Is IVF Painful? What Injections, Egg Retrieval, and Transfer Really Feel Like
If you’re starting IVF — or researching it — the question of pain is probably sitting somewhere near the top of your mind. That’s completely understandable. IVF isn’t usually painful — most people experience discomfort at certain stages, but for the majority it’s manageable, and knowing what to expect at each stage is one of the best things you can do to feel in control going in.
Author
Tassia O’Callaghan
Reviewed by
Kayleigh Hartigan
11 min read
Spotlight:
- IVF involves several distinct stages, and the level of discomfort varies across each one.
- Most people find injections more anxiety-inducing than actually painful — the needles are very fine.
- Egg retrieval is performed under sedation, so you won’t feel anything during the procedure itself.
- Post-retrieval cramping is common and usually settles within a few days.
- Embryo transfer is typically painless — most people compare it to a smear test.
- The emotional side of IVF is often harder than the physical side — and that’s worth preparing for too.
What does IVF actually involve?
Before getting into the pain question, it helps to know what you’re looking at. A typical IVF cycle involves:
- Ovarian stimulation: Daily hormone injections for around 10–14 days to encourage your ovaries to produce multiple eggs.
- Monitoring scans: Regular transvaginal ultrasounds to check how your follicles are developing.
- The trigger injection: A single shot given around 36 hours before egg retrieval to mature the eggs.
- Egg retrieval: A minor procedure, typically under sedation, to collect the eggs.
- Fertilisation: Eggs and sperm are combined in the lab (or via ICSI).
- Embryo transfer: One or two embryos are transferred back into the uterus via a thin catheter.
- Progesterone support: Pessaries, gel, or injections to support the uterine lining until your pregnancy test (typically pessaries).
Treatment Essentials: IVF
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How painful are IVF injections?
This is probably the bit people dread most — and it tends to be a lot less bad than expected.
The stimulation injections are subcutaneous, meaning they go just under the skin — usually into the lower abdomen. The needles are very fine, similar to insulin needles, and most people describe the sensation as a brief sting or small pinch. Many report barely feeling a thing, especially with the first few injections. Outside of this, you may experience some stinging or slight soreness at the injection site. [1]
Over time, as your ovaries respond to the medication, you might start to feel some heaviness or fullness in your lower abdomen. As the days go on during the injection process, you may begin to feel a heaviness in your abdominals as your ovaries and follicles enlarge. It’s not sharp pain — more of an awareness that something is happening. [2]
Side effects from the hormone medication can include bloating, headaches, mood swings, and fatigue — similar to strong PMS symptoms in some cases. These are hormone-related rather than injection-site related, and they vary a lot from person to person.
Practical things that help: rotating your injection sites, numbing the area briefly with ice beforehand, and having someone with you if needles make you anxious. Your clinic will walk you through exactly how to administer them, and many people bring a partner or friend to the first injection training so they can help.
What is the most painful IVF shot?
Most of the stimulation injections are subcutaneous and relatively mild. But not all IVF injections are the same.
The trigger shot — given once, around 36 hours before egg retrieval — is also subcutaneous for most protocols and is generally well tolerated.
Progesterone injections, if your clinic prescribes them, are a different matter. These are intramuscular injections — administered into the buttock or hip — and they do involve more discomfort. Intramuscular progesterone injections can be quite painful, and some people react to the oil in the injections and develop a rash. The needle is thicker, and the oil-based solution means it can leave soreness at the injection site for some time.
That said, many clinics offer alternatives. Progesterone can also be given as vaginal pessaries, gel, or subcutaneous injections — and most people find these more comfortable. If you’re worried about intramuscular injections, it’s worth discussing the options with your clinic upfront.
How hard is IVF on your body?
IVF asks quite a lot of your body — physically and hormonally — but most people manage to carry on with their normal lives for most of the cycle. It’s not the same as recovering from major surgery.
