The IVF Timeline: What to Expect, Phase by Phase

One of the most disorienting things about starting IVF is that it's hard to see the whole picture. Information comes in pieces — from your clinic, from late-night research, from friends who went through it — and it's not always easy to see how all the phases connect into a coherent journey.

This article maps out the full IVF timeline, phase by phase. Every clinic does things slightly differently, and your own protocol may vary based on your diagnosis and response. But this overview should help you feel less blindsided — and give you a sense of where you are at each stage.

Before You Begin: Investigations and Setup

Before your first treatment cycle starts, your clinic needs to understand your baseline. This phase typically involves:

• Blood tests: AMH (ovarian reserve), FSH, LH, estradiol, progesterone, thyroid function, and often a range of screening bloods
• Semen analysis: to assess sperm count, motility, and morphology
• Baseline ultrasound: to count antral follicles (a marker of egg reserve) and check for any uterine abnormalities
• Hysteroscopy or mock transfer: some clinics do this routinely to assess the uterine cavity and map the transfer route
• Genetic screening: if recommended based on family history or previous losses

This phase can feel slow and administrative — a lot of waiting for appointments and results. It's worth using this time to understand your protocol, ask questions, and set up whatever organisational system is going to help you manage the weeks ahead. An IVF app that tracks your phase, medications, and appointments can make a real difference here.

Phase 1: Suppression (Not Always Used)

In a "long protocol" or "down-regulation" approach, the first step is suppressing your natural hormone cycle using a daily nasal spray (like Synarel) or injection (like Buserelin). This is sometimes called the suppression phase, and it prevents your ovaries from releasing an egg before retrieval.

Suppression typically lasts two to four weeks. You might experience menopausal-like symptoms during this phase — hot flushes, headaches, low mood. This is expected and temporary, but it can be unexpectedly hard, especially on top of the emotional stress of preparing for treatment.

Not all protocols include a suppression phase. Shorter "antagonist" protocols start stimulation directly and use a different class of medication to prevent premature ovulation. Ask your clinic which protocol they're recommending and why.

Phase 2: Stimulation

Stimulation is the phase most people think of when they imagine IVF: daily hormone injections (usually FSH or a combination) to encourage multiple follicles to grow simultaneously. Where a natural cycle produces one dominant follicle, IVF stimulation aims to grow several — giving more chances of retrieving viable eggs.

Stimulation typically lasts 8–14 days, though this varies by protocol and individual response. During this time, you'll have monitoring appointments every 2–3 days.

Monitoring during stimulation

These appointments involve a transvaginal ultrasound to measure follicle size and count, and often a blood draw to check estradiol levels. Your clinic uses these results to adjust your medication dose day by day. Logging these appointments and results in an IVF tracking app helps you see your response pattern and have more meaningful conversations with your nurse or doctor.

Physically, stimulation can feel bloaty and uncomfortable as your ovaries enlarge. Emotionally, the monitoring appointments — seeing follicles growing, or not growing as hoped — are loaded. It's common to feel anxious before each scan.

Phase 3: Trigger

When your follicles have reached the target size (usually around 17–20mm for the leading ones), your clinic will instruct you to take a "trigger shot" — typically hCG (like Ovitrelle or Pregnyl) or a GnRH agonist — at a very specific time. The trigger causes the eggs inside the follicles to mature in preparation for retrieval.

The timing of the trigger shot is precise — retrieval is usually scheduled exactly 34–36 hours later. Your clinic will give you a specific time to take it, and this is one injection where timing really matters.

Phase 4: Egg Retrieval

Egg retrieval (also called egg collection) is a minor surgical procedure usually done under sedation or light anaesthetic. Using ultrasound guidance, a thin needle is passed through the vaginal wall into each follicle to aspirate the fluid and collect the eggs.

The procedure takes around 20–30 minutes. You'll typically be in recovery for an hour or two before going home. Most people feel some cramping and soreness afterwards — plan to rest for the day.

The number of eggs retrieved can be different from the number of follicles seen on scan — not every follicle contains a mature egg. You'll usually find out the number of eggs collected the same day, and fertilisation results the following morning.

Phase 5: The Lab — Fertilisation and Embryo Culture

While you recover, the embryology lab is at work. Eggs and sperm are combined — either by standard IVF (placing them together and allowing fertilisation to happen naturally) or ICSI (injecting a single sperm directly into each egg). Fertilisation is confirmed the following morning.

Embryos are then cultured for 3–6 days. At each check, the embryologist assesses how many are developing normally. Numbers typically reduce at each stage — this is completely normal, though it can be emotionally difficult to track. Clinics usually aim to grow embryos to the blastocyst stage (day 5 or 6) before transfer or freezing.

Phase 6: Embryo Transfer

Embryo transfer is the moment many people build up to. It's a straightforward procedure — a thin catheter passes through the cervix and places one (or sometimes two) embryo(s) into the uterus. There's no anaesthetic needed, though it can be uncomfortable. You'll usually be asked to have a full bladder to aid ultrasound guidance.

A fresh transfer typically happens on day 3 or day 5 after retrieval. Some clinics recommend a "freeze-all" approach — freezing all embryos and doing a frozen transfer in a subsequent cycle — to allow the uterine lining to recover from stimulation.

Phase 7: The Two-Week Wait

After transfer, you wait. The two-week wait — the time between embryo transfer and the pregnancy test — is often described as the hardest part of IVF. You're still taking medications (usually progesterone support). You're symptom-spotting. You have no way of knowing what's happening. And you have to just... get through it.

Logging your mood and symptoms during this period — without obsessing over them — can help. It gives you something concrete to do, and your records can be useful context for your clinic whatever the result.

The test is usually a blood hCG test at your clinic, around 10–14 days after transfer.

Tracking the Journey with Lumia

The IVF timeline is complex, and it moves fast. Each phase brings new medications, new appointments, new results to process. Lumia is an IVF app designed to hold all of this in one place — showing you your current phase, tracking your medications with reminders, logging your scan results, and giving you a clear view of your journey from setup to transfer and beyond. Join the waitlist to be notified when Lumia is ready.