IVF Timeline: Your Complete Week-by-Week Guide

IVF can feel like stepping into the unknown. When will things happen? How many appointments? What should you expect each day? This comprehensive timeline guide breaks down every phase of your IVF cycle so you know exactly what's coming and can plan accordingly.

Keep in mind that every cycle is different, and your doctor may adjust timing based on your individual response. This guide represents a typical cycle, but your specific experience may vary. The key phases remain consistent even when the exact days shift.

Phase 1: Pre-Cycle Preparation (2-4 Weeks Before)

During this phase, you'll have 1-3 appointments. Use this time to ask questions, ensure you understand the medication schedule, and prepare your home for the weeks ahead. Stock up on healthy foods, clear your schedule as much as possible, and mentally prepare for the journey.

Phase 2: Ovarian Stimulation (Days 1-12)

Day 1-2: Cycle Start

• Your period begins (Day 1 = first day of full flow)
• Call your clinic to schedule your baseline appointment
• Baseline blood work and ultrasound (usually Day 2 or 3)
• If baseline looks good, you'll begin injections that evening
• Typical starting medications: gonadotropins (FSH, possibly LH)

Days 3-5: Early Stimulation

• Daily injections at the same time each evening (most common)
• Follicles begin growing but aren't visible yet
• You may feel normal or slightly bloated
• First monitoring appointment around Day 4-5
• Blood work checks estradiol levels; ultrasound counts growing follicles

Days 5-6: Adding the Antagonist

• Most protocols add a GnRH antagonist (Cetrotide or Ganirelix) around Day 5-6
• This prevents premature ovulation so you don't release eggs before retrieval
• You'll now be taking 2-3 injections daily
• Dose adjustments may be made based on your response

Days 7-10: Peak Monitoring

• Appointments every 1-2 days
• Follicles growing rapidly (aim for 18-22mm at maturity)
• Bloating and discomfort increase as ovaries enlarge
• Estradiol levels rising (indicates egg development)
• Doctor watching for lead follicles and overall cohort
• Dose adjustments based on response

Days 10-12: Trigger Decision

• When multiple follicles reach 18-22mm, you're ready
• Final monitoring confirms timing
• Trigger shot scheduled (exact time is critical—usually 8-10 PM)
• Stop stimulation medications
• Retrieval scheduled for exactly 34-36 hours after trigger

Phase 3: Trigger Shot (36 Hours Before Retrieval)

• Timing window: Usually 34-36 hours before scheduled retrieval
• Example: Trigger at 9 PM Sunday → Retrieval at 9 AM Tuesday
• hCG trigger: Most common; single injection
• Lupron trigger: Used for OHSS risk; may require additional support
• Dual trigger: Some protocols use both for better maturation

Phase 4: Egg Retrieval (Day 12-14)

What Happens

• Arrive 30-60 minutes before scheduled time
• Change into a gown; IV placed for sedation
• Sedation begins—you'll be asleep within minutes
• Using ultrasound guidance, doctor passes a thin needle through vaginal wall to each ovary
• Follicular fluid aspirated; eggs collected by embryologist
• Wake up in recovery; procedure feels like it took seconds
• Rest 1-2 hours while sedation wears off
• Go home with someone else driving

Same Day: Partner's Role

• Fresh sperm sample collected at clinic (usually while you're in retrieval)
• If using frozen sperm or donor sperm, it's thawed this day
• Sperm prepared and processed for fertilization

Same Day: Fertilization

• Eggs assessed for maturity (only mature eggs can be fertilized)
• Conventional IVF: Eggs and sperm placed together in dish
• ICSI: Single sperm injected into each mature egg
• Fertilization occurs over the next 16-18 hours

Phase 5: Embryo Development (Days 1-6 Post-Retrieval)

Day 1: Fertilization Check

• Embryologists check for signs of normal fertilization (2PN = two pronuclei)
• You'll receive a call with your fertilization report
• Typical fertilization rate: 70-80% of mature eggs

Day 2-3: Cleavage Stage

• Embryos dividing into 2, 4, 6, 8 cells
• By Day 3, good embryos have 6-8 cells
• Some attrition normal—not all embryos continue developing
• Day 3 transfers are possible but less common now

Days 5-6: Blastocyst Stage

• Embryos reach 100+ cells with differentiated structures
• Inner cell mass (ICM) = becomes baby
• Trophectoderm = becomes placenta
• Embryos graded on expansion and cell quality (AA, AB, BB, etc.)
• PGT-A biopsy taken if doing genetic testing
• Best embryos identified for transfer or freezing

Phase 6: Embryo Transfer (Day 3-6 Post-Retrieval)

Fresh Transfer (Day 3 or 5-6)

• Arrive with a full bladder (helps ultrasound visualization)
• Review embryo quality and selection with doctor
• Lie back as for a Pap smear
• Speculum inserted; cervix cleaned
• Thin catheter threaded through cervix into uterus
• Embryo deposited under ultrasound guidance
• You may see the bright flash on screen—that's your embryo
• Rest for 10-15 minutes
• Go home and continue normal light activity

Frozen Embryo Transfer (FET)

• If doing a freeze-all cycle, transfer happens in a separate cycle
• Either natural cycle (tracking ovulation) or medicated (estrogen + progesterone)
• Transfer timing matched to embryo age: Day 5 blastocyst = transfer 5 days after progesterone start or 5 days after ovulation
• Same transfer procedure as fresh

Phase 7: The Two-Week Wait (Days 1-14 Post-Transfer)

What's Happening Inside

• Days 1-2: Blastocyst hatching from its shell
• Days 2-4: Blastocyst attaching to uterine lining
• Days 5-7: Implantation completing; embryo burrowing into lining
• Days 8-10: hCG beginning to be produced if implanted
• Days 10-14: hCG rising to detectable levels

What You'll Do

• Continue progesterone supplements (crucial for supporting potential pregnancy)
• Normal light activity—no bed rest required
• Avoid high-impact exercise, hot tubs, alcohol
• Stay hydrated, eat well
• Try to stay occupied and distracted
• Resist the urge to test early (results can be misleading)

Phase 8: Pregnancy Test (9-14 Days Post-Transfer)

If Positive

• Congratulations! But this is just the beginning
• Repeat beta in 2-3 days (should approximately double)
• Continue all medications as directed
• First ultrasound at 6-7 weeks to confirm heartbeat
• Continue progesterone through first trimester typically
• Graduate to OB around 8-10 weeks

If Negative

• Allow yourself to grieve—this is a real loss
• Stop progesterone; period will come in a few days
• Schedule follow-up to discuss the cycle and next steps
• If you have frozen embryos, discuss FET timing
• Take time before deciding about next steps

Timeline Summary

For International Patients

If you're traveling to Colombia for IVF, your timeline may look slightly different:

• Virtual consultation: 2-4 weeks before travel
• Home testing: Complete baseline labs locally
• Arrival: Day 1-2 of cycle (or start medications at home)
• Trip duration: 2-3 weeks for full cycle with fresh transfer
• Alternative: Two trips—retrieval trip (10-14 days) + later FET trip (5-7 days)

Many patients find that having a detailed timeline significantly reduces anxiety. Understanding that there will be periods of waiting—between appointments, between retrieval and transfer, during the two-week wait—helps you mentally prepare and plan coping strategies.

Your clinic will help coordinate timing to minimize your time away while ensuring you're present for all critical appointments. 📅