The IVF Journey: What to Expect - A Comprehensive Roadmap

Undergoing IVF can feel daunting, especially when you’re not sure what’s coming next. But knowing the steps, timeline, and what your body is doing along the way can help reduce anxiety and make you feel more empowered. In this post, we’ll walk through the typical IVF process from “checklist before we begin” through embryo transfer (or freezing), with realistic timelines, what to expect internally, and how FertilitEase supports you every step of the way.

Before You Begin: The Pre-Cycle Checklist

Before starting “meds and injections,” there are several essential steps your fertility clinic will require. Think of this as your IVF readiness checklist.

Item	Why It Matters	Typical Timing / Notes
Medical history & consultation	The doctor reviews your fertility history, health, previous surgeries, etc.	At least a few weeks out
Consent forms & legal paperwork	You’ll sign consents around risks, lab use, genetic testing, embryo disposition, etc.	Must be done before medications begin
Baseline bloodwork, hormones, & pelvic trans-vaginal ultrasound	To assess your ovarian reserve (AMH, FSH, LH, estradiol, TSH, prolactin, AFC, etc.)	Typically early in cycle, at least 1-2 cycles before starting treatment
Infectious disease / STD screening	Clinics screen for HIV, hepatitis, syphilis, etc. for lab safety	Required prior to sperm/egg handling (both partners, if applicable)
Uterine cavity evaluation (e.g. HSG, sonohysterogram, saline ultrasound)	To confirm the uterine/fallopian tubes are healthy, no big polyps, adhesions, structural issues, blockages, etc.	Typically done cycle days 5-12, often completed 1-2 cycles before starting treatment
Pap smear, mammogram, standard health screening	To ensure general gynecologic & breast health is up to date	As needed, per clinic protocol
Semen analysis (for partner, if applicable)	To assess sperm parameters (count, motility, morphology)	Before or during IVF cycle prep (*if using donor sperm, sperm vial(s) should be selected and on-site prior to starting treatment)
Genetic testing / carrier screening	To identify inherited conditions and plan PGT or embryo selection	Often done in 4-6 weeks advance, due to length of time needed for results
Counseling / psychological screening	IVF is emotionally demanding... many clinics offer or require counseling	Often early, before cycle start

Everyone's "checklist" is individualized. Once all items are completed and cleared, your clinic will schedule your IVF cycle and provide your medication plan, calendar, and instructions.

Priming (If Applicable)

Some IVF protocols include a priming or “pre-treatment” phase before starting injections/meds. The goal is to optimize your ovaries, synchronize follicles, decrease the risk of cysts, etc...

• Examples:

  • Oral contraceptives (birth control pills): A common priming tool to regulate cycle timing, help coordinate response, or suppress cysts.

  • Estradiol or low-dose estrogen: Commonly used in select protocols to improve follicle synchrony.

If your clinic uses priming, it’s usually several days to ~2 weeks ahead of your stimulation start (in the menstrual cycle prior to starting). The priming makes it easier to “turn on” the stimulation phase in a controlled way.

Suppression / Baseline Check

Before stimulation/starting injections, your clinic will have you come in for a baseline or suppression check visit: bloodwork (LH, progesterone, estradiol, HCG) and a baseline trans-vaginal ultrasound to confirm there are no cysts or dominant follicles already growing. This is typically performed about cycle day 2-4 of your period or timed out by your clinic if you don't get regular cycles/are on birth control for priming.

• If your baseline is not “quiet” (e.g. estradiol too high, follicle > 10 mm), they may delay or modify your protocol.

• If "cleared," injections will likely start same day if not the next 1-2 days.

Getting an optimal “baseline” ensures the stimulation phase starts under favorable conditions.

Stimulation Phase: Growing the Follicles

This is where the majority of your injectable medications, monitoring, and appointments occur. Here’s what to expect:

What happens in your body:

• You’ll receive daily (sometimes twice-daily) injections of gonadotropins (FSH, sometimes with LH).

• These stimulate multiple ovarian follicles (follicle = sac that holds your eggs... eggs are too small to see via ultrasound) to grow (versus the single follicle you’d typically grow in a natural cycle).

• The goal is to recruit several follicles, giving more eggs to retrieve and utilize.

  • This number depends on your body and ovarian reserve.

Timeline (approximate):

• The stimulation phase usually lasts 8 to 14 days (often around 10–12 days) but can vary depending on your age, ovarian reserve, response, and protocol.

• Early days (Day 1–4): Small follicles begin to respond, estrogen gradually rises.

• Mid phase (Day 5–8): You start seeing multiple follicles of 10–14 mm or more, estrogen curves upward.

• Late phase (Days 9–14): You look for a cohort of follicles ~16–20+ mm, and your estradiol may be in thousands of pg/mL depending on how many follicles.

• The goal is for a gradual estradiol increase, follicular growth of ~1-2mm/day, and the follicles are growing uniformly.

What we’re looking for (monitoring):

• Trans-vaginal ultrasound follicular measurements – to see how many follicles, their sizes, and uniformity.

• Estradiol (E2) levels – helps judge how well follicles are producing estrogen, and whether the response is too high (risk of OHSS) or too low.

• LH, progesterone levels (sometimes) – to detect unwanted premature rises and ovulation.

• Endometrial thickness / lining – to ensure your uterus is developing a receptive lining (if doing a fresh transfer).

Frequency of office visits / labs:

• Usually every other day early, then daily visits toward the end (expect ~6-8 visits during stimulation).

• Early morning blood draws and ultrasounds are common so you get same-day lab results to adjust doses.

  • It is normal for your provider to increase or decrease medication dosages during the cycle (you didn't do anything wrong!), depending on your body's response, to achieve optimal results.

