No More Needles & Tears: The Truth About Pain in IVF Treatment
September 01, 2023


One of the major reasons patients are very reluctant to do an IVF cycle is because of the fear of pain. They've heard a lot of horror stories from their friends about how many injections they have to take and most of us are needle phobic! Others have heard horror stories about how painful the vaginal egg collection is, while some patients still have nightmares about how painful the HSG they did was!

But the reality is when IVF is done in a good IVF clinic with a kind doctor, you should have absolutely no pain at all. I can promise you that none of our patients have any pain, and I can say this very confidently.

The injections which we use for superovulation are administered subcutaneously - under the skin. Patients take these themselves, and because the needle is very sharp and very short, the drug is injected into the subcutaneous fat, which doesn't have many pain nerve endings, which is why these shots don’t cause pain.

The egg collection in our clinic is done under general anesthesia. We are not unkind and don't want to inflict unnecessary pain on our patients. Unlike IVF clinics in other parts of the world, we have an anesthetist who gives short general anesthesia to all our patients, which makes it extremely safe and pain-free. In fact, for many patients, the anesthesia becomes the highlight of their IVF treatment, because they enjoy it so much!

Many patients complain about pain after the embryo transfer because many doctors are unkind, and use intramuscular progesterone oily injections and painful heparin shots routinely after the transfer. In fact, the injections are so painful that most patients can't even sit on their butt after a few days – and they need to take them daily for more than 14 days during the 2ww! This is cruel and unusual punishment because we give the same progesterone in the form of a vaginal pessary. This avoids the pain and is actually far more effective because absorption through the vagina is much better. This also bypasses the liver metabolism, as a result of which it can act directly on the uterine lining.

This is why I can confidently promise patients that they will never have any pain when doing an IVF cycle in our clinic. In fact, if your IVF cycle has been physically painful, you should definitely consider changing your clinic!

Many doctors add insult to injury by forcing patients to stay in bed after the embryo transfer. This causes their pain to multiply because the physical inactivity causes their back to start hurting. Also, an idle mind is a devil's workshop, and they start obsessing over every minor twinge and ache.

We encourage our patients to resume a normal life after the transfer. We remind them that their embryos are safe in their uterus, like a pearl in an oyster, and that nothing they do can harm them!

After all, IVF patients are healthy women who are just having difficulty getting pregnant in their own bedroom, and all that IVF does is bypass the procedure of what would normally happen in their bedroom for five days. We replace their fallopian tube with our test tube in the IVF lab.

Yes, the emotional pain is a different matter altogether, especially when the cycle fails, but if you have done your groundwork, and have realistic expectations about the uncertainty of the final outcome, there is no reason why the process itself should be painful!

Authored by : Dr Aniruddha Malpani, MD and reviewed by Dr Anjali Malpani.