When beginning (or thinking about beginning) a cycle of IVF, it’s natural to be curious about exactly how long it will take. What does the IVF timeline look like exactly? You may want to plan around work, family reunions, or even a vacation and that’s OKAY. I want to be clear and say that depending on your circumstances or your specific physician’s protocol, your timeline may differ from mine. Whether you decide to do a fresh embryo transplant or a frozen embryo transfer will also affect your timeline greatly. Finances. PGS testing. There. Are. So. Many. Factors.
**Please note that my IVF calendars are specific to me and my needs. Do not look at my calendar and feel like yours is inadequate because it looks different than mine. All doctors do things differently and a good doctor should be personalizing your treatment to meet YOUR needs. NOT ALL IVF TIMELINES will be the same.
4 Steps of IVF
When it comes to the process of IVF, there are four main stages of IVF. The following stages are required and necessary to the process. Although it seems like a lot of work and very time-consuming (especially if you struggle with patience like I do), I promise you it is worth it and it goes by faster than you think it would. Trust me.
- Preparation & Ovulation Induction
Before you even begin any shots, your physician will usually put you on birth control to begin regulating your cycle and to have your follicles begin at the same place size-wise. The amount of time you are on birth control largely depends on your estimated egg retrieval date. By using birth control, they can manipulate your cycle to fit their schedule. Afterward, you will begin your stomach injections to prepare your eggs for retrieval. You will have at least two injections a day (maybe more depending on your fertility diagnosis) for about 10 days (the exact amount of time here depends again on your diagnosis and your doctor’s preference). The medicine I used for my injections was Gonal-F and Menopur which are very common. Unfortunately, these medications are very expensive. Here you can find ways to make it a little more affordable!
- Egg Retrieval
After you have taken your trigger shot and stopped all medications, you will have your egg retrieval. This is a simple outpatient procedure, but it DOES require anesthesia (usually….although I have heard of some clinics not using it. I highly recommend it though!) so be aware of this, and please let your doctor know if you have had previous side affects to anesthesia. Your partner is NOT allowed to be in the room during this process. The procedure takes about 30 minutes and you will not be permitted to drive for the rest of the day so plan accordingly. During Egg Retrieval, your doctor will go through your vaginal canal and into your ovaries and take out all the eggs they can find.
- Egg Fertilization
After your physician removes all the eggs, they will be taken to their laboratory where they will be introduced to the sperm (albeit your partner’s or donor). If it’s your partner’s sperm, it is usually collected that same day. The next day you will find out how many eggs successfully fertilized. In the next 5-7 days you will receive a report detailing how many viable embryos you have for a potential transfer. These days are some of the most stressful days. You are just hoping and praying some make it. Try to keep your mind off it as much as possible or you’ll drive yourself crazy!
**If I could tell you one thing…THIS would be it so read carefully! At each stage, you will lose about 50%. So from your initial egg count, you’ll probably have only about half of those successfully fertilize. And then only about 50% of those that fertilize grow into viable blastocysts (or embryos). This is completely normal and although it’s terrifying to see the numbers dwindle, it’s okay! Deep breaths! REMEMBER THIS.
- Embryo Transfer
After egg retrieval and fertilization, your viable embryos will be placed back into your uterus, and the ones that aren’t will be frozen for use at a later time. Your partner is usually allowed to be with you during this time and no anesthesia is required, but it is common to be prescribed valium to help calm your nerves. You could transfer embryos anywhere from 5-7 days or a month+ after your egg retrieval depending on many factors which I will mention later on.
Note: Many (but not all) fertility clinics will ask you to have a partially full bladder for the procedure. It helps them transfer the embryo(s) easier.
Factors that WILL affect Your IVF Timeline
- Finances– This is probably obvious, but I will explain anyway. If you go through with the egg retrieval process, but decide you cannot afford the price of a transfer quite yet, you may decide to hold off a couple of months or so which will obviously affect your IVF cycle timeline. Not every office is like this (in fact I would say most aren’t), but my office charged separately for the transfer. It was around $3,000 for a transfer. A lot of times, offices put the transfer fee into the large lump some price they require upfront. You may want to check and see how your doctor’s office does this.