This portion is often the most logistically heavy: coordinating injections, travel to clinic, labs, and staying on schedule. Keep this ~2 weeks flexible and limit unnecessary travel, if possible.

Trigger Shot

Once your lead follicles reach the proper size (often ~18–20+ mm, or depending on clinic protocol), you’ll administer a “trigger” injection (usually hCG and/or a GnRH agonist trigger (Lupron)). This mimics the natural LH surge (pre-ovulation) and prompts final maturation of the eggs in their follicles.

• Timing is crucial: your retrieval is typically scheduled ~34–36 hours after the trigger injection (before natural ovulation).

• The trigger helps detach the eggs from the follicular wall and complete the final meiotic division, making them ready for retrieval.

Egg Retrieval

The egg retrieval is a minor surgical procedure, usually done under sedation or anesthesia, guided by transvaginal ultrasound.

What to expect:

• In the OR / procedure room, a needle is passed through the vaginal wall into each follicle, and fluid (with eggs) is aspirated.

• This is fairly quick (often 10–20 minutes, depending on how many follicles).

• You go home the same day (unless complications)... expect to be at the clinic for ~3hrs.

• You may feel cramping, mild bloating, or spotting afterwards. You'll get detailed discharge instructions.

In the lab, embryologists identify eggs and evaluate their maturity (some may be immature or degraded). Mature eggs are fertilized (by conventional insemination or ICSI) and begin embryo culture.

Recovery, Embryo Development & Transfer Planning

Recovery Phase

• The first 24 hours post retrieval is “rest and recovery.”

• Many patients feel back to normal in 1–2 days, though bloating or mild cramping may linger (~3-4 days).

• Expect your period (if applicable) ~5-7 days if Lupron only trigger and ~10-14 days if HCG or dual trigger.

Embryo Culture & Attrition

• Not all retrieved eggs are mature, not all mature eggs successfully fertilize, and not all fertilized eggs make it to blastocyst stage (Day 5/6). It’s normal and expected to have attrition in the embryo development process.

• The lab may grade embryos by quality, cell number, symmetry, and fragmentation.

When You’ll Hear About Results

• Day of egg retrieval, you should know the number of total eggs retrieved, the next day you should receive an egg maturation and fertilization update, then on Day 3 and/or Day 5/6/7 (depending on your clinic), you’ll get a call with embryo results.

• If you are doing Preimplantation Genetic Testing (PGT), the biopsy occurs at the embryo blastocyst stage (day 5/6/7), and results may take ~2 weeks.

Fresh Transfer vs Frozen

• Fresh transfer: If this is the plan and your endometrium and hormone levels look favorable, you may have an embryo transferred within the same cycle (often Day 5).

• Freeze-all / deferred transfer: If this is the plan and/or stimulation caused an overly high estrogen level, or poor lining, clinics often freeze all embryos and transfer in a later “prepared/FET (frozen embryo transfer)” cycle.

  • If PGT is done, the earliest an FET may take place (depending on results) is 6-8 weeks from egg retrieval.

    
    

Realistic Timeline Snapshot

• Pre-cycle prep and testing: ~ 4–6 weeks

• Priming (if used): ~ 1-2 weeks

• Stimulation: ~ 8–14 days

• Retrieval to blastocyst embryo development: ~ 5–7 days

• (If PGT) Waiting period for results: ~ 2 weeks

• Transfer in same cycle OR next cycle: plan dependent (see above)

• Pregnancy test: ~ 9 days post transfer

How FertilitEase Supports You Throughout

At FertilitEase, we understand that IVF is more than a medical procedure—it’s an emotional, logistical, and deeply personal journey. We fill the gaps in education and support that your clinic can't always provide, including after hours. On-demand support so you get the most out of every step:

1. Personalized care coordination

   • We walk with you from pre-cycle readiness through to embryo transfer (or freeze), helping you navigate calendars, protocols, results, and questions.

2. Medication guidance & coaching

   • Many patients feel overwhelmed by injections and protocols. We provide teaching, reminders, troubleshooting, and confidence as you do your meds.

   • We also help monitor side effects and ensure safety.

3. Emotional & mental health support

   • Through the ups and downs of each phase, we help you stay grounded, hopeful, and informed.

4. Education & transparency

   • We provide resources, infographics, and explanations so that you understand why your clinic is taking each step.

   • We help you anticipate next steps and reduce surprises.

5. Advocacy

   • If something seems off (response unexpectedly low, or stuck), we consult, ask questions, and help you advocate for protocol changes or adjustments with your clinic.

   • We can help interpret lab results, follicle growth charts, and hormone trajectories so you are an informed partner in decision-making.

6. Post-cycle follow up

   • After embryo transfer or freezing, we remain in communication, help with monitoring, answer questions during the “wait” period, and support you through the emotional rollercoaster until results.

   • If the cycle needs repeating, we help you optimize protocol next time, based on what was learned.

     
     

Conclusion

The IVF journey is complex, but it’s one you don’t have to face alone. Each phase—from testing and consent to stimulation, retrieval, embryo development and transfer—has its own challenges and emotions. But with clear expectations, understanding what’s happening “behind the scenes,” and a supportive partner like FertilitEase by your side, the process becomes less mysterious and more navigable. If you’re contemplating or preparing for IVF, reach out to us. We’d be honored to walk beside you, advocate for you, and help you maximize your chances every step of the way.

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About FertilitEase

FertilitEase provides RN-driven personalized educational coaching, injection teaching, and texting support that enables individuals to understand their fertility and pregnancy journeys and empowers them to advocate for their personal preferences. Support = better outcomes!! All services are delivered by registered nurses who have extensive clinical experience working with patients at leading fertility practices. Please visit our Services tab for more detail or Get Started with us today!