At a glance
In-vitro fertilization (IVF) is a fertility treatment in which eggs and sperm are joined together outside the body, in a laboratory, and the resulting embryo is then placed into the uterus (womb). The name comes from the Latin for 'in glass', referring to the dish used in the lab.
During a natural pregnancy, a sperm travels through the fallopian tube (the canal connecting the ovary to the womb) to meet and fertilize an egg. IVF bypasses this journey entirely. Doctors first stimulate the ovaries with hormones so that they produce several eggs at once, then retrieve those eggs, fertilize them in the lab, allow the embryos to develop for a few days, and finally transfer one or more into the uterus to implant and grow.
Medical Condition
IVF is used when a couple or individual has not been able to conceive naturally, or when other, simpler fertility treatments have not worked. It addresses a wide range of causes of infertility in both partners.
- Blocked or damaged fallopian tubes, which stop the sperm from reaching the egg
- Ovulation disorders, where the ovaries do not release eggs regularly (such as polycystic ovary syndrome, PCOS)
- Endometriosis, a condition where tissue similar to the womb lining grows outside the womb and affects the ovaries or tubes
- Low sperm count or poor sperm movement (motility) in the male partner
- Unexplained infertility, where tests in both partners come back normal but pregnancy has not occurred
- Premature ovarian insufficiency (early menopause), using donor eggs
- Genetic conditions in one or both partners, where embryo testing before transfer can reduce the risk of passing on a serious disease
- Same-sex couples or single individuals using donor sperm or eggs
- Fertility preservation before cancer treatment that may affect the ovaries or sperm
IVF is not always the right first step. Doctors usually consider it less suitable in certain situations.
- Women with very low ovarian reserve (few remaining eggs) who may not respond to stimulation, though donor eggs remain an option
- Untreated conditions inside the uterus, such as large fibroids (non-cancerous growths) or polyps, which may need to be treated first
- Active, serious medical illnesses where the physical demands of pregnancy or hormone treatment could pose a significant risk
- When less invasive treatments, such as medication to trigger ovulation or intrauterine insemination (IUI), have not yet been tried and are appropriate for the cause of infertility
Risks & Complications
IVF is generally safe, but like any medical treatment that involves hormones, egg retrieval, and embryo transfer, it carries recognised risks that your doctor will discuss with you in detail before you begin.
- Ovarian hyperstimulation syndrome (OHSS): the ovaries over-respond to hormone injections and become swollen and painful; mild cases are common and settle on their own, while severe cases are rare but may need hospital admission
- Multiple pregnancy: transferring more than one embryo raises the chance of twins or triplets, which carries higher risks for both the mother and babies
- Egg retrieval complications: minor bleeding or infection at the needle entry site; very rarely, injury to a nearby organ
- Unsuccessful cycle: the embryo may not implant, or pregnancy may be lost early (miscarriage); this is emotionally as well as physically significant
- Ectopic pregnancy: the embryo implants outside the womb, usually in the fallopian tube, which requires urgent treatment
- Emotional and psychological stress from the demands of treatment and the uncertainty of the outcome
- Side effects from hormone medications: bloating, mood changes, breast tenderness, and injection-site reactions are common and usually temporary
- Premature birth or low birth weight, which is more frequent in IVF pregnancies than in naturally conceived pregnancies
Preparation & Procedure
Preparation for IVF begins weeks before any eggs are retrieved, and it involves both partners. The clinic will ask for a detailed medical history, current medications, and any previous fertility treatments.
Before starting hormone injections, both partners usually undergo a set of baseline tests. These typically include blood tests to check hormone levels and ovarian reserve, an ultrasound scan of the uterus and ovaries, semen analysis for the male partner, and screening for infections. Some clinics also carry out an assessment of the uterine cavity (the inside of the womb) using a small camera or a contrast scan.
In the weeks before treatment, doctors usually advise stopping smoking and reducing alcohol. Some supplements are commonly recommended by fertility specialists, though specific choices should come from the treating doctor. Women who take long-term prescription medications will have those reviewed to check whether they are safe to continue during hormone stimulation and pregnancy.
On the day of egg retrieval, the patient is usually asked to stop eating and drinking for a set number of hours beforehand, because the procedure is done under sedation (a light, sleep-like state) or general anaesthesia (full unconsciousness). The exact fasting instructions will be given by the clinic. A companion should be arranged to take the patient home afterwards, as driving on the same day is not advisable.
The IVF process itself unfolds in several stages over roughly two to six weeks, depending on the protocol chosen by the doctor.
- Ovarian stimulation: daily hormone injections are self-administered at home for around ten to fourteen days to encourage the ovaries to develop multiple eggs
- Monitoring: regular ultrasound scans and blood tests at the clinic track how the follicles (fluid-filled sacs containing the eggs) are growing
- Trigger injection: when the follicles reach the right size, a final injection is given to mature the eggs and time their release precisely
- Egg retrieval: a doctor uses a thin needle, guided by ultrasound, to collect the eggs through the vaginal wall while the patient is sedated; this usually takes twenty to thirty minutes
- Sperm collection: on the same day, the male partner provides a semen sample; if needed, sperm may be retrieved directly from the testis (the sperm-producing gland) through a small procedure
- Fertilization in the laboratory: eggs and sperm are placed together in a dish, or a single sperm is injected directly into each egg (a technique called ICSI, intracytoplasmic sperm injection) if sperm quality is a concern
- Embryo development: fertilized eggs are observed in the lab for three to five days as they develop
- Embryo transfer: a thin, flexible tube is passed gently through the cervix (the neck of the womb) to place one or more embryos into the uterus; this is usually painless and does not require sedation
- Luteal phase support: hormone medication (usually progesterone) is taken after transfer to help prepare the uterine lining for implantation
- Pregnancy test: a blood test is done about ten to fourteen days after transfer to check whether the embryo has implanted
Aftercare
After embryo transfer, most patients go home the same day and can resume light daily activities almost immediately, but the days that follow call for some care while waiting to find out whether the transfer has worked.
