Is IVF painful? What each step can feel like

An honest answer

IVF does involve some pain and discomfort, but for most people it is more uncomfortable than painful. Experiences vary a lot. Some people barely notice the injections; others find them hard. Feeling anxious about pain is very common, and it is worth telling your clinic, as they can often explain options or adjust how things are done.

Below is what many people notice at each stage. Your own experience may be different. Our guide to IUI and IVF, step by step explains what happens at each stage.

Injections

Stimulation usually involves daily hormone injections for around 10 to 12 days, given just under the skin of the tummy or thigh with a fine needle. Most people learn to give them at home, or a partner helps.

You may feel:

• a quick sting, and sometimes a small bruise or redness where the needle went in
• bloating and a feeling of fullness as the ovaries grow
• tiredness, mood changes, headaches or breast tenderness

Changing the injection site and following the clinic's instructions can help.

Monitoring scans

Scans to track the follicles are usually done with a slim ultrasound probe placed in the vagina. It feels similar to an internal examination: a bit of pressure, sometimes awkward, but usually short. You can ask for a female staff member to be present or to pause if you need to.

Egg collection

Eggs are collected with a fine needle passed through the vaginal wall, guided by ultrasound. This is done under sedation or anaesthesia, so most people do not feel the procedure itself or remember much of it. It usually takes around 15 to 30 minutes.

You will need someone to take you home, as the sedation can make you drowsy for some hours.

After egg collection

For a day or two, it is common to have:

• cramping, similar to period pain
• light spotting or bleeding from the vagina
• bloating and tenderness in the lower tummy

Your clinic will tell you which pain relief is safe to take. Most people feel better within a few days.

Embryo transfer

Transfer is usually much simpler. A thin, soft tube is passed through the cervix into the uterus, often guided by an abdominal ultrasound. You may be asked to have a comfortably full bladder. Many people compare it to a smear test. Sedation is not usually needed.

The wait before the pregnancy test

The two weeks or so between transfer and the pregnancy test are often described as the hardest part emotionally. Many people take progesterone, a hormone that supports the lining of the uterus, during this time. It can cause bloating, breast tenderness, tiredness and mood changes.

Mild cramping and light spotting can happen, and on their own they do not tell you whether a pregnancy has started or not. Try not to read too much into each symptom.

Good to know. Emotional strain is a real part of IVF, not a sign of weakness. Our guide to looking after yourself has some ideas. If you are struggling, Tele-MANAS offers free mental-health support 24x7 on 14416 or 1-800-891-4416.

What is normal, and what is not

Usually expected	Not normal: contact your clinic or doctor
Mild bloating during stimulation	Severe or worsening tummy pain or swelling
Period-like cramps after egg collection	Pain that is not eased by the pain relief your clinic advised
Light spotting after collection or transfer	Heavy bleeding, soaking a pad in an hour
Tiredness and mood changes	Fever, chills or a bad-smelling discharge
Bruising at injection sites	Breathlessness, vomiting, passing very little urine, or fainting

Caution. Severe tummy pain, breathlessness, fainting or heavy bleeding can be signs of a complication such as ovarian hyperstimulation syndrome (OHSS), bleeding or infection. Do not wait to see if they settle.

When to see a doctor

Contact your clinic the same day if you have tummy pain or bloating that is getting worse, a fever, vomiting, or are passing much less urine than usual. Call 112 or go to the nearest hospital straight away if you have severe pain, difficulty breathing, chest pain, heavy bleeding, or you faint. If you are thinking about IVF and want to talk through what it would involve, you can book an online consultation.