Purpose: 
IVF is used to treat infertility. The common reasons for undergoing IVF include:

• Problems with the fallopian tubes (a pair of tubes along which the eggs travel from the ovaries to the womb), like damaged, blocked, or absent fallopian tubes
• For women older than 40 years who are trying to conceive
• Lack of success using less invasive treatment options
• Male infertility caused due to poor sperm quality, low sperm count, or poor motility of sperms
• Ovulation (when matured eggs are released from the ovary) disorders, like the infrequent release of eggs, absence of release of eggs, premature loss of ovary function before 40 years of age
• Unexplained infertility (fertility without a known cause)
• Uterine problems, like fibroids (non-cancerous growths in the uterus) and endometriosis (a disorder in which the tissue normally lining the uterus starts growing outside the uterus)
• If you or your partner have a genetic disorder, IVF may be performed as a means of preimplantation genetic testing
• Preservation of fertility before the start of treatment for cancer

1. Blood tests: These tests help in evaluating any underlying medical conditions that may be present in the male or female partner.
2. Ovarian reserve testing: This test helps in determining the quality and quantity of the female eggs to predict how well the ovaries would be able to respond to fertility medication.
3. Vaginal ultrasound: This is a type of imaging test in which high-frequency sound waves are used to obtain clear images of the female reproductive system. It helps the doctor to monitor the development of the follicles, which are fluid-filled ovarian sacs where the eggs mature.
4. Sonohysterography: The doctor examines the inside of the uterine lining before starting with IVF by injecting a fluid through the cervix (the narrow, lower end of the uterus) into the uterus and taking an ultrasound.
5. Hysteroscopy: A flexible, thin, lighted telescope, known as a hysteroscope, is inserted through the vagina and cervix into the uterus.
6. Semen analysis: The male partner’s semen (the thick fluid that comes from a man’s penis in ejaculation during sexual activity) analysis is done before starting with the IVF treatment cycle. It helps in evaluating male fertility.
7. Infectious disease screening: The male and female partners are both screened for infectious diseases like HIV.

The basic steps of IVF treatment include:
1. Fertility medications given to induce ovulation:
Fertility medications are hormones that stimulate the ovaries to produce multiple eggs.
Most medications are in the form of injections that need to be administered by the patient herself.
Blood tests and ultrasound exams may be needed to monitor the progress.
This step may take approximately one to two weeks.

2. Retrieval of eggs through a minor surgical procedure:
This step involves the use of an ultrasound to guide a hollow needle to the ovary.
Gentle suction helps in the retrieval of the eggs.
This step takes less than 30 minutes to complete.

3. Collection of a sperm sample:
A sperm sample is usually collected from the male partner just before egg retrieval from the female partner.
Sperm sample collection is usually done by masturbation.
However, it could be essential to collect sperm through a surgical procedure in certain cases.
Sometimes, donor sperm is obtained.

4. Fertilization of the eggs
This procedure is performed in the laboratory after preparing the eggs and sperm.

5. Transfer of the embryo:
This procedure involves the insertion of a thin, flexible tube, known as a catheter, through the female’s vagina into the uterus.
The doctor transfers the embryo into the uterus.
This procedure is done 2 to 6 days after the retrieval of the eggs.
A pregnancy test is recommended after 12 to 14 days of egg retrieval.

The risks associated with IVF are:

• Multiple births
• Low birth weight
• Premature delivery 
• Ovarian hyperstimulation syndrome (the ovaries become painful and swollen due to the use of certain fertility drugs like human chorionic gonadotropin or HCG for inducing ovulation)
• Ovarian torsion (twisting of an ovary)
• Miscarriage
• Ectopic pregnancy (a condition in which the fertilized egg implants outside the uterus instead of inside)
• Birth defects
• Increased risk of breast, cervical, ovarian, or endometrial (the lining of the uterus) cancer
• Stress
• Mood swings
• Headaches
• Nausea
• Vomiting
• Hot flashes 
• Abdominal pain and bloating 
• Sudden weight gain 
• Complications due to egg-retrieval procedure, like:
• Bleeding 
• Infection 
• Damage to the bladder (where urine is stored before being excreted)
• Blood vessel damage
• Damage to the bowel 

• The patient can resume her daily activities after embryo transfer, although the ovaries may still be enlarged.
• Avoid strenuous activities which may cause discomfort.
• It is normal to pass a small quantity of bloody or clear fluid after the procedure. This occurs due to the swabbing of the cervix prior to embryo transfer.
• It is normal to experience mild cramping and bloating after the procedure.
• It is not unusual to have some constipation after the procedure.
• There may be some breast tenderness following the procedure, due to the high levels of the female sex hormone estrogen.
• If the patient experiences moderate to severe pain after the procedure of embryo transfer, the doctor should be contacted immediately. The doctor will check for signs of infection.