IVF Step by Step: From First Visit to Pregnancy Test

Before any IVF cycle begins, a thorough evaluation ensures we understand your unique situation and can tailor the approach accordingly.

For women, this typically includes blood tests to assess ovarian reserve (including AMH), hormone levels, and infectious disease screening. A pelvic ultrasound evaluates the uterus and ovaries.

For men, semen analysis is performed, along with infectious disease screening. If there are concerns about male factor infertility, additional testing may be recommended.

This is also an opportunity to discuss your medical history, previous fertility treatments, and any concerns. Your specialist will explain your individualised treatment plan, including medication protocols and expected timeline.

In a natural cycle, your ovaries typically produce one egg. During IVF, hormone injections stimulate the ovaries to develop multiple eggs, increasing the chances of obtaining viable embryos.

Stimulation usually begins in the first few days of your menstrual cycle and continues for 10 to 14 days. The injections are administered subcutaneously (under the skin) and can be self-administered at home once you've been shown the technique.

Some women experience mild bloating, breast tenderness, or mood changes during stimulation. Your team monitors closely to optimise your response while minimising risks such as ovarian hyperstimulation syndrome (OHSS).

Approximately 36 hours after your trigger injection, eggs are retrieved through a minor surgical procedure called transvaginal oocyte retrieval.

Under light sedation, a thin needle is guided through the vaginal wall into each ovarian follicle using ultrasound guidance. The fluid containing the eggs is gently aspirated. The procedure typically takes 15 to 30 minutes, and you'll rest in recovery for 1 to 2 hours afterwards.

Most women experience some cramping afterwards, similar to period pain, which usually resolves within a day or two. You'll need someone to drive you home and should rest for the remainder of the day.

On the same day, your partner provides a fresh semen sample (unless frozen sperm or donor sperm is being used).

In the laboratory, eggs and prepared sperm are combined. There are two main techniques:

• Conventional IVF: Eggs and sperm are placed together in a dish, allowing fertilisation to occur naturally.
• ICSI: A single sperm is injected directly into each mature egg. This is used when sperm parameters are suboptimal or previous fertilisation has failed.

Fertilisation is checked the following day. Successfully fertilised eggs (now called embryos) are cultured in specialised incubators that carefully control temperature, humidity, and gas composition.

Embryos are typically monitored for 5 to 6 days, by which time the strongest will have developed to the blastocyst stage. You'll receive updates on embryo development, though it's normal for the number to decrease as some embryos stop developing, this is a natural selection process.

Embryo transfer is a straightforward procedure that doesn't require anaesthesia. Using ultrasound guidance, a thin catheter is passed through the cervix, and the embryo is gently deposited in the uterus.

The procedure takes only a few minutes and is similar to having a Pap smear. You may feel mild cramping, but most women find it quite comfortable.

The decision about how many embryos to transfer balances maximising pregnancy chances against the risks of multiple pregnancy. In Australia, single embryo transfer is standard practice for most patients, as it provides the safest outcome for both mother and baby.

Any additional good-quality embryos can be frozen (vitrified) for future use, avoiding the need to repeat the stimulation process.

After transfer, you'll continue taking progesterone support (usually as pessaries or injections) to help maintain the uterine lining.

Approximately 10 to 14 days after the transfer, you'll have a blood test measuring beta-hCG (human chorionic gonadotropin), the hormone produced by a developing pregnancy. This is more reliable than home pregnancy tests at this early stage.

The two-week wait can be emotionally challenging. It's normal to feel anxious and to scrutinise every symptom. Unfortunately, early pregnancy symptoms overlap significantly with progesterone side effects, so symptom-spotting isn't a reliable guide.

If the test is positive, further blood tests and early ultrasounds will monitor the pregnancy's progress. If unsuccessful, your team will discuss the cycle with you and consider any adjustments for future attempts.