What Happens During an IVF Cycle?

For those embarking on the in vitro fertilization (IVF) journey, knowing what to expect during each phase can help alleviate some of the anxiety that comes with fertility treatments. Dr. Lauren Murphy, a reproductive endocrinologist at Boston IVF, provides an insightful overview of the typical IVF timeline, breaking down the steps involved over a month-long process. Below is a detailed look at the stages of an IVF cycle.

Step 1: Ovarian Stimulation (9-12 Days)
The IVF cycle begins with ovarian stimulation, during which the patient takes injectable medications for approximately 9 to 12 days. These medications stimulate the ovaries to produce multiple follicles, each potentially containing an egg. During this period, you will have regular monitoring, including blood tests and ultrasounds every 2-3 days, to track the growth of the follicles and assess hormone levels.

The goal is to mature multiple eggs, increasing the chances of fertilization. Your doctor will keep a close eye on the progress, adjusting medication doses if necessary, and will eventually decide when you are ready for the next phase—the egg retrieval.

Step 2: The Trigger Injection
Once the follicles have reached the desired size, your doctor will instruct you to take a trigger injection. This injection helps finalize the maturation of the eggs, preparing them for retrieval. The timing of this step is crucial, and 36 hours after the injection, you will undergo egg retrieval.

Step 3: Egg Retrieval (Day 10-13)
Egg retrieval is a minor surgical procedure performed under light sedation. During the procedure, which typically lasts around 15 to 20 minutes, the doctor will use an ultrasound-guided needle to collect the eggs from the follicles. You’ll need to take the day off for this procedure, but most patients feel well enough to return to normal activities the next day.

Once the eggs are retrieved, they are handed to an embryologist, who will carefully identify and prepare them for fertilization with sperm (either from a partner or a donor).

Step 4: Fertilization and Embryo Development (5-6 Days)
Following retrieval, the eggs are fertilized in the lab. The resulting embryos are placed in an incubator and monitored for 5 to 6 days as they develop. Not all embryos will reach this stage, but those that do are evaluated for quality. This stage may also involve preimplantation genetic testing (PGT), where a biopsy of the embryos is taken to screen for genetic abnormalities.

Step 5: Embryo Transfer (Day 15-20 for a fresh embryo transfer)
If a fresh embryo transfer is planned, one of the embryos is transferred to the uterus five days after egg retrieval. This is a relatively quick procedure that does not require anesthesia. If you are opting for genetic testing, or if your doctor advises freezing all embryos, the transfer may be delayed for a frozen embryo transfer (FET) in a future cycle.

Step 6: The Two-Week Wait (10-14 Days)
After the embryo transfer, you enter the two-week wait, during which you will take medications to support implantation and early pregnancy. About 10 days after the transfer, you will return to the clinic for a blood test to determine whether the cycle was successful and you are pregnant.

IVF Cycle with Genetic Testing
If you opt for genetic testing, the timeline extends slightly. Embryos are frozen after day 5 or 6, and you’ll wait for the genetic results before deciding which embryo to transfer in a later cycle. The testing helps ensure the selected embryo is chromosomally normal, which increases the chances of a successful pregnancy and live birth.

Total Timeframe
From the start of ovarian stimulation to the pregnancy test, an IVF cycle typically takes about one month. For those doing a fresh transfer, the process spans two weeks to retrieval, five days to transfer, and another 10 days to the pregnancy test.

Conclusion
At Boston IVF, the process of IVF is designed to maximize the chances of success while offering patients personalized and supportive care. Dr. Murphy emphasizes that IVF allows patients to overcome numerous fertility challenges, including genetic conditions, male infertility, and more. With the possibility of freezing embryos for future use, IVF provides not only an opportunity for immediate pregnancy but also flexibility for future family planning.

If you're considering IVF or want more information, feel free to reach out to Boston IVF to schedule a consultation. Each journey is unique, and the dedicated team at Boston IVF is here to guide you every step of the way.