Is IVF Painful? What to Expect On Every Step

In vitro fertilization (IVF) involves a series of complex procedures designed to help couples struggling with infertility. It is the most effective method of assisted reproductive technology.

Every step in the IVF process may include a tolerable degree of discomfort. Some women experience pressure or bloating in their abdomen and some mild to moderate cramping.

The IVF Procedure: What to Expect

Simply put, IVF involves harvesting eggs from a woman's ovaries, then combining them with sperm in a lab. It sounds simple enough, but it is a complex series of steps.  

• Birth control pills or estrogen. Your reproductive specialist may order birth control pills or estrogen before your IVF treatment begins. This prevents ovarian cysts and helps control your menstrual cycle. Physical side effects such as mild bloating, cramping, or swelling in the ovaries can occur. It can be uncomfortable but is rarely painful.
• Ovarian stimulation. Synthetic hormones stimulate the ovaries to produce multiple eggs. You'll do these subcutaneous injections yourself.
• Egg retrieval. You are sedated during this procedure, so you won't experience discomfort or pain as your eggs are collected. Cramping, like menstrual cramps, is common afterward.
• Sperm collection. Your partner supplies a semen sample, or you use a donor sample.
• Fertilization in the lab. After screening the mature eggs for quality, a single sperm is injected directly into an egg (a process known as intracytoplasmic sperm injection, or ICSI), or a small drop of concentrated sperm is mixed with each egg (IVF insemination.)
• Embryo transfer or freezing. Embryos develop over the next five to six days. When ready, usually one embryo is transferred to your uterus or to the uterus of a surrogate. The remaining embryos are frozen for later use. The embryo transfer procedure has less discomfort than a typical pelvic exam (think PAP smear.) A mild sedative is usually unnecessary as there is minimal cramping or discomfort during the procedure.
• Fresh embryo transfers carry a higher likelihood of potential risks and discomfort, primarily due to the synchronization of the recipient's and donor's cycles and the main risk being ovarian hyperstimulation syndrome (OHSS) following egg retrieval, whereas frozen embryo transfers are associated with fewer risks and less discomfort as they allow for more precise timing and preparation.
• Pregnancy test. A pregnancy test can be done nine to fourteen days after the embryo transfer.

Pain Management During IVF: Medications and Techniques

Discuss your prescription and over-the-counter (OTC) medications with your reproductive specialist before starting IVF treatments. Some medicines can interfere with fertility drugs or cause hormonal imbalances.  

Medications your doctor may instruct you to avoid include:

• Prescription and OTC nonsteroidal anti-inflammatory drugs such as aspirin, ibuprofen, and naproxen.
• Mental health medications, such as antidepressants and anti-anxiety meds.
• Steroids
• Antiseizure medications
• Thyroid medications
• Chemotherapy drugs
• Skin products containing estrogen or progesterone

IVF Injections

There are ways to diminish the discomfort of IVF injections:

• Allow the medicine to come to room temperature
• Don't reuse needles
• Apply a cold compress or ice to the site after the injection
• If your doctor approves, try OTC acetaminophen
• Rotate injection sites

Dealing with Emotional Distress

Emotional turmoil and stress go hand-in-hand with fertility treatments. Try these measures to maintain your mental health during the IVF process:

• Cognitive behavior therapy (CBT), a form of psychotherapy
• Relaxation techniques, such as yoga or guided imagery
• Practice slow, restorative breathing
• Get plenty of sleep
• Enjoy a warm shower or bath

Balance the Benefits and Risks of IVF

IVF carries a degree of risk but offers a fantastic benefit — a child of your own. See a specialist at the Institute for Human Reproduction (IHR) to discuss whether IVF suits you.