The 5 Stages of IVF Explained: Step‑by‑Step Guide

When couples start the journey toward parenthood, In vitro fertilization is a medically assisted reproductive technique that joins an egg and sperm outside the body, then places the resulting embryo back into the uterus. Knowing the IVF stages helps you prepare emotionally and logistically, so you’re not caught off guard by each appointment, medication, or test.

Stage1 - Ovarian Stimulation (Ovulation Induction)

During the first two weeks, the goal is to coax the ovaries into producing multiple mature eggs instead of the single egg released naturally each month.

• Gonadotropins (usually a mix of FSH and LH) are injected daily. These hormones mimic the body’s natural signals.
• Doctors monitor growth with ultrasound scanning and blood tests for estradiol levels.
• Typical stimulation lasts 8-14 days, but the exact timeline depends on age, ovarian reserve, and medication dose.

Common concerns in this phase include injection site pain, bloating, and mood swings. Staying hydrated, eating a balanced diet, and keeping a simple injection log can ease the stress.

Stage2 - Final Egg Maturation (Trigger)

Once follicles reach the desired size (usually 18-20mm), a "trigger" shot is administered to complete the egg’s final maturation.

• The trigger is typically human chorionic gonadotropin (hCG) or a GnRH agonist.
• Timing is critical: the egg retrieval is scheduled 34-36hours after the trigger, before ovulation occurs naturally.
• Patients are advised to avoid heavy exercise and to arrange transportation, as the trigger can cause mild cramping.

Stage3 - Egg Retrieval (Aspiration)

Under light sedation, a thin needle guided by transvaginal ultrasound punctures each follicle to collect the eggs.

• The procedure lasts 15-30minutes, and most women experience only mild discomfort afterward.
• Collected eggs are immediately handed to the embryology lab, where they are assessed for maturity.
• In the same session, sperm-either from a partner or a donor-are prepared for fertilization.

Potential side effects include spotting or a brief feeling of fullness. Recovery tips: wear loose clothing, use a cold pack on the lower abdomen, and avoid sexual activity for 24-48hours.

Stage4 - Fertilization & Embryo Culture

There are two main ways to join the egg and sperm:

1. Conventional IVF - sperm and egg are placed together in a culture dish and left to fertilize naturally.
2. Intracytoplasmic sperm injection (ICSI) - a single sperm is injected directly into the egg, boosting fertilization chances for male‑factor issues.

After fertilization, embryos are cultured for 3-5days. During this window, labs may perform pre‑implantation genetic testing (PGT) to screen for chromosomal abnormalities, especially for older patients or recurrent miscarriage cases.

• Embryos reaching the blastocyst stage (around day5) have a higher implantation potential.
• Good-quality embryos are either transferred fresh or frozen for future use (cryopreservation).

Stage5 - Embryo Transfer & Luteal Support

Whether a fresh or frozen embryo, the transfer involves a thin catheter placed through the cervix into the uterus.

• The procedure is painless; many clinics use ultrasound guidance to ensure optimal placement.
• After transfer, patients receive luteal phase support-usually progesterone shots, vaginal gels, or oral tablets-to sustain the uterine lining.
• Two weeks later, a blood test for beta‑hCG determines if implantation succeeded.

If the test is positive, follow‑up scans confirm a viable pregnancy. If not, doctors discuss the next steps, which might include another frozen embryo transfer or adjusting the stimulation protocol.

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