01Initial investigations for both of you
Fertility investigation is a two-person process. For women: a blood sample, usually taken on day 2 or 3 of your cycle, to measure anti-Müllerian hormone (AMH), follicle stimulating hormone (FSH), thyroid stimulating hormone (TSH) and T4, and ideally a HyCoSy (tube patency test). For men: a semen analysis covering count, motility and morphology. Test results can take 2–4 weeks and give your clinic the information it needs to recommend the right treatment route.
02Understand your diagnosis
The most common diagnoses are male factor infertility (MFI, which is common), PCOS (polycystic ovary syndrome), endometriosis, low ovarian reserve, or 'unexplained infertility' (no identifiable cause, about 1 in 4 couples according to the NHS). Each has different treatment implications. Ask your consultant to explain the evidence for your specific situation.
03Explore your treatment options
IUI (intrauterine insemination) works for mild MFI and ovulatory dysfunction; it's less invasive and cheaper. IVF suits moderate-to-severe MFI, tubal issues, or unexplained infertility after IUI fails. ICSI (injecting a single sperm directly into an egg) is used for severe MFI or fertilisation failure. Donor eggs or sperm are options when your own gametes aren't viable. If you need a surrogate (after a hysterectomy, for example), the surrogacy steps in our two-dads guide are the same for any couple.
04NHS vs private: understanding your options
NHS IVF funding in England varies by Integrated Care Board. Most English boards fund one cycle, and only two fund the three NICE recommends (PET, February 2026). Check your local criteria carefully; they vary by age, BMI and existing children. If you don't qualify or can't wait, private treatment gives you more control over timing and clinic choice.
05Starting IVF: stimulation and egg collection
IVF begins with ovarian stimulation injections (typically 10–14 days). You'll have regular monitoring scans to track follicle growth. Egg collection is a day-case procedure under sedation. Your partner provides a sperm sample the same day. Fertilisation happens in the lab overnight. You'll hear how many embryos have developed the next morning.
06Embryo transfer and the two-week wait
The best embryo is selected for transfer, usually on day 5 (blastocyst stage). Transfer is usually quick and feels similar to a smear test; tell your clinic if smears are difficult for you. Then comes the two-week wait before a pregnancy test.
07After a cycle: the review
Most IVF cycles don't succeed first time. After a failed cycle your consultant should offer a review: what happened, what (if anything) can be changed, and whether to proceed with a frozen embryo transfer (if you have frozen embryos) or a new cycle.
08Pregnancy after IVF
Anxiety in pregnancy after fertility treatment is common, even when everything looks fine. Stay in contact with your clinic until the midwife handover, and tell your midwife you've been through IVF; it changes the care they offer.