Can you have IVF during Ramadan? Fasting, injections, scans and the transfer

You can have IVF during Ramadan, and injections under the skin or into a muscle do not break the fast under Malaysian guidance. But JAKIM's guide for patients and the Federal Territories Mufti count medicines or instruments placed in the vagina as breaking the fast, which affects pessaries, internal scans, egg collection and the transfer. Other scholars, including a guide from a Ministry of Health hospital, take a different view. Plan the timing with your specialist, and ask your mufti.

This page sets out what Malaysian guidance says about each step of IVF, where scholars differ, and what to think about when planning. It reports published guidance; it does not give a personal ruling.

When is Ramadan in 2027?

Ramadan 1448 is expected to begin on or around Monday, 8 February 2027, with Hari Raya Aidilfitri around 10 March. The exact date depends on the sighting of the new moon and is announced by the Keeper of the Rulers' Seal shortly beforehand.

For most people, an IVF cycle takes four to six weeks, so a cycle that begins in January is likely to run into Ramadan.

What does Malaysian guidance say breaks the fast?

We have not found a Malaysian ruling written specifically about IVF and fasting. The guidance below covers medical treatment in general.

In a 1984 ruling on heart medicines, the National Fatwa Council decided that medicine given to a fasting patient without entering through a body opening (rongga) does not break the fast. JAKIM's 2013 guide for patients, Panduan Berpuasa bagi Pesakit, as summarised by Universiti Putra Malaysia's health centre, lists:

• Does not break the fast: all injections, whether under the skin, into a muscle, a joint or a vein; giving or taking blood, including blood tests; local or partial anaesthesia; creams and plasters on the skin.
• Breaks the fast: tablets and liquid medicines taken by mouth; inhalers; inserting any pessary or medicine into the vagina (faraj), including washing and internal examination; general anaesthesia using gas.

A 2018 Ministry of Health pharmacy guideline, reviewed by JAKIM, gives a similar list: tablets, liquid medicines, suppositories, pessaries, inhalers and general anaesthesia break the fast; bolus injections, creams and sedation (separa bius) do not.

In 2023 the Federal Territories Mufti's office answered a question about a speculum examination in Ramadan. It concluded that inserting a medical instrument or a finger into the vagina breaks the fast, following the Shafi'i school. It advised having such procedures at night where possible. If that is not possible, it said they may be done in the day, and the fast is made up later (qada').

Where do scholars differ?

Not every authority takes this view.

• The International Islamic Fiqh Academy (Jeddah, 1997) listed vaginal pessaries, washes, a vaginal speculum and a finger examination, and instruments placed in the womb, among things that do not break the fast. It also advised doctors to suggest postponing, until after iftar, any treatment that can safely wait.
• A question-and-answer guide written by staff at a Ministry of Health hospital (Hospital Sultan Haji Ahmad Shah, Temerloh), not an official religious ruling, says that a vaginal examination and a speculum do not break the fast, citing the majority of scholars.
• On anaesthesia, the pharmacy guideline says general anaesthesia breaks the fast, while the Temerloh guide says anaesthesia alone does not unless fluids are given with it.

These differences come from different schools and methods of reasoning. Malaysian official guidance, including the JAKIM guide and the Federal Territories opinion, follows the Shafi'i school. If you are unsure which view to follow, ask your state mufti's office.

How does each step of IVF fit with fasting?

None of the rulings above names IVF steps. This is how the published lists line up with them, step by step.

Stimulation injections. The medicines that stimulate the ovaries are usually daily injections for around two weeks. Injections are listed as not breaking the fast. Ask your clinic whether yours can be given at a fixed time after iftar.

Monitoring scans. During stimulation you have several scans, usually with a probe placed in the vagina (a transvaginal scan), plus blood tests. Under the JAKIM guide and the Federal Territories opinion, an internal examination breaks the fast; under the Fiqh Academy view it does not. Blood tests do not break the fast. An abdominal scan, which stays on the skin, is not mentioned in the lists we read.

Egg collection. The eggs are collected with a needle passed through the vaginal wall, guided by a vaginal ultrasound probe, under sedation or anaesthetic. You are asked not to eat or drink for some hours beforehand. Under the Shafi'i view in the Malaysian guidance, this falls under instruments placed in the vagina; under the Fiqh Academy view, it does not break the fast. Sedation is listed as not breaking the fast, while the lists differ on general anaesthesia (see above).

The husband's sperm sample. The husband is usually asked to give a sample while the eggs are being collected. We have not found a Malaysian ruling on this. Jordan's official fatwa department, which also follows the Shafi'i school, has answered that deliberately producing a sample in the daytime breaks the fast, and suggested doing it at night. Ask your clinic whether a sample can be frozen beforehand, and ask your mufti.

Embryo transfer. A thin tube carrying the embryo is passed through the vagina and cervix into the womb. No anaesthetic is usually needed. Under the Shafi'i view this is an instrument placed in the vagina; under the Fiqh Academy view, it is not something that breaks the fast.

Progesterone after collection or transfer. Progesterone supports the womb lining. It can be given as vaginal pessaries or gel, as injections into a muscle or under the skin, or for some women as a tablet (dydrogesterone). Pessaries are listed as breaking the fast; injections are not; tablets break the fast but can be taken at sahur and iftar. Don't change or stop progesterone yourself. If the route matters to you, ask your specialist whether another form is suitable for you.

