Short answer
In vitro fertilisation (IVF) is a treatment in which eggs are collected from the ovaries, fertilised with sperm in a laboratory, and an embryo is placed in the womb.12 It may help when the fallopian tubes are blocked, when sperm problems are present (often with ICSI, intracytoplasmic sperm injection), or when no cause has been found after a long time trying.35 Its main limitation is age: the chance of a birth per embryo falls steeply in a person’s late thirties and forties.8 Because infertility often has more than one cause, and sometimes involves both partners, assessment of both should come before any decision.1516
| Question | Summary |
|---|---|
| What it is | Ovarian stimulation, egg collection, laboratory fertilisation (IVF or ICSI) and embryo transfer12 |
| Main factor in outcome | The age of the person whose eggs are used8 |
| Time for one cycle | Around 3 to 6 weeks, plus about 16 days to a pregnancy test1 |
| Anaesthesia | Sedation or general anaesthetic for egg collection2 |
| Most important risks | Multiple pregnancy, ovarian hyperstimulation syndrome (OHSS), ectopic pregnancy9 |
| Add-ons | None rated green by the UK regulator in its 2023 ratings12 |
| Legal framework | Differs by country; Turkey does not permit donor eggs, sperm or embryos17 |
On this page
- What IVF is and how it works
- What may be causing difficulty conceiving
- Who may be considered
- Alternatives
- Procedure, preparation and anaesthesia
- Recovery and results timeline
- How long results last
- Pain and comfort
- Risks and complications
- How strong is the evidence?
- Add-ons, legal differences and red flags
- Cost drivers and what a quote should include
- Frequently asked questions
- Bottom line
- Related reading
- Sources
What IVF is and how it works
Hormone medicines stimulate the ovaries to mature several eggs, the eggs are collected with a needle passed through the vaginal wall, and they are mixed with sperm in a laboratory.12 A few days later an embryo is placed in the womb through a thin tube.1
ICSI is a variation in which an embryologist injects a single sperm directly into each egg. It bypasses problems sperm may have entering the egg, so it is mainly used for low sperm count, poor sperm movement or shape, surgically retrieved sperm, or poor fertilisation in an earlier cycle.3 The UK regulator states that there is currently no scientific evidence supporting ICSI for infertility not related to sperm.3
| Step | What happens | Typical timing |
|---|---|---|
| 1. Suppression (some protocols) | Natural hormone cycle is switched off with injections or nasal spray12 | 2 to 3 weeks in a long protocol1 |
| 2. Stimulation | Daily injections; scans and blood tests check egg development1 | About 2 weeks1 |
| 3. Egg collection | Needle through the vaginal wall under sedation or general anaesthetic2 | About 20 to 30 minutes12 |
| 4. Fertilisation | Standard IVF (eggs and sperm mixed) or ICSI (single sperm injected)23 | Next day the clinic reports how many embryos formed1 |
| 5. Embryo transfer | Usually one embryo placed in the womb; spare good-quality embryos may be frozen2 | 2 to 5 days after fertilisation2 |
| 6. Pregnancy test | Home or clinic test, then early scan if positive1 | About 16 days after transfer; scan around 7 weeks1 |
What may be causing difficulty conceiving
IVF is a technique, not a diagnosis. The NHS lists causes in women that include ovulation disorders (for example polycystic ovaries, thyroid problems or ovaries that stop working before 40), endometriosis, fibroids, pelvic inflammatory disease, scarring from surgery and some medicines.15 In men, causes include low or poorly moving sperm, testicular damage, ejaculation disorders, low testosterone and some medicines, including anabolic steroids.15 In about 1 in 4 couples in the UK, no cause is found.15
For that reason both partners are usually tested first. Typical investigations include blood tests to check ovulation, a chlamydia test, an ultrasound scan of the ovaries and womb, tests of whether the fallopian tubes are open, and a semen analysis.16 Some causes may be treatable without IVF. NICE also advises that ovarian reserve (an estimate of how many eggs remain) is considered when IVF is discussed.5
What it will not change
Who may be considered
In England, NG257 (the March 2026 NICE guideline that replaced CG156) sets out when IVF is offered on the NHS.46 It includes people with a diagnosed cause that other treatments cannot address, unexplained fertility problems after 2 years of regular unprotected intercourse, or no conception after 12 cycles of artificial insemination.5 Under 40, NICE recommends an initial 3 full cycles, with up to 3 more considered after discussion; at 40 or 41 with no previous IVF, 1 full cycle.5 These are funding rules, not a prediction for any individual.
