Starting your first IVF cycle comes with a mix of emotions: hope, anxiety, anticipation, and a lot of questions. One of the best things you can do to prepare yourself is simply to understand what is coming. When you know what each phase involves and why it matters, the process feels far less overwhelming. Below is a plain-language, week-by-week breakdown of what a typical IVF cycle looks like, from your first consultation all the way to your pregnancy test.
Every patient’s experience is different, and your physician will tailor your protocol to your specific situation. This guide is meant to give you a general picture, not a precise prediction of your own cycle.
Before Week One: The Consultation and Baseline Testing
The first step in the IVF process is an initial consultation with a fertility specialist. At this meeting, your physician will review your medical history in detail, discuss any previous fertility treatments, and outline a care plan tailored to your needs.
Testing during this phase typically includes blood work to evaluate hormone levels and ovarian reserve, a uterine assessment, and semen analysis for your partner. A financial consultation is also part of this stage, giving you the opportunity to review costs, insurance coverage, and payment options. Altogether, the consultation and testing phase can take two to four weeks, depending on individual circumstances.
Once your results are in and your treatment plan is set, you are ready to move forward.
The Month Before Your Cycle Begins: Priming
Many IVF protocols include a priming phase before stimulation medications begin. Although it may seem counterintuitive, IVF patients often take oral contraceptives for 10 to 14 days prior to beginning their fertility medication protocol. Studies have shown that oral contraceptives taken before ovarian stimulation can increase the number of eggs available for retrieval, help follicles grow more uniformly, and support ovarian health throughout the cycle.
Your care team will also send you a detailed medication calendar outlining exactly what to take, when to take it, and what appointments to schedule.
Week One: Ovarian Stimulation Begins
The IVF cycle formally begins with ovarian stimulation, during which you take injectable hormone medications for approximately 9 to 12 days. These medications stimulate the ovaries to produce multiple follicles, each one potentially containing an egg.
This is the phase that requires the most from you on a day-to-day basis. You will be giving yourself injections at home, typically in the evening, and coming into the office several times for monitoring. Blood tests and ultrasounds are performed every two to three days to track follicle growth and hormone levels. Your physician uses this information to adjust your medication dosage as needed.
It is normal to feel some bloating or mild pelvic pressure during this time as your ovaries respond to the medication and begin producing more follicles than they would in a natural cycle. Most patients are able to continue their normal routines during stimulation, though strenuous exercise is generally discouraged.
Week Two: Monitoring, the Trigger Shot, and Egg Retrieval
As your follicles approach maturity, monitoring visits become more frequent. When your physician determines that the follicles have reached an appropriate size, you will be given a trigger shot of human chorionic gonadotropin (hCG). This injection signals the final stage of egg maturation and sets the clock for retrieval. There is a small window to complete the egg retrieval, which is 34 to 36 hours after the trigger injection and before ovulation begins.
Egg retrieval is performed at our outpatient facility under conscious sedation administered by a certified anesthetist. Using vaginal ultrasound guidance, your physician inserts a thin needle into each follicle to collect the eggs. The procedure typically takes between 30 and 60 minutes. After retrieval, you will rest in recovery for about an hour. Some discomfort and mild nausea are expected in the hours that follow, and both typically resolve the same day.
On the same day as retrieval, a sperm sample is collected from your partner or a previously frozen sample is thawed. The eggs and sperm are then brought together in our IVF laboratory.
Days Following Retrieval: Fertilization and Embryo Development
By the morning after retrieval, our embryology team will have the first report on how many eggs fertilized normally. From there, the embryos are monitored as they develop over the next three to five days.
Depending on your situation, fertilization may occur through standard insemination, in which eggs and sperm are placed together in a dish, or through ICSI (intracytoplasmic sperm injection), in which a single sperm is injected directly into each egg. Roughly 70 percent of IVF cycles nationwide involve ICSI, and our program reflects that same figure.
Embryos may be transferred at day three, when they are at the 6 to 8 cell stage, or at day five, when they have reached the more advanced blastocyst stage. Your physician will discuss the timing that gives you the best chance of success. If embryos are being tested for genetic abnormalities through preimplantation genetic diagnosis (PGD), they are frozen after day five while results are processed. This adds some time to your overall cycle but allows the selected embryo to be chromosomally screened before transfer, which can increase the likelihood of a successful outcome.
Any healthy embryos that are not transferred are cryopreserved for potential future use.
Embryo Transfer: A Straightforward Procedure
The embryo transfer itself is a relatively simple procedure that almost never requires anesthesia, though a mild sedative is offered to help you relax. You will be asked to arrive with a full bladder. Using abdominal ultrasound guidance, a soft catheter is gently passed through the cervix and the embryo or embryos are placed into the uterus. The whole process takes only a few minutes, and you will rest at our facility for about 30 minutes before heading home.
Progesterone supplementation begins after transfer to support the uterine lining and encourage implantation. You will be asked to take it easy for the next few days, though strict bed rest is not required.
The Two-Week Wait
The two-week wait following embryo transfer can be one of the most emotionally challenging parts of the entire process. During this time, it is completely normal to feel a mix of hope, anxiety, and uncertainty. Some patients notice mild symptoms like bloating, fatigue, or breast tenderness, but these can result from the progesterone medication rather than pregnancy, so they are not reliable indicators either way.
Approximately 10 to 14 days after transfer, you will return to our office for a blood pregnancy test. This blood test, which measures hCG levels, gives the most accurate reading of whether the cycle was successful.
If the First Cycle Does Not Result in Pregnancy
Not every cycle leads to pregnancy, and that is not a reflection of failure on your part or your physician’s. If the first attempt is unsuccessful, you can typically expect your period to return one to two weeks later, giving your ovaries time to rest before the next cycle can begin. Your physician will review everything that happened during your cycle and use that information to refine the protocol going forward.
Many patients conceive after two or three cycles. Each cycle teaches the team more about how your body responds, and that knowledge is applied directly to the next attempt.
A Final Word
Starting IVF for the first time takes courage. The process asks a lot of you physically and emotionally, and there are no guarantees. What we can promise at the Fertility Institute of Vancouver is that you will not go through it alone. Our entire team are with you at every step, from that first consultation to the moment you get your result. If you are ready to learn more or schedule your initial appointment, we invite you to reach out to us directly.