Step 1: Stimulation, also called super ovulation 

• Medicines, called fertility drugs, are given to the woman to boost follicle size. 
• During this step, the woman will have regular transvaginal ultrasounds to examine the ovaries and blood tests to check hormone levels. 

Step 2: Egg retrieval 

• A minor procedure, called follicular aspiration or ovum pick up, is done to remove the eggs from the woman’s body under a short general anaesthesia. 
• The procedure is carried out in operation theatre. The woman will be given short general anaesthesia before the procedure for not feeling any pain. 
• Using ultrasound images as a guide, your fertility specialist inserts a thin needle through the  vagina  into the ovary and sacs (follicles) containing the eggs. The needle is connected to a suction device, which pulls the eggs and fluid, out of each follicle one at a time. 
• The procedure is repeated for the other ovary. There may be some cramping after the procedure, but it will go away within a day. 
• In rare cases, a pelvic laparoscopy may be needed to remove the eggs. If a woman does not or cannot produce any eggs, donated eggs may be used. 
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Step 3: Insemination and fertilization

• The man’s sperm is placed together with the best quality eggs. The mixing of the sperm and egg is called insemination.
• Eggs and sperm are then stored in an environmentally controlled chamber. The sperm most often enters (fertilizes) an egg a few hours after insemination.
• If the doctor thinks the chance of fertilization is low, the sperm may be directly injected into the egg. This is called intracytoplasmic sperm injection (ICSI).

Step 4: Embryo culture

• When the fertilized egg divides, it becomes an embryo. Embryologist will regularly check the embryo to make sure it is growing properly. Within about 5 days, a normal embryo has several cells that are actively dividing.

Step 5: Embryo transfer 

• Embryos are placed into the woman’s womb 3 to 5 days after egg retrieval and fertilization. 
• The procedure is done in operation theatre without anaesthesia. The doctor inserts a thin tube (catheter) containing the embryos into the woman’s vagina, through the cervix, and up into the womb. If an embryo sticks to (implants) in the lining of the womb and grows, pregnancy results. This is determined by Beta HCG test.
• More than one embryo may be placed into the womb at the same time, which can lead to twins, triplets, or more. The maximum number of embryos transferred will not be more than 3. 
• Unused embryos may be frozen and transferred or donated at a later date. 
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