Who may not benefit or may face additional risk
When a responsible clinician may advise against it
- When a simpler, treatable cause has not yet been investigated in either partner.16
- When the predicted chance of a birth with the person’s own eggs is very low, and continuing would mainly add risk and cost.5
- When the treatment requested would breach the law of the country, for example donor treatment in Turkey.17
Alternatives
Depending on the cause, alternatives include medicines to induce ovulation, surgery for tubal or uterine problems, intrauterine insemination (IUI, placing prepared sperm in the womb), and donor insemination.4 Where the law allows, donor eggs, donor sperm or donor embryos can be used; about 1 in 5 UK births from IVF and donor insemination in 2023 involved donated eggs, sperm or embryos.8 Surrogacy, adoption and fostering are other routes to parenthood.
No treatment is a legitimate option
Some people choose to keep trying naturally, to stop, or to pursue a life without children. The NHS recommends counselling for anyone considering IVF, and clinics should offer it before, during and after treatment.1
Procedure, preparation and anaesthesia
Stimulation needs regular scans and blood tests, so the person having egg collection must be near the clinic for about two weeks.1 Egg collection is done under sedation or general anaesthetic and takes around half an hour.2 A semen sample is produced on the day, or frozen or donor sperm is thawed.12
Most UK cycles now transfer a single embryo. NICE’s quality standard says 1 or 2 embryos should be transferred according to age, cycle number and embryo quality, to reduce multiple pregnancies.7 In 2023, 88% of UK IVF cycles used single embryo transfer.8
Recovery and results timeline
Mild soreness or bruising after egg collection is common.2 Symptoms of OHSS, if they occur, usually appear in the week after egg collection.9 A pregnancy test is taken about 16 days after transfer, and a scan at around 7 weeks if it is positive.1 After a negative result, the NHS suggests allowing time to recover before deciding on another cycle.1
| Age band (own eggs) | Birth rate per fresh embryo transferred, 2023 |
|---|---|
| 18 to 34 | 35%8 |
| All ages (national average) | 25%8 |
| 43 to 44 | 5%8 |
How long results last
A successful IVF cycle results in a pregnancy, not a lasting change in fertility. Frozen embryos can be used later in the same or a future attempt, which is why a full cycle includes transfer of all fresh and frozen embryos from one stimulation.25 Storage of frozen embryos usually carries extra cost.1
Pain and comfort
The stimulation injections are daily and are usually self-administered.1 Egg collection is done under sedation or general anaesthetic, so it is not usually felt at the time; afterwards a person may feel a little sore or bruised.2 Embryo transfer uses a thin tube passed through the vagina.1
Risks and complications
| Category | Examples |
|---|---|
| Expected temporary effects | Soreness or bruising after egg collection; effects of hormone medicines, which a clinician should discuss12 |
| Recognised complications | Mild OHSS (around a third of women); multiple pregnancy if more than one embryo is transferred; ectopic pregnancy9 |
| Rare serious complications | Severe OHSS, which in very rare cases can be life-threatening9 |
The HFEA calls multiple pregnancy the main risk of fertility treatment: at least half of twins are born premature and underweight, and mothers of multiples have higher rates of high blood pressure, gestational diabetes, anaemia and haemorrhage.9 The UK multiple birth rate fell to 3.4% in 2023 as single embryo transfer became routine.8 Most OHSS settles with supportive care and monitoring; severe cases may need hospital treatment.10 For ICSI, long-term effects on children are not proven either way, and a boy may inherit his father’s infertility.3
Warning signs that need urgent help
The NHS advises calling 999 or going to A&E for difficulty breathing, chest or upper back pain, severe thirst with passing little urine, swelling of the body, one-sided lower tummy pain or shoulder-tip pain.1 Tummy pain and bloating, feeling sick or faint, vaginal bleeding or brown watery discharge, or pain when using the toilet should be reported to the clinic or NHS 111 as soon as possible.1
How strong is the evidence?
| Claim | Vireon assessment | What supports it | Important limitation |
|---|---|---|---|
| Birth rate per embryo falls with age | Strong | UK national register data on every licensed cycle8 | Recent years are preliminary; averages hide individual variation |
| Single embryo transfer reduces multiple births | Strong | Fall in UK multiple births alongside rise in single transfer; regulator guidance89 | Observational national data rather than one trial |
| ICSI helps fertilisation when sperm are the problem | Moderate | Regulator and professional guidance3 | No added benefit shown for non-sperm causes |
| Most add-ons raise the chance of a birth | Insufficient | HFEA 2023 ratings; ESHRE good practice recommendations1214 | Few large trials; ratings are revised as evidence changes |
| Rate of severe OHSS | Uncertain incidence | HFEA describes mild OHSS in about a third and severe as rare9 | No reliable single figure; depends on response and protocol |
Most success figures come from registers, not randomised trials, and report averages for whole age groups. Individual chance depends on cause, egg source and embryo quality, and can only be estimated after assessment.
