What Is IVF, Really?
In vitro fertilization literally means "fertilization in glass." Your eggs are retrieved from your ovaries, combined with sperm in a lab, and the resulting embryo (or embryos) are transferred back into your uterus. That's the elevator pitch. The reality is a carefully orchestrated process involving hormone injections, monitoring appointments, a minor surgical procedure, and about a month of your life per attempt.
IVF has been around since 1978, when Louise Brown became the first "test tube baby" born in England. Since then, more than 12 million babies worldwide have been born through IVF. In the US alone, 98,289 infants were born via assisted reproductive technology in 2022—that's roughly 1 in every 37 babies, according to the CDC.
It's not a magic bullet. It doesn't work for everyone. And it's expensive. But for many people facing infertility, it represents the best chance at biological parenthood. Here's what you actually need to know.
Who Needs IVF?
IVF isn't always the first step. Many couples start with less invasive (and less expensive) options like timed intercourse or IUI. But IVF becomes the recommended path when:
- Blocked or damaged fallopian tubes — sperm and egg can't meet naturally
- Severe male factor infertility — very low sperm count, poor motility, or abnormal morphology
- Advanced maternal age — particularly over 38, where IUI success rates drop dramatically
- Endometriosis — especially moderate to severe cases affecting egg quality or tubal function
- Ovulation disorders — when medication alone hasn't worked
- Unexplained infertility — after other treatments have failed
- Genetic concerns — when PGT (preimplantation genetic testing) is needed to screen embryos
- LGBTQ+ family building — using donor eggs, donor sperm, or gestational carriers
- Single parents by choice — using donor gametes
- Fertility preservation — cancer patients or others facing medical treatments that affect fertility
Most reproductive endocrinologists recommend moving directly to IVF (rather than trying IUI first) when there's bilateral tubal blockage, severe male factor, the female partner is 40+, or there's a known need for genetic testing. Don't waste months on lower-probability treatments when the data points to IVF as your fastest path.
The IVF Process, Step by Step
Every clinic has slightly different protocols, but the core process follows the same arc. Here's what a typical IVF cycle actually looks like:
Ovarian Stimulation
You'll inject hormone medications (gonadotropins) daily to stimulate your ovaries to produce multiple eggs instead of the usual one. During this phase, you'll visit the clinic every 2–3 days for blood work and ultrasound monitoring to track follicle growth.
8–14 daysTrigger Shot
When your follicles reach the right size (typically 18–22mm), you'll take a "trigger shot" (usually hCG or Lupron) to finalize egg maturation. Timing is critical—retrieval must happen 34–36 hours later.
1 day (timing is exact)Egg Retrieval
A minor outpatient surgical procedure performed under sedation. Using ultrasound guidance, the doctor inserts a thin needle through the vaginal wall to aspirate eggs from each follicle. It takes 15–30 minutes. You'll rest for about an hour afterward, then go home. Mild cramping and bloating are normal.
15–30 minutesFertilization & Embryo Development
Retrieved eggs are combined with sperm (conventional insemination or ICSI). Embryologists monitor development over 3–6 days. By day 5–6, viable embryos reach the blastocyst stage. If PGT genetic testing is done, embryos are biopsied and results take 1–2 weeks.
3–6 daysEmbryo Transfer
A thin catheter is used to place the embryo into your uterus. It's quick (5–10 minutes), usually painless, and doesn't require sedation. Single embryo transfer (SET) is now the standard of care to reduce twin risk. Remaining embryos can be frozen for future use.
5–10 minutesThe Two-Week Wait & Pregnancy Test
You'll take progesterone supplements to support implantation. About 9–12 days after transfer, a blood test (beta hCG) confirms pregnancy. This waiting period is widely considered the hardest part of the entire process.
9–14 daysIVF Success Rates by Age: The Numbers That Actually Matter
Age is the single biggest factor in IVF outcomes. This isn't about shaming anyone—it's about making informed decisions with real data. These figures come from CDC and SART national surveillance data:
| Age Group | Live Birth Rate Per Transfer | Key Considerations |
|---|---|---|
| Under 35 | 50–55% | Highest success. Single embryo transfer recommended. Consider embryo banking for future siblings. |
| 35–37 | 30–40% | Still strong. Don't linger on IUI (3–4 max). PGT-A can reduce miscarriage risk. |
| 38–40 | 20–25% | May need multiple retrievals. Have an honest conversation about timeline and cycle limits. |
| 41–42 | 10–15% | Consider PGT-A heavily. Begin discussing donor eggs as a parallel option. |
| Over 42 | 3–5% | Donor eggs generally recommended. Success with donor eggs holds at 45–55%. |
| Donor Eggs | 45–55% | Recipient age doesn't significantly affect success. Rates depend on donor age and egg quality. |
Clinics report success differently: per cycle started, per retrieval, or per transfer. The most meaningful number is live birth rate per embryo transfer—that's babies in arms, not just positive pregnancy tests. Always ask your clinic which metric they're quoting, and compare apples to apples using the CDC IVF Success Estimator or SART national dashboard.
