Brief synopsis of what happens during an ivf cycle

Last updated: May 1st, 2021 at 09:10 am

What Happens During IVF Cycle Treatment Step by Step in easy to understand words & graphics (includes IVF side effects & risks of IVF):

graphic showing what happens during the ivf process

IVF Step by Step

There are several different steps to IVF

IVF Step 1: IVF Cycle Birth Control Pills Phase

This is the first possible phase of IVF, it lasts for approximately 14-21 days. At the beginning of your IVF cycle, you may be put on birth control pills for a 2 to 3 week period of time.  If not, then you will go to start at step 2 below.

IVF Step 2: IVF Cycle Down Regulation Phase

The aim of this phase is to calm down your ovarian function and you are given medications to do this. The down regulation medications work by suppressing the production of hormones from your pituitary gland. The medication may be a nasal spray of Synarel/Lupron or Buserelin for approximately 10-15 days. You will usually begin these medications at around day 21 of your menstrual cycle or 7 days post LH (Luteinizing Hormone) surge.

IVF Side effects: Some women experience side effects such as headaches, night sweats, irritability, feelings of depression.

IVF Step 3: IVF Cycle Baseline Ultrasound & Blood Test

This is usually about an hour appointment. You will be be asked to go to the IVF clinic for an ultrasound examination (this is usually a vaginal ultrasound) and a blood test for your estradiol level. If the results of the scan and blood test are in the normal range, you will be cleared to enter into the next phase of your IVF cycle: Stimulation.

IVF Step 4: IVF Cycle Stimulation Phase -Egg production stimulated by medications

This phase of the IVF cycle lasts for approximately 10-12 days. This involves injections in to your abdomen. Giving the injections is not something that the IVF clinics do for you, this is something you must do yourself. The clinics usually offer instructions on how to administer the injections or they refer you to instructional videos on YouTube. Usually you or your partner give the injections. The injections that you will begin at this time are commonly called “Stimulation injections”, specifically they are Gonadotropin injections. The purpose of administering gonadotropin is to stimulate the ovaries to produce more than one egg. Bravelle, Repronex, Pergonal (hMG), Follistim and Gonal-F (FSH) are some of the medications given as an injection once or twice a day to recruit multiple eggs which develop inside follicles. You will also need to take another injection ( such as Antagon and Cetrotide) to prevent a premature release of the stimulated eggs before the egg retrieval procedure. After reviewing blood test results, your physician will determine (on or about the 6th through 8th day of gonadotropin injections) when to begin the  injections that will prevent premature release of eggs. During this stimulation phase you will probably be asked back to the IVF clinic several times for vaginal ultrasound scans. These scans track how many follicles are developing as well as the thickness of your uterine lining. These scans are valuable because it gives the IVF clinic information on how things are progressing for you and they may change your medication levels accordingly, tweaking and fine tuning the medications to get the desired results.

IVF Side effects:  the medication itself can cause some women to experience uncomfortable breast tenderness and abdominal distention. Also some women have bruising and skin irritation at the site of the injection from the act of inserting the needle.

IVF Risk: Occasionally the ovaries are over stimulated and there is a risk of developing OHSS-Ovarian Hyper Stimulation Syndrome. This when there are a large number of follicles present and the ovaries might possibly enlarge and release chemicals into the bloodstream that make blood vessels leak fluid into the body. OHSS can be classified as Mild, Moderate or Severe.  Most instances are mild or moderate with the enlarged ovaries developing cysts and fluid filling up the abdominal cavity. Your IVF cycle may be cancelled.  The most severe occurs in only 1%-1.5% and requires in hospitalisation and treatment to recover, (symptoms are nausea, vomiting, abdominal distention and pain, breathlessness, feeling weak, reduced urine output, heartburn or indigestion).

IVF Step 5: IVF Cycle Trigger Shot

Once the IVF clinic has determined that you are ready for the next phase of the IVF cycle (egg retrieval /egg collection), you will take an injection of hCG (Pregnyl, Novarel). This injection is usually administered late in the evening, approximately 37 hours prior to egg retrieval. This medication “ripens”/ “matures” the developing eggs and initiates the ovulation process. If you were to not have the egg retrieval procedure then ovulation would occur about 42 to 48 hours from the time of your injection. Many women can experience abdominal discomfort after the injection of hCG and may be worried that they are ovulating. However, this discomfort is due to ovarian enlargement because of the stimulation medications.  You can rest assured that your clinic is monitoring you very closely and the chance of you ovulating prior to egg collection is extremely slim, and almost zero if you are receiving the medication to prohibit ovulation such as Lupron, Synarel, Antagon or Cetrotide.

IVF Step 6: IVF Cycle Egg Retrieval/ Egg Collection -Eggs retrieved from ovary

This procedure is usually performed 36-37 hours after you take the trigger shot of hCG. Before the egg collection procedure you may receive small doses of medication given intravenously, which will make you feel relaxed and sleepy during the procedure. During the procedure your eggs will be retrieved with a needle inserted through the vaginal wall under the visual guidance of ultrasound. No abdominal incisions are required. Your partner will be asked to provide a semen specimen either before or immediately after the time of your egg collection procedure.

IVF Side effects: Following this egg retrieval procedure you may experience some pelvic area tenderness and feel tired or sleepy from the medications you have received during the procedure. You may also experience some light vaginal spotting. This bleeding may be red to brown in color and should be scanty. The medications given during your egg retrieval to calm you may not be eliminated by your body for up to 24 hours, so you may feel “hung over” or just not your normal self for a little while afterwards.