During stimulation, you might feel bloated, tender around the lower abdomen, and emotionally sensitive. Some people barely notice the effects; others find this phase genuinely uncomfortable. The hormones are doing significant work, and your ovaries are growing multiple follicles simultaneously — so a feeling of fullness or pressure is completely normal.
The bigger physical challenge tends to come post-egg retrieval (more on that below), and from the cumulative toll of a process that’s also emotionally intense. Hormonal fluctuations can affect sleep, mood, and energy — and the psychological pressure of the two-week wait adds its own layer. It’s worth acknowledging that the mental load of IVF is often heavier than the physical side. Modern techniques and support focus on minimising physical pain, while emotional challenges remain the primary concern.
One thing to be aware of is Ovarian Hyperstimulation Syndrome (OHSS). OHSS can cause stomach pain and swelling (which gets worse after egg collection) and other symptoms including passing small amounts of concentrated, dark urine. Overall, OHSS affects only about 2% of people, but your clinic will tell you if you’re at higher risk. Mild cases can usually be managed at home with fluids and rest. Severe OHSS is rare, but it’s important to contact your clinic if symptoms worsen. [3,4]
Egg retrieval: What does it feel like?
Egg retrieval is the step that sounds most daunting — a needle going through the vaginal wall to collect eggs from your follicles. In practice, you won’t feel it happening.
You’re given sedation for the procedure, which helps you relax and prevents pain. The procedure itself usually takes around 20 minutes. You’ll be awake enough to be aware of where you are, but deeply relaxed and comfortable. Afterwards, you’ll spend some time in recovery before being discharged — usually within a couple of hours. You can’t drive that day, so you’ll need someone to take you home. [5]
How long will I be in pain after egg retrieval?
This is where most people feel the most physical impact. The procedure itself is painless, but the aftermath is a different story.
In the week following egg retrieval, you may experience some cramping similar to menstrual pain, along with some soreness and spotting. You can take paracetamol for this. Bloating is also very common — your ovaries have been working hard, and they need time to settle.
Most people take the day of retrieval off, and many also rest the following day. Discomfort after egg retrieval typically resolves within one to two weeks, or when your period arrives. If you’ve had a lot of follicles collected, the recovery period may take a little longer.
It’s important to know which symptoms are normal and which need attention. Mild to moderate cramping, bloating, and spotting are expected. But if you experience severe pain, heavy bleeding, a fever, or rapidly worsening symptoms after retrieval, contact your clinic straight away — these could be signs of OHSS or, very rarely, an infection. There is a very small risk that the needle used for egg collection may puncture the bowel or blood vessels, though this is uncommon. [3]
What does embryo transfer feel like?
Good news: for most people, this is the easiest part physically.
Embryo transfer doesn’t involve sedation. A thin catheter is passed through the cervix and into the uterus, guided by ultrasound, and the embryo is placed inside. This part of the IVF process is often likened to a smear test or ultrasound — it’s usually not painful. You might feel a little pressure or mild cramping during or shortly after, but this typically passes quickly.
After transfer, you’ll start your progesterone support (if you haven’t already) and enter the two-week wait — the stretch of time between transfer and your pregnancy test. This phase can bring its own set of physical sensations, partly from progesterone and partly from the tension of not knowing. It can be the hardest part of the whole cycle emotionally, even when the body is relatively settled.
Does the down-regulation phase of IVF hurt?
Not every IVF protocol includes this, but if yours does, it’s worth knowing about. Down-regulation uses nasal sprays or injections to temporarily suppress your natural cycle before stimulation begins. This phase can mimic menopause, with symptoms like headaches, hot flushes, poor concentration, or low mood. It doesn’t hurt in a direct sense, but the hormonal effects can be noticeable.
Tips for managing IVF discomfort
There’s quite a lot you can do to make each stage more comfortable:
- For injections: Ice the area briefly beforehand, rotate sites each day, and use the thinnest needle your protocol allows.
- During stimulation: Stay hydrated, rest when you need to, and avoid strenuous exercise as your follicles grow.
