How long does the IVF or surrogacy process take?

Depending on a lot of different factors, IVF will take weeks and surrogacy will take months

How long does the IVF or surrogacy process take?

It’s one of the most common questions I get asked by patients, and understandably so. Once people make the decision to build a family, they want to hold their baby as soon as possible, knowing that pregnancy alone takes nine months (and there’s no rushing that).

Whatever fertility treatments you need, that’s necessary added time. And it’s incredibly important that everything is done thoughtfully and no corners are cut. Believe it or not, taking extra steps can help make sure the overall process takes less time.

When to seek reproductive help

If you’re a woman in a heterosexual relationship and have been trying to conceive for six months, it’s time to visit a reproductive endocrinologist (REI) to talk about next steps. If you are over 35, we recommend seeking a consultation after three months.

There are various reasons you may be having trouble conceiving. I worked with one couple several years ago who fixed the man’s low-sperm-count issue by not using a laptop or putting his cell phone in his pocket anymore. A fertility specialist will, through tests, attempt to identify the issues, and outline the best treatment options for you.

If in vitro fertilization (IVF) is determined to be the best option, it will be about a two week treatment process to create the embryos for freezing, and then a three week process to prepare the uterus for an embryo transfer a month or more later.

The first step is a series of evaluations and tests to assess the ovaries, pelvic anatomy, and sperm quality and quantity. Like detective work, the fertility specialist will evaluate each variable to see which factors may be interfering with spontaneous conception. Women will have an evaluation of their uterus and fallopian tubes to make sure there are no issues that require surgical repair. Pre-cycle testing includes hormonal evaluation to assess thyroid function and ovarian reserve.

Both partners will be screened for sexually transmitted infection, and we’ll do a semen analysis of the male partner. This can all be accomplished in a couple weeks.

Preparing the ovaries for egg harvesting

Each month the ovaries recruit a group of eggs for potential development. In the natural cycle only one follicle/one egg is ovulated and the others fade away. In an IVF treatment cycle we give daily injections of follicle stimulating hormone to push the entire group of follicles to grow to maturity. We want the highest chance of success on the first attempt, and we’ll need more than one egg for that regardless of the age or health of the woman.

After eight to 12 days of these fertility drugs, the egg retrieval will usually yield 10 to 20 eggs, though depending on the woman it can be more or less. Even with a healthy woman, only about 75% of the eggs retrieved will be mature enough for insemination.

Once the eggs are retrieved, they will be fertilized and developed into embryos. After five to seven days of culture, the embryos will then undergo preimplantation genetic testing (PGT) to determine if they contain the correct number of chromosomes.

The genetic test results and the embryo grades help guide us towards the best embryo for transfer into the uterus.

Gay men, same-sex male couples and others using a surrogate

For people using surrogacy, the timeline is somewhat different.

There can be various reasons to use a surrogate. Gay or single men, as well as same-sex male couples, will need to work with a surrogate to carry the pregnancy; opposite-sex couples may require surrogacy due to uterine issues, medical contraindications to pregnancy, or other factors interfering with pregnancy.

While the IVF process to reach the embryo implantation stage can take as little as two to three weeks, the surrogacy process, when done right, will take an additional three to 12 months, not including the pregnancy. And there are good reasons to not rush it.

5 steps for gestational surrogacy

The first step is to test and freeze your sperm. Depending on the results of the tests, we may have some treatments to improve the motility or abundance of the sperm. While we’re doing that, you can keep the fertility train moving forward.

The second step is to identify your egg donor. It’s important to not rush this part of the process. Whether it takes weeks or months to find the perfect egg donor for you, your family will be living with the results of that decision for a lifetime -- She will provide half of your child’s genes. So take your time.

If you’re working with an egg-donor agency and they don’t have a donor that suits you, be sure to keep looking. As I tell patients all the time, it’s far more important to get this right than get it fast.

The egg donor goes through similar tests and procedures that any woman would follow for IVF, including hormone treatments ahead of the retrieval.

Now that we have the sperm and egg, we create the embryos. Once the embryos are created and tested, you can, again, pause as long as you’d like. And you will likely need to pause as you search for your surrogate.

A surrogate could be a family member or friend who knows you, or you can find a surrogate through a surrogacy agency. Know that this will add some time -- Wait times for surrogates can be from weeks to months, even up to a year depending on the agency. You can also use a concierge surrogacy search firm that works with many different agencies -- This can cut down on the wait time.

Once you’ve matched with a surrogate (remember, she has to choose you too), there are legal issues to work through and then we can move forward with the steps necessary to implant the embryo.

I know when people finally make the decision to be a parent, it’s hard to wait. But this process is slow and steady, and it’s important to not skip a single step. Whether it’s IVF or surrogacy, taking each step seriously and focusing on the end goal, instead of how fast you get there, is important to making sure you are successful in having the family of your dreams.