With hot celebrity couples like Rebecca Romijn and Jerry O’Connell, Angelina Jolie and Brad Pitt, and Nicole Kidman and Keith Urban purportedly using the in vitro method of fertilization to get pregnant, it’s no wonder women everywhere are becoming interested in this highly-publicized procedure.

Regardless of whether these celebrity couples deny they conceived with the help of fertility treatments, the treatments are out there, and are significantly improving every year. If you’re struggling to get pregnant, you may be considering in-vitro. But is in-vitro fertilization (IVF) right for you? And how does it work?

Who should consider IVF?

IVF is not for everyone. It is an extremely expensive procedure, and the time and cost that must be devoted to having it done make it a heavy decision. Here are some determining factors in couples’ decisions to use IVF:

1. The woman’s fallopian tubes are blocked or damaged. If this is so, it will be difficult for an egg to be fertilized naturally, or for the embryo to travel into the uterus.
2. Severe endometriosis (the build up of tissue similar to that of your uterus outside of your uterus) can make it difficult for an embryo to implant itself in the uterus.
3. Ovarian problems that keep the woman from releasing or producing eggs.
4. An abnormal uterus shape.
5. A low sperm count, or issues with sperm function in the male may make it difficult for the sperm to fertilize the egg without help.

How does IVF work?

IVF starts by inducing ovulation.

During this beginning stage of treatment, you will be placed on medications that help trigger the development of your eggs during ovulation. Typically, a woman releases one mature egg with each menstrual cycle. Ovulation induction can cause the ovaries to release two or three eggs at one time, increasing your chances of getting pregnant.

Sometimes, fertility drugs are all a woman needs to be on her way to pregnancy. If, however, your egg quality or quantity is poor, this might not be the best route to pregnancy for you.

IVF’s next step is egg retrieval.

In order to create embryos, several mature eggs need to be retrieved from your ovaries. This is a relatively easy procedure. You will be placed under local anesthetic. Next, your doctor will insert a needle into your ovary, guided by the help of an ultrasound machine. The doctor will then take out anywhere between 5 and 20 eggs. The whole procedure takes between 15 and 30 minutes.

Directly after the egg retrieval, the eggs will be mixed with a sperm sample from your partner, and will be cultured overnight. If fertilization has taken place, you may continue to the next stage of IVF treatment—transferring the embryo back into your uterus.

NOTE: Blastocyst transfers are becoming more and more popular. Instead of transferring embryos back into your uterus at day 3 in their development, they are allowed to develop a full 5-7 days, then are transferred. These kinds of embryos are more likely to stay implanted in your uterus and develop into a fetus.

In natural states of reproduction, the embryo doesn’t pass through the fallopian tube and into the uterus until about day 5-7 in its development. Because of their higher success-rate at implanting, only 1 or two blastocyst embryos will be implanted in your uterus, as opposed to 2-4 embryos used in a day 3 procedure. It also reduces the risk of a multiple pregnancy, which are far more common with day 3 procedures.

IVF’s last stage is the embryo transfer.

In this stage, your embryos are implanted into your uterus, with the hopes they will hold and you will become pregnant.

The number of embryos transferred will depend on: your age, embryo health, number of embryos that were formed, and your risk for multiple pregnancy.

The procedure is completely painless. It is important, though, that it is conducted by a skilled reproductive endocrinologist, because if done incorrectly, it can affect your chances of becoming pregnant in the future.

First, you will drink several ounces of fluids to increase the size of your bladder, which will make your uterus easier to see on an ultrasound. Your doctor will select the healthiest of your embryos, which will then be put in a special fluid and placed in a catheter. A speculum will be placed in your vagina, and your cervix will be cleaned of any mucus. Then, a rubber catheter will be placed up into your uterus. The special catheter with your embryos will go inside the rubber one.

Your doctor will perform an ultrasound to figure out where it’s best to deposit your embryos. Finally, the embryos will be flushed out of the catheter into the lining of your uterus.

You will lie down for two hours following the procedure, then you may resume your usual activity. You will return in 12 days for a blood test to determine if you are pregnant.

Leftover embryos

If you have leftover embryos that were not transferred, you may decide to preserve them for a future transfer attempt, donate them, or have them destroyed.

Sex selection

If you are having in vitro fertilization, it is possible in this day and age to determine the sex of your embryos. Some of the reasons couples choose to do this are: to prevent genetic disease, because of the death of a child, and to balance out their family. If this is something you are interested in, talk to your doctor.

In vitro fertilization is not just a Hollywood trend. While expensive (one round can cost around $12,500), it is not a procedure reserved solely for Brad and Angelina. The only reason it seems so many of these couples are doing it is because several Hollywood women have put child-bearing on hold for their careers, and are reaching ages at which it is difficult to conceive.

For many women who have tried everything, and are still having trouble getting pregnant, in vitro fertilization may be the miracle they’ve been waiting for. If you are having trouble becoming pregnant, and have reviewed or tried other procedures and medications at your fertility clinic without results, this may be an excellent option for you.

In the end, women who choose in vitro are not following a Hollywood trend; they’re making the life-giving choice of becoming pregnant, when they might not otherwise be able to do so.