Is it safe to fast during IVF?

There is little research. One study of 600 women in Egypt (2016) compared women who fasted during IVF in Ramadan with women who did not. It found no difference in embryo quality, although the women who fasted needed higher doses of medicine for longer, and those who became pregnant had more pregnancy complications. It was not a randomised trial. A study from Israel (2023) found lower sperm motility in samples given during Ramadan than in samples from the same men at other times. Neither study is strong enough to give firm advice, and we have not found specific guidance on fasting from the major fertility bodies.

What matters more is your own health. Ovarian hyperstimulation syndrome (OHSS) is an over-response to the stimulation medicines. The Royal College of Obstetricians and Gynaecologists (RCOG) advises women with mild OHSS to drink regularly according to thirst. Severe OHSS can cause extreme thirst, dehydration, reduced dark urine and difficulty breathing. If you have worsening pain, vomiting, problems passing urine, chest pain or breathlessness, contact your clinic straight away, and do not keep fasting against medical advice.

Am I allowed not to fast?

Islam gives sick people a concession (rukhsah) not to fast. The Ministry of Health pharmacy guideline says a patient may break the fast if fasting would worsen their illness or slow recovery. Someone who misses fasts while unwell, with hope of recovery, makes them up later.

Whether IVF treatment counts as a reason not to fast on a given day is a religious question. Your specialist can tell you which steps carry a medical reason, for example OHSS or dehydration, and your mufti can advise on the ruling.

What if I am pregnant during Ramadan?

If the transfer works, early pregnancy may fall during Ramadan. Guidance from Hospital Sultan Haji Ahmad Shah lists situations in which pregnant women are not advised to fast, including diabetes in pregnancy, high blood pressure in pregnancy and twin pregnancy. It also lists signs that a pregnant woman should break her fast, such as dizziness that does not settle after 30 minutes' rest, extreme thirst, or a fever. Ask your doctor about your own situation.

How can I plan treatment around Ramadan 2027?

Talk to your specialist early, ideally by December. Common options are:

• Finish before Ramadan. Start in time for the transfer to be done before early February. This depends on your cycle and the clinic's schedule.
• Start after Hari Raya. Wait until mid-March 2027. Whether a delay of a few weeks matters depends on your age and egg reserve, so ask your specialist before deciding to wait. See fertility after 35 and low AMH.
• Stimulate and freeze, transfer later. Have stimulation and egg collection, freeze the embryos, and have a frozen embryo transfer after Ramadan. This still involves scans and egg collection.
• Go ahead during Ramadan. Fast where you can, have injections after iftar, and make up any days you miss, following your mufti's guidance.

Ask your clinic which appointments can be moved to after iftar and which cannot. For the wider question of what Islam permits in IVF, see Is IVF halal?

Sources

• JAKIM, Kompilasi Pandangan Hukum Muzakarah Jawatankuasa Fatwa Majlis Kebangsaan Bagi Hal Ehwal Ugama Islam Malaysia, 5th printing, 2015: Penggunaan Ubat Penyakit Jantung Bagi Pesakit-Pesakit Yang Sedang Berpuasa (7th meeting, 11–12 April 1984).
• Pusat Kesihatan Universiti, UPM, Puasa & Ubat, 2019, summarising JAKIM, Panduan Berpuasa bagi Pesakit (2013).
• Ministry of Health Malaysia, Pharmacy Services Programme, Panduan Penggunaan Ubat-ubatan dari Perspektif Islam, 1st edition, January 2018, section 7.0.
• Jabatan Mufti Wilayah Persekutuan, Irsyad Fatwa Edisi Khas Ramadhan Siri ke-221: Hukum memasukkan peralatan perubatan ke dalam faraj ketika siang Ramadan, 3 April 2023.
• Hospital Sultan Haji Ahmad Shah, Temerloh (Ministry of Health), Soal Jawab Puasa dan Perubatan.
• International Islamic Fiqh Academy, resolution on things that break the fast in medical treatment, 10th session, Jeddah, 1997, as reproduced by IslamOnline; see also its Resolution 174 (12/18), Putrajaya, 2007.
• Darul Iftaa Jordan, Ruling on masturbating during daytime in Ramadan to undergo semen analysis.
• Wahba KA, Effect of fasting of Ramadan on infertile women undergoing IVF/ICSI cycles, Open Journal of Obstetrics and Gynecology, 2016;6:171–179.
• Engel OJ et al., The effect of month-long daily fasting on semen parameters, Gynecologic and Obstetric Investigation, 2023;88:384–390.
• RCOG, Ovarian hyperstimulation syndrome (OHSS), patient information.
• Griesinger G et al., Network meta-analysis of progestogen administration routes for luteal phase support, Reproductive BioMedicine Online, 2026 (summarising ESHRE's recommended routes).
• HFEA, In vitro fertilisation (IVF); NHS, IVF: what happens; Guy's and St Thomas' NHS Foundation Trust, IVF step 2: egg collection; Northwestern Medicine, Ovarian stimulation.
• RTM, Umat Islam di Malaysia mula berpuasa pada Khamis, 2026; Wego, Ramadan 2027 (projected dates).

This page is general information, not a fatwa or medical advice for your own treatment.