5 Stages of IVF: What Really Happens Step by Step

If you’ve ever wondered what actually happens during IVF, you’re not alone. The internet is full of complicated medical jargon, but in reality, the process boils down to five main stages. Each step has its own challenges, little victories, and even a few awkward moments (just wait till you hear about the shots).

People often think IVF is so high-tech and mysterious that regular folks can’t get the details. But once you break it down, it’s less sci-fi than you’d expect. Knowing how each stage works helps you feel less anxious and gives you more control over what’s coming next. Whether you’re just starting to look into IVF or gearing up for your first appointment, it’s smart to get the facts upfront.

• Screening and Preparation
• Ovarian Stimulation and Monitoring
• Egg Retrieval and Fertilization
• Embryo Development
• Embryo Transfer and Waiting

Screening and Preparation

This stage is all about making sure IVF is safe and has the best shot of working. Before you even get near the lab, both partners go through a bunch of tests and meet with doctors. The goal? Spot anything that could affect success or cause problems down the line.

Here’s what typically goes down during screening and prep:

• Fertility tests for both partners: Blood tests track hormone levels, check egg reserve, and rule out issues like thyroid problems. For men, there’s a semen analysis to check sperm count and quality.
• Transvaginal ultrasound: This scans the ovaries and uterus so doctors know everything’s in working order.
• Screening for infectious diseases: Stuff like HIV, hepatitis B and C, and chlamydia needs to be checked to keep everyone safe.
• Genetic tests: Sometimes, a couple may do extra testing if there’s a family history of genetic conditions.
• Consults and counseling: You’ll talk with the fertility specialist and sometimes a counselor to set expectations and go over any worries.

People are often surprised how thorough this part is, and it can take a few weeks. But missing something here can mess up the whole IVF process later.

It’s also smart to line up any meds you’ll need later, like birth control pills (sometimes used to control timing) or vitamins, before jumping into stimulation. If you smoke or drink a lot, doctors will ask you to hit pause—your body handles IVF meds way better without those habits in the mix.

Ovarian Stimulation and Monitoring

This is probably the busiest part of the whole IVF timeline. The main goal here is to get your ovaries to produce more eggs than usual. In a regular cycle, your body usually matures just one egg. With IVF, you want as many good eggs as possible, since not every egg leads to a healthy embryo.

Your doctor will give you daily hormone shots—usually for about 8 to 14 days. The most common medications are FSH (follicle-stimulating hormone) and LH (luteinizing hormone). You’ll probably have to stick yourself with a small needle every evening. It sounds scary, but most people find it’s not as bad as it looks.

• You’ll need to go for ultrasound scans every few days. This is where they check the size and number of follicles (tiny sacs in your ovaries that hold the eggs).
• Blood tests are also common. These measure your hormone levels so the doctors can decide if they need to adjust your medication.
• When enough follicles are the right size, you’ll get a “trigger shot.” This forces the eggs to finish maturing and gets your body ready for egg retrieval.

Here’s what a typical IVF stages monitoring schedule might look like:

Fun fact: It’s totally normal to feel bloated—your ovaries can get three to four times bigger than usual! Drink lots of water and don’t hesitate to ask your clinic about weird symptoms. Your team wants to catch signs of rare but serious side effects like OHSS (Ovarian Hyperstimulation Syndrome), so keep them updated, especially if your belly balloons up overnight.

One tip: Write down your medication schedule or use a reminder app. Missing a shot or taking it at the wrong time can mess up your whole cycle, and no one wants to start over again. If needles freak you out, ice the area for a minute—it helps numb the skin.

Egg Retrieval and Fertilization

This is the part of the IVF process where you really feel like things are moving. Up until now, it’s been about prepping the body and monitoring hormone levels, but during egg retrieval and fertilization, the action happens.

First, doctors use a needle guided by ultrasound to collect mature eggs from the ovaries. The whole thing is done under mild sedation—it usually takes about 20-30 minutes. Most people say they’re a bit sore afterward, but it’s usually not worse than a heavy period cramp. Clinics typically aim to retrieve 8 to 15 eggs, but don’t freak out if your number is lower or higher because it really depends on your unique response.