Add-ons, legal differences and red flags
Add-ons are optional extras offered alongside IVF. The HFEA rates them using a traffic-light system based mainly on randomised controlled trials and reviews the ratings every 12 months.11 In its 2023 ratings, no add-on was rated green: time-lapse imaging and PICSI (for male factor infertility) were rated black (evidence of no effect), endometrial scratching and elective freeze-all cycles were rated yellow (not clear whether effective), and assisted hatching was rated grey (insufficient evidence).1213 ESHRE’s 2023 recommendations advise against routine use of pre-implantation genetic testing for aneuploidy (PGT-A), PICSI and IMSI, and do not recommend assisted hatching, current endometrial receptivity tests, or immune testing and immunomodulating treatments.14 The HFEA says red-rated add-ons should not be charged for when the aim is a higher live birth rate.11
The law varies between countries. In the UK, donor treatment is permitted and reported to the HFEA, the national regulator.8 In Turkey, regulation limits assisted reproduction to a married couple’s own eggs and sperm; donor eggs, sperm and embryos are prohibited, and a 2010 regulation added penalties that also target cross-border donor treatment.17 Surrogacy is also prohibited in Turkey.18 Anyone planning treatment abroad should check the current rules in both the country of treatment and the home country.
- Success rates quoted without age band, egg source or whether they count pregnancies or live births.
- Routine transfer of more than one embryo without discussion of multiple pregnancy risk.79
- ICSI or add-ons recommended for everyone, regardless of cause.311
- Offers of donor treatment where the law of that country does not permit it.17
Cost drivers and what a quote should include
Cost depends on the stimulation medicines and dose, number of monitoring scans, anaesthesia for egg collection, whether ICSI is needed, embryo freezing and storage, frozen embryo transfers, and any add-ons.13 Unnecessary ICSI raises cost without clear benefit.3 A written quote should list each of these, state what happens and what is charged if a cycle is cancelled, separate medicines from clinic fees, and show storage fees per year.
If you are travelling for treatment
- Bring written results of both partners’ tests.
- Plan to be near the clinic for around two weeks of stimulation scans, egg collection and transfer, which follows 2 to 5 days later.12
- OHSS symptoms usually start in the week after egg collection, so ask the clinic how they would manage symptoms if you have already travelled.9
- Arrange who will do the pregnancy test follow-up and early scan at home, and how records will be shared.1
- Check that the treatment is legal both where it is done and at home.17
Questions worth asking a clinician
- What have the tests shown for each of us, and is IVF the right next step?
- What is the live birth rate for people of my age using my own eggs at this clinic?
- Do we need ICSI, and why?
- How many embryos would you transfer, and why?
- Which add-ons do you offer, and how are they rated by the HFEA?
- How would OHSS be prevented and managed?
- What counselling is available?
Frequently asked questions
Does IVF hurt?
Egg collection itself is done under sedation or general anaesthetic, so it is not usually felt at the time.2 Some soreness or bruising afterwards is common, and the daily injections are self-administered.12
How long does one IVF cycle take?
A full cycle takes around 3 to 6 weeks, and the pregnancy test follows about 16 days after transfer.1
When can I go back to work after egg collection?
The sources we checked give no fixed return-to-work time; the clinic should advise individually, taking into account the sedation, any soreness and whether OHSS symptoms develop.29
How many cycles might be needed?
There is no fixed number; NICE recommends an initial 3 full NHS cycles under 40 because many people do not succeed at the first attempt.5
Is ICSI better than standard IVF?
Not for everyone: ICSI helps when sperm are the problem, but success rates are very similar to IVF, and it has no proven benefit for other causes.3
Can I fly after embryo transfer?
Our sources give no specific flying rule after transfer; the main concern is recognising OHSS or ectopic pregnancy symptoms, so discuss travel plans with the clinic in advance.9
Bottom line
IVF can overcome tubal and sperm problems, but it cannot undo the effect of age on eggs, and most add-ons lack good evidence. Testing both partners, transferring one embryo where possible, and checking the law before travelling are the steps most likely to protect both safety and expectations.
Related reading
- Fertility overview
- How to verify a doctor’s credentials
- Understanding a treatment quote
- Medical travel red flags
Sources
- NHS. IVF. NHS website; page last reviewed 15 April 2025. https://www.nhs.uk/tests-and-treatments/ivf/ Accessed 5 November 2026.
