 — Access criteria for IVF NICE NG257 — Procedures used during IVF NHS inform (Scotland) — Infertility and fertility access NHS Wales — Specialist fertility services commissioning policy (CP38) Northern Ireland — Regional Fertility Centre (Belfast Trust)
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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