The IVF Process Step by Step: What to Expect at Every Stage
From your initial consultation to the pregnancy test, here's a week-by-week breakdown of what the IVF process actually looks like.
Before You Start: The Consultation
Your IVF journey begins with a fertility evaluation. Expect:
- Blood tests: AMH (ovarian reserve), FSH, estradiol, thyroid function
- Ultrasound: antral follicle count (AFC) to assess ovarian reserve
- Semen analysis: volume, count, motility, morphology
- Uterine assessment: sonohysterogram or hysteroscopy to check the uterine cavity
Results take 1–2 weeks. Based on these, your doctor will design your stimulation protocol.
Week 1–2: Ovarian Stimulation
You'll start injectable medications (FSH, LH, or a combination) to grow multiple follicles. This phase typically lasts 8–14 days.
What to expect:
- Daily self-injections (usually in the abdomen)
- Monitoring appointments every 2–3 days (ultrasound + blood draw)
- Mild bloating and mood changes are common
- Your doctor adjusts doses based on your response
Day 14 (Approx): Trigger Shot & Retrieval
When 2–3 follicles reach 18–20mm, you'll take a "trigger shot" to finalize egg maturation. Exactly 36 hours later, your eggs are retrieved.
Retrieval day:
- Arrive fasting; sedation is administered
- Procedure takes 15–30 minutes
- You'll feel groggy afterward — arrange a driver
- Mild cramping and spotting are normal
- Results (number of mature eggs) reported same day
Days 1–6: Fertilization & Embryo Development
The lab reports fertilization results the morning after retrieval. Over the next 5–6 days, you'll receive updates:
- Day 1: Fertilization report
- Day 3: Early cleavage check (optional)
- Day 5/6: Blastocyst report — the final count of viable embryos
If PGT-A genetic testing was ordered, a small biopsy is taken on day 5–6, and embryos are frozen while awaiting results (1–2 weeks).
The Transfer: Fresh or Frozen?
Fresh transfer occurs 3–5 days after retrieval (if no testing). Frozen embryo transfer (FET) happens in a subsequent cycle — either natural or medicated.
FET is increasingly preferred because it allows the uterus to recover from stimulation and synchronize more naturally.
Transfer day:
- No sedation needed (you're awake)
- Catheter is guided through the cervix into the uterus
- Takes about 10 minutes
- You'll see the embryo on ultrasound
- Rest for a day, then resume normal light activities
The Two-Week Wait (2WW)
The hardest part. You wait 10–14 days before a blood pregnancy test (beta hCG). Avoid reading into early symptoms — progesterone supplements cause many pregnancy-like effects regardless of outcome.
Stay busy, rest when needed, and lean on your support network.
After the Result
Positive: You'll have a repeat hCG test 48 hours later to confirm rising levels, then an ultrasound at 6–7 weeks.
Negative: Give yourself time to grieve, then meet with your doctor to review what happened and plan next steps. Most clinics recommend a 4–6 week wait before trying again.
IVF is a marathon, not a sprint. Most people need more than one cycle. Knowledge and preparation make the journey significantly easier.