5 Steps of the IVF process

If you’ve ever cringed at the phrase “test-tube baby,” know this: The IVF process is neither weird nor antiquated; it’s grounded, purposeful, and built to help real people build families. In just five phases, from stimulating the ovaries through fertilisation to embryo transfer, you partner with science, but the prognosis is deeply personal.

Since 1978, it’s helped bring over 8 million babies into the world, from couples to single and LGBTQIA+ parents alike. IVF is an advanced way for hopes of parenthood to take shape.

Anyway, let's take a detailed look at the 5 stages of the IVF process;

Step 1: Ovarian Stimulation / Medication

You begin the IVF process with daily injectable hormones, usually FSH, and sometimes LH or HMG, to encourage the growth of multiple follicles instead of just one.

Start Dose: 150 IU/day for 8–12 days. (May vary based on your age and ovarian reserve).

Your fertility team adjusts doses along the way, depending on ultrasounds and estradiol levels every few days.

You’ll likely log injection times on your phone and mark your calendar for blood draws and follicle scans. As follicles grow, often around 17–20 mm in diameter, you look forward to the "trigger shot" (either HCG or a GNRH agonist) around 34–36 hours before retrieval.

Step 2: Egg Retrieval & Sperm Collection

By the morning of retrieval, you’re fasting and maybe nervous, but the waiting ends fast. Under twilight sedation (often propofol + fentanyl), doctors use a transvaginal ultrasound-guided needle to gently aspirate follicle fluid from your ovaries, where each egg hides, all usually in 10–20 minutes.

You’re breathing on your own the entire time and often wake within minutes. At most clinics, the recovery area is your next stop, 30–60 minutes of monitoring, followed by same‑day discharge.

Sperm collection happens around the same time if you're using partner or donor sperm; labs may perform ICSI immediately if needed. At the end of the day, you’ll usually get a call on how many eggs the lab found.

Step 3: Fertilization & Embryo Culture

Once your eggs and sperm reach the lab, the IVF process enters its most delicate phase, fertilisation. In conventional IVF, tens of thousands of sperm and each egg share a dish; in ICSI, a single carefully chosen sperm is injected into each mature egg. While both paths typically yield fertilisation rates over 60 %, ICSI helps boost the odds when sperm count or motility is an issue, and catches up well even when IVF has failed before.

In the days following fertilization, embryos grow under precise lab conditions. Some clinics pause at Day 3, when embryos hit the 6–8-cell mark. Many others allow embryos to reach Day 5 or 6 (blastocyst stage), a filter in the IVF process that helps highlight those with stronger implantation potential.

Although only about 30–50 % make the leap to blastocyst, those that do are strongly considered for fresh transfer or freezing, helping shape the next crucial step.

Step 4: Embryo Development & Quality Assessment

Now our laboratory team, powered by microscopes, trained eyes, and sometimes genetics, tallies every embryo’s potential in the IVF process. On Day 3, embryos are judged by their symmetry and slowdowns (fragmentation).

By Day 5 or later, they’re re‑entered into the grading system: expansion (1–6), inner cell mass quality, and trophectoderm strength (A, B, C) under microscopic review.

Genetic testing, if chosen, happens at this stage too. With PGT‑A/PGD, a handful of cells are gently sampled from healthy blastocysts to check for chromosomal issues or specific mutations. It’s a tool to help select the best embryo, though it adds cost and a slight delay, and not everyone chooses it. Ultimately, this stage assists your team in prioritizing embryo quality over quantity in the next transfer cycle.

Step 5: Embryo Transfer & Pregnancy Test

Here comes the big moment in the IVF process: embryo transfer. Whether you're doing a fresh Day 3 or Day 5 transfer, or a thawed frozen embryo, it’s typically a quick and mild outpatient procedure. A tiny catheter places one (sometimes two) top-quality embryo into your uterus, guided by ultrasound and requiring no anaesthesia (just a well‑hydrated bladder and a deep breath).

Afterwards, strict bed rest is discouraged; research shows getting up, walking to the restroom, or even driving in the car are fine. That said, avoiding strenuous exercise or heavy lifting for 1–2 days is standard advice, part science, part peace of mind.

Around 9–10 days post-transfer (or 10–14 days after the trigger shot), our clinic will run a quantitative blood HCG test, your first “yes or no” about implantation. At-home strips often mislead, so holding out is usually best, and everything you feel in the meantime is completely normal.

In final words, you’re not just following a protocol, you’re making decisions, asking questions, and showing up, again and again. The IVF process is never easy, but it’s not hollow either.

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