Once the eggs are out, lab specialists jump in. Each egg is placed in a dish with about 100,000 washed sperm (yeah, that many), hoping for fertilization. Sometimes, if sperm quality is low, they’ll use ICSI (intracytoplasmic sperm injection), which means injecting a single sperm directly into an egg—pretty wild stuff.

Dr. Nisha Patel, a senior IVF specialist, puts it bluntly: “Egg retrieval day marks a turning point. Patients often feel anxious, but most are surprised by how quick and straightforward the actual procedure is.”

Check out what typically happens on the big day:

• Pre-procedure: No food or drink for about 8 hours. You’ll get instructions on what meds to take.
• Sedation: You get an IV for medication to relax.
• Egg retrieval: Doctor uses an ultrasound probe and thin needle, collecting eggs from each follicle.
• Recovery: Rest for 30-60 minutes in the clinic before heading home.
• Fertilization: Lab staff work their magic the same afternoon.

The science is amazing, but here’s something practical—a quick look at egg retrieval numbers and fertilization success rates:

Keep your phone close—most clinics will call the next day to tell you how many eggs actually fertilized. It’s a nerve-wracking wait, but these updates give you a clear idea of how things are moving along.

Embryo Development

Once the egg and sperm meet in the lab, we move into one of the most crucial phases of the IVF process: embryo development. Here, the fertilized eggs—now called embryos—are placed in a special incubator that keeps everything at the right temperature and humidity, almost like a high-tech nursery.

Embryologists check these embryos every day. They're looking for cell division and normal growth. On day 1, you want to see two nuclei (that means fertilization worked). By day 3, embryos usually reach about 6–8 cells. Around day 5 or 6, the best ones will turn into what’s called a blastocyst—a more developed ball of cells, which has a better shot at becoming a pregnancy.

Here’s a quick look at what happens day by day:

• Day 1: Embryos checked for successful fertilization.
• Days 2-3: Embryos should continue to divide and grow (about 4-8 cells).
• Days 5-6: Blastocyst stage; embryos are graded based on their quality for transfer or freezing.

Not every embryo makes it to the blastocyst stage, which is totally normal and doesn’t mean you did anything wrong. In fact, clinics usually expect only about 40–50% of fertilized eggs to develop into blastocysts. Embryologists pick the healthiest-looking embryo(s) for transfer, since higher-quality embryos boost your odds of success.

*Percentages show what portion of fertilized eggs typically reach each stage in a standard IVF cycle.

One thing to know: many clinics now do genetic testing of embryos at the blastocyst stage. This helps check for chromosomal problems that might cause a failed transfer or miscarriage. If you're offered this, it's okay to ask about the pros and cons based on your age and situation.

If you have unused, good-quality embryos, clinics can freeze them for future use. That means if the first transfer doesn’t work, or if you want a second child later, you may not need to repeat all the earlier steps. Freezing technology is really good now—over 95% of embryos survive the thaw.

Embryo Transfer and Waiting

Alright, the big moment in the IVF process is here—the embryo transfer. This is when one or more selected embryos are placed directly into the uterus. No surgery, no anesthesia; it feels like a long Pap smear, honestly. Doctors usually use a thin tube called a catheter, and the entire thing is over in about 10 minutes. Most clinics recommend resting for a short while right after, but you can usually go home the same day.

How do doctors pick which embryos to transfer? They grade them based on how they look under a microscope. Day 5 blastocysts are usually preferred because they have a higher rate of successful implantation, but sometimes day 3 embryos are used if you have fewer good options. Here’s a quick look at typical success rates for different days:

**Success rates vary by age and clinic.

After the transfer, you hit what many call the “two-week wait.” This is the stretch between the transfer and the blood test that checks for pregnancy. Most clinics ask you to avoid heavy exercise, alcohol, and hot baths. Honestly, this is the toughest part for a lot of people because all you can do is wait and try not to worry.

Here are some smart moves during the wait:

• Stick to gentle exercise like walking, unless your doctor says otherwise.
• Eat regular, balanced meals—don’t go overboard with “fertility diets.”
• Don’t obsess over symptoms; cramping and spotting can happen whether you’re pregnant or not.
• Make a plan to distract yourself: pick a show to binge, hang out with friends, or dive into a hobby.

About 9-14 days after transfer, you’ll do a blood test (not a home test—those can be unreliable this early). No matter what the result, give yourself some credit for getting through the hardest part.