- Human Fertilisation and Embryology Authority (HFEA). In vitro fertilisation (IVF). HFEA. https://www.hfea.gov.uk/treatments/explore-all-treatments/in-vitro-fertilisation-ivf/ Accessed 5 November 2026.
- Human Fertilisation and Embryology Authority (HFEA). Intracytoplasmic sperm injection (ICSI). HFEA. https://www.hfea.gov.uk/treatments/explore-all-treatments/intracytoplasmic-sperm-injection-icsi/ Accessed 5 November 2026.
- National Institute for Health and Care Excellence (NICE). Fertility problems: assessment and treatment (NG257). NICE; 2026. https://www.nice.org.uk/guidance/NG257 Accessed 5 November 2026.
- National Institute for Health and Care Excellence (NICE). Fertility problems: assessment and treatment (NG257) – Access criteria for in vitro fertilisation (IVF). NICE; 2026. https://www.nice.org.uk/guidance/NG257/chapter/access-criteria-for-in-vitro-fertilisation-ivf Accessed 5 November 2026.
- National Institute for Health and Care Excellence (NICE). Fertility problems: assessment and treatment (CG156). NICE; 2013, updated 2017. https://www.nice.org.uk/guidance/cg156 Accessed 5 November 2026.
- National Institute for Health and Care Excellence (NICE). Fertility problems (QS73). Quality statement 8: Number of embryos transferred. NICE. https://www.nice.org.uk/guidance/qs73/chapter/Quality-statement-8-Number-of-embryos-transferred Accessed 5 November 2026.
- Human Fertilisation and Embryology Authority (HFEA). Fertility treatment 2023: preliminary trends and figures. HFEA; 2025. https://www.hfea.gov.uk/about-us/publications/research-and-data/fertility-treatment-2023-trends-and-figures/ Accessed 5 November 2026.
- Human Fertilisation and Embryology Authority (HFEA). Risks of fertility treatment. HFEA. https://www.hfea.gov.uk/treatments/explore-all-treatments/risks-of-fertility-treatment/ Accessed 5 November 2026.
- Royal College of Obstetricians and Gynaecologists (RCOG). The Management of Ovarian Hyperstimulation Syndrome (Green-top Guideline No. 5). RCOG; 2026. https://www.rcog.org.uk/guidance/browse-all-guidance/green-top-guidelines/the-management-of-ovarian-hyperstimulation-syndrome-green-top-guideline-no-5/ Accessed 5 November 2026.
- Human Fertilisation and Embryology Authority (HFEA). Treatment add-ons. HFEA. https://www.hfea.gov.uk/treatments/treatment-add-ons/ Accessed 5 November 2026.
- Human Fertilisation and Embryology Authority (HFEA). UK fertility regulator launches improved ratings for fertility treatment add-ons. HFEA; 19 October 2023. https://www.hfea.gov.uk/about-us/news-and-press-releases/2023/uk-fertility-regulator-launches-improved-ratings-for-fertility-treatment-add-ons/ Accessed 5 November 2026.
- Human Fertilisation and Embryology Authority (HFEA). Endometrial scratching. HFEA. https://www.hfea.gov.uk/treatments/treatment-add-ons/endometrial-scratching/ Accessed 5 November 2026.
- Lundin K, Bentzen JG, Bozdag G, et al; ESHRE Add-ons working group. Good practice recommendations on add-ons in reproductive medicine. Human Reproduction; 2023. https://doi.org/10.1093/humrep/dead184 Accessed 5 November 2026.
- NHS. Infertility – Causes. NHS website; page last reviewed 9 August 2023. https://www.nhs.uk/conditions/infertility/causes/ Accessed 5 November 2026.
- NHS. Infertility – Diagnosis. NHS website; page last reviewed 9 August 2023. https://www.nhs.uk/conditions/infertility/diagnosis/ Accessed 5 November 2026.
- Gürtin ZB. Patriarchal pronatalism: Islam, secularism and the conjugal confines of Turkey’s IVF boom. Reproductive BioMedicine and Society Online; 2016;2:39–46. https://doi.org/10.1016/j.rbms.2016.04.005 Accessed 5 November 2026.
- Atabay SŞ, Kıbrıs ES. Multiple perspectives on surrogacy and in-vitro fertilization in Turkey. Türkiye Biyoetik Dergisi; 2022;9(1):13–20. https://dergipark.org.tr/en/download/article-file/2983965 Accessed 5 November 2026.
Article history
- — First published.