- After egg retrieval: Rest for the remainder of the day, use a heat pad on your lower abdomen, and keep paracetamol handy (avoid ibuprofen unless your clinic advises otherwise).
- During the two-week wait: Gentle movement like walking is fine; give yourself permission to take it easy.
- Emotionally: Talk to your clinic about counselling options — most are required to offer this, and many people find it genuinely helpful.
When to contact your clinic for IVF pain
Most discomfort during IVF is normal and expected. But there are signs to watch for that warrant a call to your clinic:
- Severe or worsening abdominal pain or swelling after egg collection
- Passing small amounts of very dark, concentrated urine [3]
- A high temperature or signs of infection
- Heavy bleeding (more than light spotting)
- Shortness of breath or chest pain
These are uncommon, but knowing what to look out for means you can act quickly if something doesn’t feel right.
Is IVF painful? The bottom line
For most people, IVF is uncomfortable — sometimes more so than they’d like — but it isn’t painful in the way many fear it will be. The injections are manageable; the retrieval is done under sedation; the transfer is usually fine. The parts people often find hardest are the cumulative physical fatigue of a demanding process, the hormonal effects of the medication, and the emotional weight of waiting and hoping.
Being prepared helps. Knowing what each stage involves, what’s normal, and what to do if something doesn’t feel right makes a real difference to how you experience it. You don’t have to go in blind — and you don’t have to go through it alone.
IVF pain FAQs
Can I go to work during IVF?
Yes, most people continue working through an IVF cycle. The stimulation phase can cause some tiredness and bloating, but it’s usually manageable. You’ll likely want to take at least the day of egg retrieval off — and possibly the following day too. The two-week wait is physically quiet for most people, though emotionally it can feel like anything but.
Is IVF more painful than a natural pregnancy?
They’re hard to compare directly. IVF involves more procedures and more medication, but any discomfort is usually short-term and managed within a clinical setting. A natural pregnancy can involve significant physical symptoms too — nausea, pelvic pain, exhaustion — and those aren’t as closely monitored.
Can I take painkillers during IVF?
Paracetamol is generally considered safe during IVF. However, you should avoid ibuprofen and other NSAIDs unless your clinic specifically tells you otherwise — some evidence suggests they may interfere with implantation. Always check with your clinic before taking any medication during a cycle.
Does the embryo transfer hurt more with a tilted uterus?
Some people with a retroverted (tilted) uterus report slightly more discomfort during transfer, as the catheter angle can be trickier to navigate. Your clinic will be aware of your anatomy and will adjust accordingly. It’s worth mentioning if you know this applies to you.
Is a frozen embryo transfer less painful than a fresh one?
The transfer procedure itself is the same either way. The main difference is that a frozen embryo transfer (FET) cycle doesn’t involve ovarian stimulation, which means you skip the stimulation injections, egg retrieval, and associated recovery. Many people find FET cycles physically easier for this reason.
What’s the most painful part of IVF overall?
This varies person to person, but post-egg retrieval is where most people feel the most physical discomfort. Cramping, bloating, and fatigue are common in the days following retrieval. For those on intramuscular progesterone, that can also be a source of ongoing soreness. Emotionally, the two-week wait is often cited as the hardest stretch.
Sources
- NHS University Hospitals Coventry and Warwickshire, NHS Trust. In Vitro Fertilisation (IVF) / Intracytoplasmic Sperm Injection (ICSI) – Information for Patients. Amended March 2023.
- NHS Guy’s and St Thomas’, NHS Foundation Trust. IVF treatment: Step 1: Medicines to produce eggs. Last reviewed July 2023.
- NHS Guy’s and St Thomas’, NHS Foundation Trust. IVF treatment: Risks of IVF. Last reviewed July 2023.
- NHS The Newcastle upon Tyne Hospitals, NHS Foundation Trust. Risks of treatment. Last updated 8 November 2022.
- NHS Guy’s and St Thomas’, NHS Foundation Trust. IVF treatment: Step 2: Egg collection. Last reviewed July 2023.
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