Is IVF painful?
Compared to other gynecologic procedures, IVF is not very painful.
Nonetheless, different parts of an IVF cycle can cause mild to moderate discomfort.
In this article, you will learn how much pain you might expect at each step of the IVF process.
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What is the most painful part of IVF?
An in vitro fertilization cycle is composed of three parts:
- The ovarian stimulation
- The egg retrieval
- The embryo transfer cycle
During each step, you will experience different side effects and different levels of discomfort.
On average, the egg retrieval will likely cause the most amount of discomfort.
However, if you undergo a medicated frozen embryo transfer cycle, the progesterone injections might be the most painful.
Let’s go over these in more detail.
Part 1: The Ovarian Stimulation
Ovarian stimulation is the first part of an IVF cycle.
During this time, you will inject yourself with two or more subcutaneous medications every day.
How painful are IVF injections?
The subcutaneous injections themselves are relatively painless because the needle used is very small.
However, despite using a thin needle, you might experience some local side effects like redness, swelling, and skin irritation at the injection site.
These symptoms are more of an annoyance rather than physical pain.
How will I feel during IVF stimulation?
The most common side effect you might experience during the stimulation phase is a bloated feeling.
This is caused by the growth of multiple follicles in your ovaries, which can stretch and press on surrounding tissues. The level of discomfort varies from patient to patient.
Other common side effects of IVF include:
- mood swings,
- hot flashes
The good news is that most of these side effects are mild and temporary.
What else can I expect from the IVF procedure?
You will need to come into the office for transvaginal ultrasounds and blood tests every 1-3 days during the initial stimulation.
The vaginal ultrasound probe and the frequent blood draws can add another layer of mild discomfort to the IVF process.
As you approach the retrieval, your visits will be more frequent.
Part 2: The Egg Retrieval
Once your follicles have reached a sufficient size of development, you will administer another subcutaneous injection called the trigger shot.
The egg retrieval is then scheduled ~36 hours after you receive the trigger.
Is the egg retrieval during IVF painful?
The egg retrieval procedure can be the most uncomfortable part of an IVF cycle, but it isn’t always painful.
The most common side effect of this procedure is abdominal cramping, bloating, and light bleeding.
The cramping should subside within 2-3 days, and it responds well to over-the-counter pain medications.
If you develop ovarian hyperstimulation syndrome (OHSS), you will likely experience more intense abdominal cramping and bloating.
Unfortunately, symptoms from OHSS can last for 1-2 weeks.
Is the egg retrieval done under anesthesia?
The egg retrieval is done under light sedation, not general anesthesia. The latter requires you to be paralyzed and have a breathing tube.
Nevertheless, you won’t feel anything during the procedure.
What can I expect after the egg retrieval?
After the egg retrieval, you should not engage in strenuous activity or exercise for ~2 weeks. You should also avoid vaginal intercourse during this time.
The reason is that your ovaries are still enlarged from the stimulation. As such, any strenuous activity after the procedure can increase the risk of ovarian torsion.
Ovarian torsion presents as severe pain in the lower abdomen, and it is a surgical emergency.
Fresh embryo transfer
If you are undergoing a fresh transfer, the procedure will take place on Day 3 or Day 5 after the retrieval.
If you don’t have a transfer, you will get your period 10-14 days after the retrieval.
I’ll discuss what to expect at the transfer below.
Does the menstrual cycle after the retrieval hurt more?
It is not uncommon to experience a bit more bleeding, cramping, and abdominal pain with the period following your egg retrieval.
If needed, you can take some over-the-counter pain medication as required.
Part 3: The Embryo Transfer Cycle
If you do not have a fresh embryo transfer, you will undergo a frozen embryo transfer cycle in the future.
There are two types:
- The natural frozen embryo transfer cycle
- The medicated frozen embryo transfer cycle
The medicated approach requires the use of progesterone injections.
Do progesterone shots hurt?
Progesterone injections are potentially the most painful part of the entire IVF process.
These hurt more than the stimulation medications because you need to inject the progesterone intramuscularly (IM). The needle is a little bigger, and it goes in deeper than a subcutaneous injection.
The most common location used to inject the progesterone is the upper outer buttock.
After an IM injection, you can expect some pain, redness, and swelling at the injection site. You might also experience soreness in the buttocks.
Luckily, these symptoms improve over time.
Does the embryo transfer hurt?
The embryo transfer is the least painful part of an IVF cycle.
All it involves is a speculum examination and inserting a small catheter through the cervix and into the uterus.
The discomfort you experience will likely be similar to that of a pap smear.
You might feel some mild cramping after the procedure, but this usually subsides quickly.
Does embryo implantation hurt?
Another common question many patients have is if implantation causes pain. Any discomfort you feel after the embryo transfer will most likely be mild.
Implantation occurs in the first 24-48 hours after the embryo transfer.
If you experience any discomfort, it will be similar to menstrual cramps or mild period pain.
You will then check a pregnancy test ~10-14 days after the transfer.
Are pregnancy symptoms worse after IVF?
Pregnancy symptoms after an IVF cycle are no different than after a natural conception.
The severity of pregnancy symptoms varies from patient to patient and isn’t related to IVF.
Other Related Questions
How many injections do you need for IVF treatment?
On average, you will need to give yourself 2-3 injections daily during the stimulation process. They are administered subcutaneously (just under the skin).
On average, you can expect the stimulation to last 8-12 days.
If you do a medicated frozen embryo transfer, you will need to give yourself an intramuscular progesterone injection daily.
The IM progesterone is done daily for several weeks until your healthcare provider tells you to stop the injections.
Should I administer my IVF injections in the stomach or thigh?
Most patients prefer to give themselves injections in the abdomen as it is more easily accessible than the thigh.
However, either approach is equally acceptable, and you can choose the one you find most comfortable.
Final Words on Pain During Infertility Treatment
Injectable fertility medications aren’t as painful as you might expect. Do not let the fear of pain prevent you from undergoing fertility treatment.
While every patient will have a different experience, you can be sure to find them a tolerable part of the process.
The multiple daily injections are an annoyance, but they are often necessary for your fertility journey.
As always, don’t hesitate to speak with your fertility clinic for more information on what to expect!
- The IVF Timeline: How Long Does An IVF Cycle Take?
- The Egg Retrieval Day: What To Expect
- Embryo Transfer Precautions: What To Avoid After A Transfer
Make An Appointment With Dr. Robles To Discuss Your Fertility Options Today!
Alex Robles, MD
Dr. Alex Robles is a Spanish-speaking Latino-American Reproductive Endocrinologist and Infertility specialist in New York City, and a board-certified OBGYN. He has a special interest in health, lifestyle, & nutrition. Make an appointment with Dr. Robles to discuss your fertility options today!