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4. What to Expect During IVF: A Step-by-Step Guide

What to Expect During IVF: A Step-by-Step Guide

If you're considering in vitro fertilization (IVF), you probably have one question running through your mind: what does the process actually involve, day to day?

It's a fair question. IVF has come a long way since the first successful procedure in 1978, and it's now the most widely used form of assisted reproductive technology worldwide. But "widely used" doesn't mean well understood; for most patients, an IVF cycle is unlike anything else they've experienced medically. Knowing what's ahead can make the process feel a lot less overwhelming.

Here's a clear, step-by-step breakdown of what an IVF cycle typically looks like.

What Is IVF, Exactly?

In vitro fertilization is a process where eggs are retrieved from the ovaries and combined with sperm in a lab setting, outside the body. Once fertilization occurs, the resulting embryo is transferred into the uterus.

IVF may be recommended if you're dealing with:

• Blocked or damaged fallopian tubes (or if the tubes have been removed)
• Male-factor infertility, such as low sperm count or poor sperm motility
• Irregular ovulation
• Uterine fibroids
• Advanced reproductive age
• Unexplained infertility

Step 1: Ovarian Stimulation with Fertility Medications

Most people naturally produce one egg per menstrual cycle. IVF changes that math. Fertility medications stimulate the ovaries to produce multiple eggs in a single cycle, which improves the odds of a successful outcome. Alongside these, a synthetic hormone is typically used to prevent the eggs from being released too early, before retrieval can happen.

Step 2: Monitoring Appointments

During the stimulation phase, expect frequent visits to your clinic, generally every 2 to 3 days. These appointments involve:

• Blood tests to track hormone levels
• Ultrasounds to monitor follicle development (the fluid-filled sacs where eggs mature)

This monitoring helps your care team time everything precisely, since eggs need to be retrieved at just the right point in their development, not too early, not too late.

Once your follicles reach the ideal stage, you'll receive a "trigger shot," a hormone injection that finalizes egg maturation and prepares the eggs for retrieval.

Step 3: Egg Retrieval

Egg retrieval is a minor surgical procedure, not a major operation. Using ultrasound guidance, a thin, hollow needle is used to gently drain the follicular fluid from the ovaries, with the goal of collecting as many eggs as possible. The entire process usually takes under 30 minutes.

Because egg maturity can't be assessed until after retrieval, the number of eggs collected varies significantly from patient to patient, depending on individual response to fertility medications. If you're not using frozen or donor sperm, your partner will typically provide a fresh sperm sample on the same day.

Step 4: Fertilization in the Lab

Once the eggs — technically egg masses called cumulus-oocyte complexes, or COCs — are retrieved, the method used to fertilize them depends on your treatment plan and the characteristics of the sperm sample.

With conventional IVF, the COCs are placed in a petri dish together with the prepared sperm sample, allowing fertilization to happen naturally. This approach relies on the sperm being healthy enough to fertilize the eggs on their own.

With ICSI, the embryology team first assesses each COC individually to identify which eggs have reached maturity, since only mature eggs can be used for this technique. A single sperm is then carefully injected directly into each mature egg.

After either method, the eggs are monitored closely to check for normal fertilization. It's common for some eggs not to fertilize, this can relate to egg maturity, sperm factors, or other biological factors.

Once normal fertilization occurs, the developing embryo enters the cleavage stage and is cultured in the lab for up to six days. Many embryos that progress successfully reach the blastocyst stage by day 5 or 6, though not every embryo gets there. The likelihood of an embryo developing into a viable blastocyst depends on several factors, including the age of the egg source, and laboratory data can help provide an estimated statistical likelihood. Blastocysts suitable for continued use may then be selected for embryo transfer or cryopreservation, with or without genetic testing, depending on your treatment plan.

Step 5: Embryo Transfer

Embryo transfer happens 3 to 5 days after egg retrieval. Using a thin catheter, the embryo is placed directly into the uterus, a quick procedure that typically doesn't require anesthesia.

Step 6: The Two-Week Wait and Pregnancy Test

If the transfer is successful, the embryo implants into the uterine lining and begins to grow. Most clinics schedule a pregnancy test around 10 days after transfer to confirm whether the cycle was successful. This waiting period is often described by patients as the hardest part of the entire process, which is completely normal to feel.

Frequently Asked Questions About IVF

How long does one full IVF cycle take?

From the start of fertility medications to the pregnancy test, a single IVF cycle typically spans about 4 to 6 weeks.

Is egg retrieval painful?

Unless general anesthesia is needed or requested, patients are given conscious sedation, meaning you're awake during the procedure. Your care team will do their best to keep you comfortable, topping up medication as needed. Most patients feel more pressure than pain, though some discomfort is possible while the team adjusts your medication, and for some patients the medication doesn't fully manage the discomfort.

How many eggs are typically retrieved in one cycle?

This varies significantly from patient to patient, depending on individual response to fertility medications. Your care team will talk you through what to expect based on your monitoring results.

Why Patients Choose PCRM for IVF Treatment

Every fertility journey is different, and your own chances of success depend on your unique medical history. That's why our team takes the time to sit down with you, review your situation, and build an IVF treatment plan designed around your specific path to parenthood.

The Pacific Centre for Reproductive Medicine has helped build families across British Columbia and Alberta for over two decades, with success rates that rank among the highest in the country. Ready to take the next step? Receive a referral to PCRM, and let's talk about what an IVF plan could look like for you.

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