If you've been told that IVF might be the right path for you, it's natural to feel overwhelmed. The acronyms, the medical terminology, the daily injections — it can all seem daunting at first. But knowledge is power, and understanding what lies ahead can transform anxiety into confidence.
Having guided thousands of patients through IVF at PTA Fertility Centre since 1999, we want to share a clear, honest walkthrough of what the process actually involves — from your first consultation to the moment you take that pregnancy test.
Before You Begin: The Initial Consultation
Every IVF journey starts with a thorough consultation. We review your medical history, previous treatments (if any), and conduct baseline investigations. For women, this typically includes blood tests for hormone levels (AMH, FSH, oestradiol), an antral follicle count via ultrasound, and assessment of the uterine cavity. For men, a semen analysis is essential.
This assessment helps us determine the most appropriate treatment protocol — which medications, what doses, and what we can realistically expect in terms of response.
Step 1: Ovarian Stimulation (Days 1-12)
The IVF cycle begins on day 2 or 3 of your menstrual period. You start daily hormone injections (gonadotropins such as Gonal-F, Menopur, or Bemfola) to stimulate the ovaries to develop multiple follicles rather than the single egg that would normally mature.
These injections are subcutaneous — given just under the skin of the abdomen using a thin needle, similar to those used by diabetic patients. Most patients find the injections manageable after the first day or two, though some experience bloating, mild discomfort, or mood changes as hormone levels rise.
Step 2: Monitoring (Every 2-3 Days)
Throughout stimulation, you'll visit the clinic every 2-3 days for ultrasound scans and sometimes blood tests. We measure each follicle's size and track the thickness of your uterine lining. This monitoring is crucial — it allows us to adjust medication doses and determine the precise moment for the next step.
Expect each monitoring appointment to take 30-45 minutes. Most patients manage to continue working during this phase, scheduling appointments in the early morning.
Step 3: The Trigger Injection (Day 10-14)
When your follicles reach the target size (typically 17-20mm), you receive a trigger injection — either hCG (Ovitrelle/Pregnyl) or a GnRH agonist (Lucrin). This injection matures the eggs and prepares them for retrieval. Timing is critical: egg retrieval must occur exactly 36 hours after the trigger.
Step 4: Egg Retrieval
Egg retrieval is performed in our procedure room under light sedation (you'll be comfortable but not under general anaesthetic). A thin needle, guided by ultrasound, passes through the vaginal wall to aspirate fluid from each follicle. The procedure takes 15-20 minutes.
You'll rest for 1-2 hours afterwards and need someone to drive you home. Most patients experience mild cramping and spotting for a day or two. We'll call you that afternoon to tell you how many eggs were retrieved.
Step 5: Fertilisation in the Laboratory
On the same day, your partner provides a semen sample (or frozen sperm is thawed). Our embryologists then combine eggs and sperm. For standard IVF, sperm and eggs are placed together in a dish. For ICSI (used when sperm numbers or quality are suboptimal), a single sperm is injected directly into each mature egg.
The following morning, we check for fertilisation — indicated by the presence of two pronuclei within the egg. On average, 60-80% of mature eggs fertilise successfully.
Step 6: Embryo Development (Days 1-5)
Fertilised eggs are cultured in our incubators under carefully controlled conditions. Our embryologists monitor development daily:
- Day 1: Check for fertilisation (2PN stage)
- Day 2-3: Embryos divide into 4-8 cells
- Day 5: The best embryos reach blastocyst stage — a fluid-filled structure of 100+ cells
Not all embryos will reach blastocyst stage. This is a natural selection process — embryos that arrest early typically had chromosomal abnormalities incompatible with development.
Step 7: Embryo Transfer
On day 3 or day 5 (depending on your protocol), the best embryo is selected for transfer. Using a thin, soft catheter guided by ultrasound, the embryo is placed gently into the uterine cavity. The procedure takes 2-3 minutes, is painless (no anaesthesia needed), and feels similar to a Pap smear.
We typically transfer one embryo (single embryo transfer) to minimise the risk of twins. Surplus good-quality embryos are vitrified (frozen) for future use.
The Two-Week Wait
After transfer, you begin progesterone supplementation (to support the uterine lining) and then wait 12-14 days for a blood pregnancy test. This period — affectionately known as the "two-week wait" — is often described as the most emotionally challenging part of IVF.
My advice: continue your normal routine, avoid Dr Google, and lean on your support system. There is nothing you can do during this time to influence the outcome — the embryo will either implant or it won't.
The Pregnancy Test
A blood test measuring beta-hCG confirms whether implantation has occurred. If positive, we repeat the test 48 hours later to confirm levels are rising appropriately, followed by an early pregnancy ultrasound at 6-7 weeks.
If the test is negative — and We want to be honest about this possibility — it is deeply disappointing. But a single negative cycle does not mean IVF won't work for you. We review each cycle carefully, learn from the results, and adjust our approach. Many patients conceive on their second or third attempt.
Final Thoughts
IVF is both a medical process and an emotional journey. Having walked this path with thousands of couples over 25 years, we can tell you that knowledge, patience, and realistic expectations are your greatest allies. If you have questions about whether IVF is right for you, we welcome the opportunity to discuss your options in a consultation.