IVF, In Vitro Fertilisation
IVF involves stimulating the ovaries with daily hormone injections over 10–14 days to produce multiple eggs. These are collected under sedation, fertilised in a laboratory, and, if successful, one or two embryos are transferred to the uterus several days later.
The process typically involves:
• Down-regulation or suppression (not always required)
• Ovarian stimulation with daily injections
• Monitoring scans every 2–3 days
• Egg collection under sedation (day procedure)
• Embryo culture in the lab (3–5 days)
• Embryo transfer
• A two-week wait before a pregnancy test
A single cycle takes 4–6 weeks. Many people require multiple cycles. Success rates vary significantly by age, diagnosis, and clinic, but broadly, the cumulative live birth rate after three full cycles is approximately 50–60% for women under 35 (HFEA 2025).
IUI, Intrauterine Insemination
IUI involves placing prepared sperm directly into the uterus around the time of ovulation. It may be done in a natural cycle or with mild ovarian stimulation.
It is less invasive than IVF but has lower success rates per cycle, typically 10–15% per attempt. It is often used as a first-line treatment, for same-sex female couples using donor sperm, or for single women.
The monitoring schedule can be unpredictable, scans and the insemination procedure itself are timed around ovulation, which may mean appointments at very short notice.
Egg Freezing (Fertility Preservation)
Egg freezing follows the same stimulation and collection process as IVF, daily injections, monitoring scans, and egg collection under sedation. The difference is that eggs are frozen (vitrified) immediately rather than fertilised.
The physical demands are equivalent to a full IVF cycle. Recovery from egg collection is the same.
People freeze eggs for many reasons: before cancer treatment, because of a diagnosis that may affect future fertility, because they haven't yet found a partner, or because they want to preserve options. The reason is private and does not change the medical process.
Donor Conception
Donor conception involves using donated eggs, sperm, or embryos. This may be combined with IVF, IUI, or surrogacy.
For the person carrying the pregnancy, the medical process is similar to standard IVF or IUI. For those using a surrogate, the process involves coordinating with another person's treatment cycle.
Since April 2005, donor-conceived people in the UK have the right to access identifying information about their donor at age 18 (HFEA). This is an important consideration that some people are navigating alongside treatment.
Donor conception is used by heterosexual couples, same-sex couples, and single people. The medical process does not differ based on the reason.
Surrogacy
Surrogacy involves another person carrying a pregnancy. The intended parents may provide eggs, sperm, or both, or donor gametes may be used.
The legal framework in the UK is complex: the surrogate is the legal mother at birth, and a parental order must be obtained after birth to transfer legal parenthood. This legal process adds a significant layer of stress and uncertainty.
The intended parents still undergo the medical aspects of IVF (stimulation, collection) if using their own gametes, even though they are not carrying the pregnancy.
The Medication
Fertility treatment involves multiple medications with real physiological effects:
• GnRH agonists (e.g. buserelin): suppress the body's own hormones. Can cause hot flushes, mood changes, headaches, fatigue. These are pharmacological effects, not psychological.
• Gonadotropins (e.g. Gonal-F, Menopur): stimulate egg production. Can cause bloating, abdominal discomfort, mood changes, and in some cases ovarian hyperstimulation syndrome (OHSS).
• Progesterone: used after transfer to support implantation. Can cause fatigue, mood changes, bloating, and symptoms that mimic early pregnancy, making the two-week wait significantly harder.
• Oestrogen: used in some protocols. Can cause headaches, nausea, mood changes.
These are not side effects that can be powered through. They are real physiological changes that affect cognitive function, energy, and emotional regulation (APA Resource Document, Becker et al. 2019).