Everything you need to know about the IVF process — from your first appointment to your pregnancy test. Explained clearly by Dr. E. Prashanthi Reddy, 5,000+ ICSI cycles, Mother Hospitals & IVF Center, Boduppal, Hyderabad.
Each IVF cycle follows the same sequence. Here is exactly what happens at every stage — and what you need to do.
Your IVF journey begins with a full fertility evaluation. Dr. E. Prashanthi Reddy reviews both partners. Tests include: AMH (ovarian reserve), Day 2 blood tests (FSH, LH, estradiol), pelvic ultrasound (antral follicle count), semen analysis, uterine assessment (saline sonography or hysteroscopy if needed). Results guide the exact stimulation protocol chosen for you. This phase takes 1–2 weeks.
Daily hormone injections (FSH, LH or combined gonadotrophins) are self-administered or administered at the clinic for 10–14 days. These stimulate multiple follicles to grow simultaneously. Monitoring ultrasound scans every 2–3 days track follicle size and number. When the leading follicles reach 18–20mm, a trigger injection (hCG or GnRH agonist) is given to mature the eggs. Egg retrieval is scheduled exactly 36 hours later.
Eggs are collected under intravenous sedation — you are comfortable and have no memory of the procedure. A fine needle guided by transvaginal ultrasound aspirates each follicle. The procedure takes 20–30 minutes. You rest for 2–3 hours and go home the same day. On the same day (or the previous day if using frozen sperm), the male partner provides a semen sample. → Learn more about egg retrieval
In the embryology laboratory, eggs and sperm are combined. In conventional IVF, sperm is added to the dish with eggs and fertilisation occurs naturally. In ICSI (Intracytoplasmic Sperm Injection) — used in the vast majority of cycles at Mother Hospitals — a single sperm is injected directly into each egg under a high-powered microscope. Fertilisation is confirmed the next morning (Day 15). Fertilised eggs are called embryos. → What happens in the IVF lab?
Embryos are cultured in specialised incubators that mimic the conditions of the fallopian tube. They are graded daily. By Day 5, the best embryos reach the blastocyst stage — the highest implantation potential. Mother Hospitals aims for Day 5 blastocyst transfer whenever possible. Extra embryos are vitrified (snap-frozen) for future frozen embryo transfer cycles. → Blastocyst transfer explained
The best embryo(s) are loaded into a fine catheter and guided through the cervix into the uterus — a painless, 5-minute procedure requiring no anaesthesia. You rest for 30 minutes and go home. Progesterone support (pessaries or injections) is continued for 2 weeks. A beta-hCG blood test on Day 14 after transfer confirms pregnancy. A positive beta-hCG is followed by a confirmatory scan at 6–7 weeks to detect the foetal heartbeat. → Embryo transfer — detailed guide
A typical IVF cycle lasts 4–6 weeks. Here is the complete schedule.
| Week | What Happens | Your Role |
|---|---|---|
| Week –1 to –2 | Pre-cycle blood tests, Day 2 scan, semen analysis, consultation to finalise protocol | Attend clinic for tests; bring partner for semen analysis |
| Week 0 — Day 2 | Start stimulation injections; baseline scan confirms ovaries are quiet | Begin daily injections at same time each day |
| Week 1 — Days 2–7 | Daily injections; scan on Day 5–6 to check follicle growth | Continue injections; attend scan appointment |
| Week 2 — Days 8–13 | More frequent scans (every 1–2 days); trigger injection when follicles ready | Attend clinic for scans; administer trigger injection at exact prescribed time |
| Day 14 (approx) | Egg retrieval under sedation — 20–30 minutes; same-day discharge | Fast from midnight; arrive at clinic; partner provides semen sample |
| Day 15 | Fertilisation check — embryologist reports how many eggs fertilised | Await phone call from embryologist; start progesterone support |
| Days 15–19 | Daily embryo development updates; Day 5 blastocyst grading | Continue progesterone; rest and avoid strenuous exercise |
| Day 17–19 | Fresh embryo transfer (or freeze-all + frozen transfer next cycle) | Attend clinic; rest for 30 minutes post-transfer then go home |
| Days 19–33 | Two-week wait (2WW) — continue progesterone support | Continue medications; avoid heavy exercise; stay hydrated |
| Day 33 (14 days post-transfer) | Beta-hCG blood test — pregnancy confirmation | Blood test at clinic; await result (same day) |
| Week 7–8 (if positive) | Confirmatory scan to detect foetal heartbeat | Attend scan; transition to antenatal care |
* Dates are approximate and vary based on your individual response to stimulation.
The first 5 steps are identical. The fertilisation method on Day 14 differs.
Sperm and eggs are placed together in a laboratory dish. Fertilisation occurs naturally. Requires at least 100,000 motile sperm per egg. Used when sperm parameters are normal and previous ICSI cycles showed high fertilisation rates.
A single sperm is selected under a high-powered microscope and injected directly into each mature egg. Works with very low sperm counts, poor motility, poor morphology, or frozen/surgically retrieved sperm (TESA/PESA). The majority of cycles at Mother Hospitals use ICSI. → IVF for male infertility
Sometimes all embryos are frozen after Day 5 and transferred in a subsequent natural or medicated cycle. This reduces the risk of OHSS (ovarian hyperstimulation syndrome) and may improve implantation by allowing the uterine lining to recover fully from the stimulation medications.
MBBS, DGO · ART Training — Kiel University, Germany · TGMC Reg: 50624
19+ Years Experience · 5,000+ ICSI Cycles · Mother Hospitals & IVF Center, Boduppal, Hyderabad
📞 97059 93366 / 97059 93355 | 💬 WhatsApp: 90520 74999
Deep dives into each step of the IVF process.