One critical stat most clinics don't lead with: only about 29.7% of patients succeed on their first embryo transfer. The average patient undergoes 2.3 cycles before achieving a live birth. Going in expecting to need more than one round is healthier—emotionally and financially—than expecting a miracle on round one.
IVF Costs: The Real Numbers
Let's cut through the vague "it depends" answers. Here's what IVF actually costs in the United States in 2026:
| Component | Cost Range | Notes |
|---|---|---|
| Base IVF cycle | $12,000–$18,000 | Monitoring, retrieval, lab fees, transfer |
| Medications | $3,000–$7,000 | Average ~$5,000. Varies by protocol and dosage. |
| ICSI | $1,500–$3,000 | Used in ~70% of US cycles. Often added automatically. |
| PGT-A genetic testing | $4,000–$5,000 | Per batch of embryos tested. Requires frozen transfer. |
| Frozen embryo transfer | $3,000–$5,000 | Per transfer. Needed if doing PGT or banking. |
| Embryo freezing + 1yr storage | $1,000–$2,000 | Annual storage renewal: $500–$1,000/yr |
| Total single cycle (all-in) | $20,000–$25,000 | National average including meds |
| Total per live birth | $40,000–$60,000 | Based on 2–3 cycle average |
Costs vary significantly by location. A cycle in San Francisco averages around $24,749, while budget-focused clinics like CNY Fertility offer all-in cycles starting at roughly $12,000. Major metro areas (NYC, LA, Boston) tend to run 10–20% above national averages.
IVF Abroad: The Colombia Option
Here's something most US fertility clinics won't tell you: world-class IVF is available internationally at a fraction of American prices. Colombia has emerged as Latin America's leading fertility destination, with WHO-ranked healthcare (#22 globally), internationally accredited clinics, and IVF cycles costing $3,500–$8,500.
| United States | Colombia | |
|---|---|---|
| IVF cycle cost | $20,000–$25,000 | $3,500–$8,500 |
| Medications | $3,000–$7,000 (separate) | Often included in package |
| Success rates | 40–55% (varies by age) | 40–60% at top clinics |
| Total trip cost | — | $6,000–$12,000 (flights, hotel, treatment) |
| LGBTQ+ inclusive | Varies by state | Constitutionally protected since 2016 |
| Wait times | Weeks to months | No wait times; 15–20 days for full cycle |
Medellín in particular has become a hub for fertility medical tourism. The city offers direct 3–5 hour flights from most major US cities, modern infrastructure, and clinics like InSer Fertility (29 years of experience, GHA accredited, multi-cycle packages from $5,250). Even including flights ($300–$800 round trip) and 15–20 nights of accommodation ($600–$2,000), the total is still less than a single US base cycle.
International IVF makes most sense if you're paying out of pocket, need donor eggs (significantly cheaper abroad), are open to combining treatment with recovery in a comfortable climate, or are LGBTQ+ and want guaranteed inclusive care. It's not ideal if you need frequent follow-ups with a local clinic or have complex medical conditions requiring close coordination.
IVF Medications: What You'll Take and What They Cost
IVF medications are a significant cost driver and, for many patients, the most physically demanding part of the process. Here's what a typical protocol looks like:
Stimulation Phase (8–14 days)
Gonadotropins (Gonal-F, Follistim, Menopur): These injectable hormones stimulate your ovaries to produce multiple follicles. They're the most expensive medication, running $3,000–$6,000 depending on your dosage. You'll inject these subcutaneously (tiny needle, belly or thigh) once or twice daily.
GnRH antagonists (Cetrotide, Ganirelix): Added mid-cycle to prevent premature ovulation. Usually $200–$500 for the course.