- Fresh Vs. Frozen Embryo Transfer– If you decide to and are able, you can do a fresh transfer which means that only about 3-6 days after the eggs are retrieved, you can do a transfer. If you decide to do PGS or PGT testing (genetic embryo testing), then you will have no choice but to do a frozen embryo transfer. This means you will wait at least until your next menstrual cycle to do a transfer. I know that sounds like a long time to wait, but I promise you that it’s worth it. In the grand scheme of things, a month isn’t that long. Be patient.
- Poor Response to Medication– If you have a poor response to the ovarian stimulation medication, then the doctor may go ahead and cancel your cycle extending your IVF timeline a bit. If you continue a cycle with a poor response to the medication, there is a high possibility you may have close to no eggs retrieved or no viable embryos at the end. Your doctor will probably change up the plan and tweak your medication protocol to hopefully improve your response next time.
- Excessive Response to Medication– I want to stress that this is very rare and nothing you should go into your cycle anticipating. This is quite the opposite of the one right above. This means that the medication stimulated too many follicles. When this happens, you can endure a severe case of OHSS (Over Hyperstimulation Syndrome) which is not good and can send you to the E.R. So, if your physician sees that you respond a little too well, they may have you stop all medication and wait to proceed on your next cycle. Trust me…you do not want OHSS if you can avoid it. NO FUN AT ALL.
- Progesterone Levels are NOT Optimal– If your progesterone levels are not adequate (sometimes they elevate too much or not enough), then you may have to wait for another cycle to transfer. So this doesn’t mean that your cycle is necessarily canceled, but if you were planning on doing a fresh embryo transfer and your levels are too high, your doctor may choose to freeze your embryos and wait until next month to do an FET.
What is OHSS?
OHSS stands for Over Hyperstimulation Syndrome. According to the Mayo Clinic, this is an “exaggerated response to excess hormones.” This is pretty common (some have mild cases and some more severe making them take a trip to the ER). This happens during the IVF process because you are literally giving yourself more hormones to help your follicles grow and get the most eggs out of your Egg Retrieval. If you are experiencing any of the following symptoms, make sure to contact your doctor or head to the hospital if it becomes too severe.
- Abdominal Pain (can range from mild to severe)
- Blood Clots
- Decreased Urination
- Difficulty Breathing
- Facial Numbness
- Increased Thirst
- Kidney Failure
- Rapid Weight gain in a short amount of time (think 2-3 lbs. in 24-48 hours)
- Severe abdominal bloating- You will feel this regardless, but if it starts to hurt significantly, you need to speak with someone
- Tight Abdomen
Fresh Embryo Transfer
With a fresh embryo transfer, you will be transferring an embryo(s) very soon after egg retrieval…usually about 3-6 days. Like I mentioned above, this can only happen if your hormone levels are on par. If they aren’t, then you will probably be heading in the direction of an FET (Frozen Embryo Transfer) and that’s okay.
|Faster Time to Pregnancy (if the transfer is successful)||Less time for your hormones to regulate post egg retrieval|
|Your embryos won’t need to be thawed||Since your Uterus has just undergone surgery, it may be less receptive to an embryo transfer without time to recover|
|If you have to take time off of work for your retrieval, it may be more convenient to have a transfer soon after retrieval potentially decreasing travel time and expenses along with time off of work||You will not be able to have your embryos PGS or PGD tested|
Frozen Embryo Transfer
Doing a frozen embryo transfer also has its pros and cons to your IVF Timeline. With a frozen embryo transfer, it’s typical that you will wait about a month (depending on your menstrual cycle) before your transfer (unless for some reason you need to wait longer). During this time you may choose to have additional testing done such as PGS or PGD genetic screening.
|This allows time for your body’s hormones to regulate||In order to transfer, your embryos must survive the thaw|
|The time for your body to heal and relax can help your Uterus be more receptive to an embryo implantation||If you are travelling and taking time off from work, another appointment for the transfer a month later may be a nuisance|
|This allows time for PGS or PGD (genetic) testing on your embryos|
|Babies born from frozen embryos may have a better health outcome|
|You get a short break from all the injections|
Fresh vs. Frozen Embryo Success Rates
|Live Birth Rate- 50.2%||Live Birth Rate- 48.7%|
Some doctors even prefer to do frozen embryo transfers over fresh. Make sure to consult your doctor to see what they recommend for YOU.
