The IVF Process Step by Step: What Happens From First Visit to Pregnancy Test
Updated: 3 days ago
In vitro fertilisation (IVF) can sound complicated. In practice it follows a clear sequence of steps. Knowing what happens at each stage can make the process less stressful and help you prepare questions for your fertility doctor. This guide explains a typical IVF cycle in plain language. Your own plan may differ depending on your tests, age and medical history.
Who might need IVF?
IVF may be suggested when:
The fallopian tubes are blocked or damaged
There is a male-factor problem, such as a low sperm count or poor motility. In this case ICSI is often added.
There is endometriosis, or reduced ovarian reserve
Ovulation problems, such as PCOS, have not responded to simpler treatment
Several cycles of IUI (intrauterine insemination) have not worked
Infertility is unexplained after tests
Couples or individuals want to use donor eggs or sperm, or preserve fertility, as permitted under Indian law (the Assisted Reproductive Technology (Regulation) Act)
Many couples start with simpler options, such as timed intercourse, ovulation induction or IUI. Your doctor will explain which treatment makes sense for you first.
Step 1: Fertility assessment
Both partners are usually assessed:
For the woman: medical history and a pelvic ultrasound, including an antral follicle count; hormone tests such as AMH, FSH, LH, TSH and prolactin; and sometimes an HSG or saline sonography to check the tubes and uterus.
For the man: semen analysis, and sometimes hormone tests or further evaluation by a urologist or andrologist.
For both: infection screening (HIV, hepatitis B and C, and others) as required by guidelines.
These results help decide whether IVF is appropriate and which protocol to use.
Step 2: Ovarian stimulation
Normally the ovaries release one egg a month. In IVF, daily hormone injections, usually for about 8–12 days, help several follicles (fluid sacs containing eggs) grow at the same time.
Monitoring: you will have regular ultrasound scans, and sometimes blood tests, to track the follicles.
Preventing early ovulation: another medicine stops you ovulating too early.
Adjustments: your doctor may adjust the dose based on how your ovaries respond.
Mild side effects such as bloating, tenderness and mood changes are common. Rarely, the ovaries over-respond (ovarian hyperstimulation syndrome, OHSS). Your team monitors you to reduce this risk.
Step 3: Trigger injection
When the follicles reach the right size, you receive a "trigger" injection to complete egg maturation. Egg collection is timed precisely, usually about 34–36 hours later.
Step 4: Egg collection (oocyte retrieval)
For patients of THE CLINICS, egg collection is done at partner centres.
How it is done: a short procedure under light anaesthesia or sedation. A fine needle, guided by vaginal ultrasound, collects fluid from each follicle. The embryologist identifies the eggs under a microscope.
How long it takes: usually 15–30 minutes.
Afterwards: most women go home the same day. Mild cramping or spotting is common.
On the same day: the male partner gives a semen sample, or previously frozen or donor sperm is prepared.
Step 5: Fertilisation, IVF or ICSI
Conventional IVF: eggs and prepared sperm are placed together in a dish so fertilisation can happen naturally.
ICSI (intracytoplasmic sperm injection): a single sperm is injected directly into each mature egg. ICSI is often used when sperm count or quality is low, or when fertilisation failed in an earlier cycle.
The next day, the embryologist checks how many eggs have fertilised.
Step 6: Embryo culture
Fertilised eggs (embryos) are grown in the laboratory for 3 to 5 days. By day 5, a healthy embryo may reach the blastocyst stage. The embryology team grades embryos to help choose which to transfer. In specific situations, genetic testing of embryos (PGT) may be discussed, as regulated under Indian law.
Step 7: Embryo transfer
For patients of THE CLINICS, embryo transfer is done at partner centres.
The procedure: one embryo, or sometimes two depending on age and guidelines, is placed in the uterus through a thin, soft catheter, guided by ultrasound.
What it feels like: it is usually quick, takes a few minutes, and does not need anaesthesia. It feels similar to a Pap smear.
Spare embryos: good-quality embryos that are not transferred can be frozen (vitrified) for future use.
Frozen embryo transfer: sometimes doctors recommend freezing all embryos and transferring one in a later cycle (frozen embryo transfer, FET). This may be advised if there is a risk of OHSS or if the uterine lining is not ideal.
Step 8: The two-week wait and pregnancy test
Progesterone support: you will usually take progesterone, as tablets, vaginal gel or injections, to support the uterine lining.
The test: about 10–14 days after transfer, a blood test (beta-hCG) checks for pregnancy.
If positive: early ultrasound scans follow to confirm the pregnancy.
If negative: your doctor will review the cycle with you and discuss next steps.
How long does one IVF cycle take?
From the start of stimulation to the pregnancy test, a fresh IVF cycle usually takes about four to six weeks. Tests and preparation beforehand add time.
What affects the chance of pregnancy?
The chance of pregnancy with IVF varies widely from couple to couple. The main factors are:
The woman's age: this is the most important single factor, because egg quantity and quality fall with age, especially after the mid-30s
Ovarian reserve
Sperm quality
The cause of infertility
The health of the uterus
Lifestyle factors: weight, smoking and alcohol
Your doctor can discuss what is realistic for you after reviewing your tests. No clinic can promise a pregnancy, so be cautious of any claim that does. See also our fertility calculator by age and does losing weight improve fertility?
Preparing for IVF: practical tips
Aim for a healthy weight, stop smoking, and limit alcohol and caffeine.
Take folic acid as advised.
Ask about costs and what each stage includes. Costs depend on the medicines needed, laboratory procedures such as ICSI and embryo freezing, and the number of cycles.
Look after your emotional health. Counselling and support can help.
Fertility care at THE CLINICS, South Delhi
Fertility consultations, ultrasound and IUI take place at the women's clinic at THE CLINICS, Green Park (OPD 9 am to 9 pm), where Dr Niti Vijay (DMC Reg. No. 6333) explains each step of IVF and ICSI before treatment begins and personalises the plan to your tests. Egg collection and embryo transfer are done at partner centres. Any cost estimate is shared after your tests and examination.
Read more on our IVF and fertility page and IUI, ICSI & IVF treatment page.
To book a fertility consultation, call or WhatsApp +91 9217381353 or book online.
This article was prepared with AI assistance. Medically reviewed by Dr Saurabh Bansal (Delhi Medical Council Reg. No. 37887). It is for general information and is not a substitute for medical advice. Treatment decisions should be made with your doctor.