Trigger Shot
hCG trigger (Ovidrel, Pregnyl) or Lupron trigger: Triggers final egg maturation exactly 36 hours before retrieval. $100–$300.
Post-Retrieval / Transfer Support
Progesterone (PIO injections, Endometrin, Crinone): Supports the uterine lining for implantation. Progesterone in oil (PIO) injections are intramuscular—these are the ones partners often help administer. Vaginal suppositories are an alternative. $200–$800.
IVF vs. IUI: Which Treatment Is Right for You?
IUI (intrauterine insemination) is less invasive and far cheaper—$500–$2,000 per cycle versus $20,000+ for IVF. But the success rates tell a different story:
| IUI | IVF | |
|---|---|---|
| Cost per cycle | $500–$4,000 | $20,000–$25,000 |
| Success rate (under 35) | 10–20% | 50–55% |
| Success rate (38–40) | 5–10% | 20–25% |
| Success after 3 cycles | ~20% | ~50–75% |
| Genetic testing option | No | Yes (PGT-A/PGT-M) |
| Best for | Mild male factor, cervical issues, unexplained (young patients) | Tubal factor, severe male factor, age 38+, genetic concerns |
The math often favors IVF sooner than you'd think. Three failed IUI cycles at $2,000 each ($6,000 total) with a cumulative ~20% success rate may be a worse investment than a single IVF cycle at $20,000 with a 50%+ success rate. Most reproductive endocrinologists recommend a maximum of 3–4 IUI attempts before moving to IVF.
Insurance & Financing: How to Actually Pay for IVF
The financial barrier to IVF is real, but the landscape is improving fast. As of 2026, 22 states plus DC have enacted some form of fertility insurance mandate. Here's the breakdown:
States With IVF Coverage Requirements
Strongest mandates (coverage required): Colorado, Connecticut, DC, Delaware, Illinois, Maine, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Rhode Island
Coverage must be offered (employer decides): Arkansas, California (large group plans starting 2026), Hawaii, Texas
Fertility preservation only: Florida, Georgia, Kentucky, Louisiana, Montana, Nevada, Ohio
About 61% of American workers are covered by self-insured employer plans, which are generally exempt from state mandates under ERISA federal law. This means even if your state requires IVF coverage, your specific plan may not include it. Always verify directly with your insurance provider and HR department.
Other Ways to Pay
- Employer fertility benefits: Companies like Carrot and Progyny provide fertility benefits that many employers now offer. Ask your HR department.
- IVF grants: Organizations like RESOLVE, Baby Quest Foundation, and The Cade Foundation offer grants ranging from $2,000 to $10,000+.
- Shared-risk / refund programs: Some clinics offer multi-cycle packages where you get a partial refund if treatment doesn't result in a live birth.
- FSA/HSA funds: IVF is a qualified medical expense. Use pre-tax dollars.
- IVF abroad: Save 50–70% at internationally accredited clinics in Colombia, Mexico, or the Czech Republic.
- Fertility-specific loans: Companies like Future Family and CapexMD offer financing specifically for fertility treatment.
The Emotional Side of IVF (The Part Nobody Prepares You For)
We're not going to tell you to "stay positive" or "just relax." That advice is unhelpful at best and dismissive at worst. Here's what's actually true about the emotional experience of IVF:
The hormones are real. Stimulation medications can cause mood swings, irritability, and anxiety. This isn't weakness—it's pharmacology. Your body is producing 10–20 times the normal amount of estrogen.
The two-week wait is brutal. Between embryo transfer and the pregnancy test, time moves differently. You'll analyze every twinge, every symptom, every absence of symptoms. This is universal, and knowing it's universal helps a little.
Failed cycles hurt. A lot. If your first cycle doesn't work—and statistically, the majority don't—the grief is real and valid. You are mourning a specific hope. Give yourself space to feel it before you start strategizing your next move.
Your relationship will be tested. IVF introduces stress into the most intimate part of a partnership. Communication matters more than ever. Consider seeing a reproductive therapist—not because something is wrong, but because navigating this is genuinely hard.
1 in 6 people worldwide experience infertility. In 2022, over 250,000 patients underwent IVF in the US alone. There are vibrant support communities—RESOLVE, r/infertility, and clinic-based support groups—filled with people who understand exactly what you're going through. Lean on them.
Preparing for IVF: Evidence-Based Supplements
Research supports certain supplements for improving egg quality and IVF outcomes. Always discuss supplements with your reproductive endocrinologist before starting.