- Rest on the day of transfer is common practice, though strict bed rest is not required and is not shown to improve results
- Hormone medication (progesterone support) is continued as prescribed, usually as vaginal pessaries, injections, or oral tablets, until the pregnancy test and often beyond if the test is positive
- Avoid heavy exercise, swimming in public pools, and sexual intercourse until the pregnancy test result is known, unless the clinic advises otherwise
- Mild cramping and light spotting in the days after transfer can be normal; heavy bleeding or severe pain should be reported to the clinic without delay
- A blood pregnancy test at the clinic, roughly ten to fourteen days after transfer, gives the first result; a positive test is followed by an ultrasound scan a few weeks later to confirm a heartbeat
- If the cycle is unsuccessful, a follow-up appointment with the doctor is usually scheduled to review what happened and discuss next steps, which may include a further cycle using any frozen embryos that were stored from the same retrieval
- Emotional support matters as much as physical recovery; many clinics offer counselling, and connecting with a support community can help during what is often a stressful waiting period
- Women who conceive through IVF are typically monitored more closely during pregnancy than those who conceive naturally, and the first trimester especially involves more frequent check-ups
Cost & What Determines It
The cost of IVF varies more than almost any other medical procedure because so many factors shape the final bill, from the complexity of the individual case to the country and hospital chosen, to the number of cycles needed before a pregnancy is achieved.
- Complexity of the case: the underlying cause of infertility and whether additional techniques are needed, such as ICSI (direct sperm injection into the egg), embryo genetic testing (preimplantation genetic testing, PGT), or surgical sperm retrieval
- Number of treatment cycles: a single retrieval and transfer rarely guarantees a result, and additional cycles using fresh or frozen embryos each carry their own cost
- Stimulation medications: the hormone injections used to stimulate the ovaries are often the single largest variable in an IVF budget, as the dose and duration differ between patients
- Use of donor eggs or donor sperm: cycles using donated material carry additional costs related to donor recruitment, screening, and compensation
- Embryo freezing and storage: if extra embryos are created and frozen for future use, annual storage fees apply
- Hospital class and country: the same procedure can differ very significantly in price between a public hospital, a private clinic, and an internationally accredited fertility centre, and between different countries
- Pre-treatment tests and consultations: baseline hormone panels, semen analysis, uterine assessments, and infectious disease screening are usually charged separately or bundled differently depending on the clinic
- Anaesthesia and operating room fees for egg retrieval
- Laboratory fees for embryo culture, ICSI if used, and genetic testing if requested
Many fertility clinics abroad offer package prices that include one stimulation cycle, egg retrieval, laboratory fertilization, a set number of embryo transfers, and the basic monitoring scans and blood tests. What is often billed separately includes the hormone medications themselves, embryo freezing fees, genetic testing, donor materials, and any additional medical care needed if a complication such as OHSS occurs.
BPJS Kesehatan does not cover IVF treatment, whether done in Indonesia or abroad. Most Indonesian private health insurance policies also exclude fertility treatments. Patients who pursue IVF abroad typically pay out of pocket, or through international private insurance that specifically lists fertility treatment as a covered benefit. Before travelling, asking the clinic for a written cost estimate that itemises what is and is not included in the package is the most reliable way to avoid unexpected bills once the process has begun.
Frequently Asked Questions
How many IVF cycles will I need?
Most people need more than one cycle, and your doctor will decide based on your age, egg quality, and test results. Some couples succeed in the first cycle, while others go through two or three before a pregnancy is achieved. Your fertility specialist will review your response to each cycle and adjust the plan if needed.
What does IVF feel like, and does the process hurt?
The hormone injections used during IVF can cause bloating, tenderness, and mood changes, but most people find them manageable. The egg retrieval procedure is done under sedation (medicine that puts you in a light sleep), so you are not awake during it. Some cramping and spotting are normal in the day or two after retrieval, and most women feel well enough to go home the same day.
How soon will I know if IVF worked?
A blood test to check for pregnancy is usually done about 10 to 14 days after the embryo transfer. Your clinic will give you a specific date to come in, so it is best to wait for that test rather than relying on a home pregnancy test, which can give unclear results at this stage.
How much does IVF cost?
IVF costs vary depending on how many cycles you need, the medications used for hormone stimulation, whether additional procedures like ICSI (injecting a single sperm directly into an egg) or embryo freezing are required, and the class of the fertility clinic. A written cost estimate from the hospital or clinic is the most reliable way to understand what you will be paying for your specific situation.
This page is general information, not a substitute for medical advice. Every case is different. Your doctor decides what is right for you.