Egg Retrieval Calendar
Jeff and I opted for a frozen embryo transfer because we wanted to do PGS testing. So, if you want to do PGS testing, please be aware that your only choice will be a frozen embryo transfer which will undoubtedly affect your IVF timeline. If you look below, you can see my calendar for egg retrieval. Different doctors may keep you on birth control for different amounts of time which will affect the length of your IVF cycle.
In my case, I was on birth control for almost 3 weeks before my egg retrieval. And then a little over two weeks after ending birth control, I had my egg retrieval. This calendar is a day off because I actually had my egg retrieval on July 19th. The doctor wanted me to have one more day of stimulation medication before the retrieval. Boy am I happy that she did. We were blessed to have 26 eggs retrieved. So when planning for your egg retrieval, please be aware that the day may change by one or two days depending on how you react to the medication. Plan accordingly.
My IVF Egg Retrieval Timeline
- June 16th- Begin birth control pills
- July 1st- Begin a daily Z-pack (both partners)
- July 2nd- Stop birth control Pills
- July 5th- Stop Z-Pack & Baseline Ultrasound
- July 7th- Begin stomach injectibles (Menopur & Gonal F)
- July 12th- Begin Cetrotide Injections & Ultrasound to measure follicles
- July 14th- Last Day for High Impact Exercise
- July 17th- Trigger Shot & Last Day of Gonal F and Menopur
- July 19th- Egg Retrieval
- July 20th- Fertilization Report
- July 24th- Embryo Biopsy & Freeze
- July 25th- Additional Embryos Freeze
26 eggs retrieved. 13 successfully fertilized. 8 blastocysts. 7 PGS tested normal embryos. These were the results of our IVF cycle in 2019. We were incredibly blessed.
Below, you will find my Frozen Embryo Transfer schedule. Please note that sometimes they will put you back on birth control for a couple of weeks. In my case, this is not what happened. Our embryo transfer was performed on August 22nd. We tested about 8 days later and received a positive pregnancy test. On September 3rd we had a blood test that confirmed the pregnancy. Unfortunately, one week after that blood test, we had another blood test and our levels dropped to a 9 which means I would be inevitably miscarrying the two precious embryos that we transferred. We were told to stop all meds and about 3 days later I did indeed miscarry. It was truly heartbreaking. My doctor was also shocked that we weren’t successful.
FET #1: My Unsuccessful IVF Transfer Calendar
FET #2: My Successful IVF Transfer Calendar:
You are probably wondering what the differences are between these two calendars. After our first unsuccessful transfer, we did testing for Endometritis (NOT ENDOMETRIOSIS) and Uterine Receptivity (ERA) and the latter test told us I needed more progesterone in my system before an embryo transfer so we started our progesterone shots earlier and transferred at a very specific time. I’d like to think the $600 we spent on the ERA testing allowed us to successfully conceive, but we can never truly be sure. Oh how blessed we are though! For more information about ERA testing, you can find it here. This is the company we used and had a great experience with them.
So, as you can see, this is how long an IVF cycle generally takes. This is a typical IVF Timeline. Yes, there are always things that come up and affect the timing of your cycle. It’s very rare that something will not come up and throw off your schedule. Everything went pretty smooth sailing for us until we learned that our transfer failed so we were very lucky throughout the process. The quickest IVF cycle would be about a month if you were doing a fresh transfer. The quickest frozen transfer would be about 2 months. I know it’s hard if something were to go wrong and throw off your cycle, but here’s how I look at it…you have already waited so long. You CAN wait another month or two to ensure a healthy and successful pregnancy.
IVF is a b****, but you can and will get through it. For some tips on what to have during an IVF cycle, go check out my 15 Must-Haves for IVF post. For a different perspective on an IVF cycle, you can visit this website.
Even though this journey is hard, you are strong and you will come out of this successful. Keep the faith and NEVER give up! I’ll be cheering you on from a distance!