IVF Risk: Pelvic infection

IVF Step 7: IVF Cycle Fertilisation & Incubation -egg & sperm combine to allow fertilisation

This can last from 3-5 days after egg retrieval.  This is the time when sperm is introduced to the egg/s and fertilisation should occur to create embryos.  The resulting embryos are put into an incubator to develop and grow for 3 to 5 days.

It is important to know that the lack of control and lack of information at this time can be very stressful for couples as they will not know how things are progressing because their embryos are in the care of someone else, in another location.

IVF Step 8: IVF Cycle Embryo Transfer &/or Embryo Freezing -fertilised eggs introduced into uterus

This procedure is usually performed 3-5 days after egg retrieval.  The best quality embryos are chosen by the Embryologist to be transferred back in to your womb.  Usually 2 embryos is the maximum number that will be returned to your womb.  If you have more than 2 embryos the “extra” embryos will be allowed to progress to a state that is desirable for freezing.  Embryos can be frozen so that they can be transferred back in to you at another date during another IVF cycle.

This can be a very exciting day for couples to have reached this point of Embryo Transfer.

IVF Step 9: IVF Cycle Two Week Wait ( 2WW )

This is the time period after embryo transfer and before your pregnancy test. It may not be a full 2 weeks, the amount of days waiting depends on how many days your embryo was transferred back after egg collection. You may be prescribed progesterone for this time period.

It is important to know that the 2 week wait after IVF embryo transfer can be a very stressful time for couples as they do not know if their embryo/s are implanting as there are usually no further appointments with the IVF clinic during the 2 week wait.  So the lack of information about how things are progressing can lead to feelings of stress and doubt.

IVF success rates:

About 1 in 3 IVF cycles are successful and result in pregnancy. Factors such as age, pre-existing conditions like PCOS or low AMH or high FSH or sperm issues can have an impact on your chances of success.

IVF Step 10: IVF Cycle Pregnancy Test

This is usually performed about 14 days after retrieval, the timing of the test depends on how many days after egg collection your embryo was transferred back. Depending on the medication you are on, you may need a blood test instead of a urine test to confirm whether or not you are pregnant.

You can visit the mayo clinic website to read more about  what happens during an IVF cycle

Want to know how you can increase your chances of success with IVF? read article about New study on acupuncture & IVF listed below

Related Articles:

Fertility Feng Shui to get Pregnant: 4 simple feng shui steps

How much does IVF cost in Ireland? Read the Price Comparison List of IVF prices in Irish Clinics

New study shows getting Acupuncture with IVF doubles the success rate

New Study indicates drinking red wine may help fertility

Read about the MINDFUL IVF APP to reduce stress with mindfulness and meditation

MACA and fertility. Is Maca good for fertility?

IVF diet cookbooks

Get the words to the famous fertility prayers of St. Gerard and St. Rita

Linda Ryan- Founder of MARA Fertility Acupuncture Clinic



Hi, I’m Linda Ryan, Fertility Acupuncturist & mother of three: Having overcome my own fertility issues is what drives me to help women like you to achieve the results that I made happen for myself.


If you do not become pregnant as a result of IVF you can schedule an appointment with your doctor to plan for the next step, which could be another fresh cycle of IVF, or with your frozen embryo or with egg donation.

Want to know how you can increase your chances of success with IVF?

Click here  to read our article about how combining IVF with Acupuncture doubles the success rate of IVF


If you become pregnant as a result of IVF, you will usually return to the IVF clinic for an ultrasound scan to determine viability.  This scan is sometimes referred to as a “Reassurance Scan”

1st scan at approximately 6 ½-7 weeks pregnant.  2nd scan at approximately 7 ½ – 8 ½ weeks pregnant
You are usually referred to an Obstetrician from about 8-10 weeks pregnant.


*Note that having IVF does not always result in a positive pregnancy test.  Success rates of IVF vary, consult with your clinic for their success rates.


Lupron (leuprolide acetate) is an analog of gonadotropin releasing hormone (GnRH). This will stimulate the “turning-off” of your pituitary gland. The suppressive actions improve the recruitment of multiple follicles and prevent premature ovulation.

IVF Medication Side effects are short term. Hot flashes may be felt when your estrogen level lowers and will disappear when you begin gonadotropin injections. Occasionally, patients experience headaches as well.
Antagon and Cetrotide (ganirelix acetate) are antagonists. Antagonists block the action of something. In this case it blocks the ovulation stimulating action of gonadotropin releasing hormone (GnRH). The effect is similar to Lupron in that Antagon and Cetrotide prevent premature ovulation. Side effects are infrequent, minor and usually limited to redness or soreness at the site of injection.

Injectable Gonadotropins

Menopur is a brand name for hMG. Bravelle, Repronex, Pergonal. hMG is a combination of the hormones FSH (Follicular Stimulating Hormone) and LH (Luteinizing Hormone).
Bravelle, Follistim & Gonal-F contain only pure FSH. They directly affect the ovaries to recruit multiple follicles before normal selection of a single dominant follicle occurs. Eggs develop inside follicles.

IVF medication Side effects here may include abdominal distention/discomfort, bloating sensation, mood swings, fatigue or restlessness. In most cases, the side effects are relieved by follicular aspiration. Multiple births may occur with this medication.

Human chorionic gonadotropin (hCG).

Brand names: Pregnyl, Novarel. This is a hormone closely similar in the biologic effect of LH (Luteinising Hormone). LH normally induces ovulation. hCG initiates follicular changes, thus triggering ovulation approximately 42 to 48 hours after injection. Egg retrieval must occur before ovulation otherwise the follicles will be empty. hCG is also secreted by the placenta during pregnancy

IVF Medication Side effects here are similar to those encountered with the above mentioned IVF medications may be briefly noticed.