Starting IVF can feel overwhelming – there are injections, scans, procedures and a lot of waiting. Knowing what happens and when makes it much easier to plan work, appointments and your emotional energy. This guide walks through a typical first IVF cycle, from the first consultation to the pregnancy test.
Quick answer: once you start medication, a typical IVF cycle takes about 4–6 weeks to reach a pregnancy test: around 8–14 days of hormone injections, an egg retrieval, 3–6 days of embryo growth in the lab, an embryo transfer, then about 9–12 days until a blood test. If your embryos are frozen and transferred later, add around 1–2 months. Every clinic’s protocol is slightly different, so use this as a general guide.
Before you start: consultation and testing (2–6 weeks)
Your first appointment is usually with a reproductive endocrinologist (REI). Before treatment, most clinics arrange:
- Ovarian reserve tests – an AMH blood test and an ultrasound to count antral follicles, which help predict how many eggs you may produce
- Hormone and infectious disease blood tests for both partners
- Semen analysis
- A check of the uterus, such as a saline ultrasound (sonohysterogram)
- A financial consultation to explain costs and insurance coverage – see our IVF cost guide
Some protocols start with birth control pills for a few weeks to help time the cycle. Bring a list of questions – our first consult checklist can help.
Days 1–14: ovarian stimulation and monitoring
Stimulation usually starts at the beginning of your period. You’ll inject hormones (FSH, sometimes with LH) once or twice a day for around 8–14 days to help several eggs mature at once, rather than the single egg of a natural cycle. Partway through, most people also start a second injection to stop ovulation happening too early.
You’ll have monitoring appointments every one to three days – usually early in the morning – with a vaginal ultrasound to measure follicles and a blood test to check hormone levels. Your doctor adjusts your doses based on the results. Because these visits are frequent and at short notice, it really helps to choose a clinic close to home or work.
Common side effects include bloating, tenderness, mood changes and tiredness. Tips: our guides to mixing Menopur and freezer meals to make before stims.
Trigger shot: about 36 hours before retrieval
When your follicles are ready, you’ll take a “trigger” injection to complete egg maturation. Timing is precise – egg retrieval is usually scheduled about 34–36 hours later – so your clinic will tell you the exact time to inject.
Egg retrieval day
Egg retrieval is a short procedure, usually around 20–30 minutes, done under sedation. A thin needle guided by ultrasound collects eggs from the follicles. Most people go home the same day and rest for the remainder of it. If using a partner’s sperm, a fresh sample is usually given that morning. See our retrieval day packing list.
Days 1–6 after retrieval: fertilization and embryo growth
The same day, eggs are fertilized in the lab – either by mixing eggs and sperm, or by ICSI (injecting a single sperm into each egg). Over the next days the embryology team updates you on progress:
- Day 1: how many eggs fertilized normally
- Day 3: embryos have several cells
- Days 5–6: the strongest embryos reach the blastocyst stage, which is when most transfers or freezing happen
It’s normal for numbers to drop at each stage. If you’re having genetic testing of embryos (PGT-A), a few cells are taken from each blastocyst, and the embryos are frozen while you wait for results.
Embryo transfer: fresh or frozen
In a fresh transfer, an embryo is placed in the uterus 3–5 days after retrieval. In a frozen embryo transfer (FET), embryos are frozen and transferred in a later cycle, after the uterus is prepared with medication – this is now very common, and is required after PGT-A testing.
The transfer itself takes only a few minutes, doesn’t need sedation, and feels similar to a Pap smear. Most clinics transfer a single embryo to reduce the risk of twins. You’ll usually take progesterone afterwards to support the uterine lining.
The two-week wait and pregnancy test
A blood pregnancy test (beta hCG) is usually done about 9–12 days after transfer. Home tests before then can be misleading, particularly because of the trigger shot. This wait is often the hardest part emotionally – see our guide to surviving the two-week wait.
What if it doesn’t work first time?
Many people need more than one transfer or retrieval. If you have frozen embryos left, the next step is usually a frozen embryo transfer. Your doctor will review the cycle with you and may suggest changes. See IVF success rates by age for how chances build up over multiple cycles.
When to call your clinic
Contact your clinic straight away if you have severe abdominal pain or swelling, rapid weight gain, shortness of breath, or vomiting during or after stimulation – these can be signs of ovarian hyperstimulation syndrome (OHSS), which needs medical assessment.
Frequently asked questions
How long does one IVF cycle take?
About 4–6 weeks from starting medication to a pregnancy test with a fresh transfer, or around 2–3 months if embryos are frozen and transferred later. Testing beforehand can add several weeks.
How many injections are there in IVF?
Usually one or two injections a day for 8–14 days during stimulation, plus a trigger shot, and sometimes progesterone afterwards.
Do I need time off work for IVF?
Most people need flexibility for early-morning monitoring visits and at least the day of egg retrieval off. Many also rest on transfer day.
How do I choose an IVF clinic?
Compare success rates for your age, total costs and location. See our IVF clinic rankings by city or browse clinics by state.
Sources
- ReproductiveFacts.org – American Society for Reproductive Medicine patient information
- CDC – Assisted Reproductive Technology
This guide describes a typical cycle and is not medical advice. Always follow your own clinic’s instructions.
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