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What To Expect During First IVF Cycle

Understanding IVF before starting the process is crucial to maximize its success. In this guide, I will walk you through each step of the IVF procedure, providing clear and detailed information to help you feel confident and prepared throughout your IVF journey, ensuring the best possible outcomes.

1. Initial Consultation and Testing

First and most important step is Initial consultation. In first consultation your fertility consultant will go through history like since how many years you are trying for pregnancy, both partner age, will need to know about any medical problem you have, any surgery in past, any medications you are having now, any history of previous pregnancy or abortion. Fertility consultant will also ask you about your menstrual cycle history, intercourse frequency, any problem during intercourse like premature ejaculation or erectile dysfunction,  vaginismus or any other difficulty during intercourse.

Apart from this we also go through history of past treatment taken. Results of past treatment. Past investigations done.
Once this part is done if required we may ask you to do:
  • Blood test like : hormones , CBC, Thyroid , prolactin, AMH , Viral markers, Rubella, RBS , etc
  • Semen analysis of partner. If require some hormonal test from partner along with viral markers can be requested.
  • Transvaginal or Transabdominal Ultrasound to know status of ovary, uterus and adnexa.
  • Sometime genetic testing may be needed.
Based on findings of above medical history, investigations, fertility consultant will decide appropriate personalise plan of treatment for you. Treatment is different for all patients depending on their cause of infertility. So, it is very important to first investigate cause of infertility and then to personalize treatment plan accordingly.

2. Ovarian Stimulation

Ovarian stimulation is the second stage of treatment after deciding personalize plan. Goal of this stage is to stimulate ovarian follicles in control way so as to retrieve maximum number of mature follicles. Fertility doctor will usually call you on second or third day of your menstrual cycle. On this day we will do Ultrasound to know status of ovary, number of follicles, also rule out of presence of any ovarian cyst. Will also review all your blood investigations. Once done then we usually start giving you necessary hormones like FSH, LH, etc for appropriate growth of follicles. The ultrasound is done on periodic basis along with hormonal blood test to know the growth of follicle. Once follicles are mature (desired size is achieved) then preparation is done for retrieval of eggs.
Patient may experience following side effects during this phase:
  • Bloating
  • Mild abdominal discomfort
  • Mood swings
  • Breast tenderness

3. Egg Retrieval

This is third phase during IVF cycle. In this phase actual retrieval of eggs happen. Once desired size of follicles achieved then we give trigger injection in order to bring final maturation in eggs. Approximately 33 to 36 hours after trigger injection process of egg retrieval is plan. The process of egg retrieval is done under mild sedation or anaesthesia. With the help of ultrasound machine and long needle follicles are aspirated. Immediately after aspiration of follicular fluid it is handed over to embryologist in order to search for presence of egg in it and further procedure of fertilization.

Procedure is usually safe and take 15 to 60 minutes to complete depending on number of follicles present. Sometime patient may experience mild cramp and spotting after procedure. Mostly patient is discharge on same day after 4 to6 hours.

4. Fertilization and Embryo Development

Once eggs are retrieved and separated, partner semen sample is taken. Semen sample is washed and good motile sperm are separated from it. Sometimes patient may need additional procedures like Zymote, P-ICSI for sperm selection. Once sperms are ready then fertilization is done in laboratory. After fertilization we need to wait for 3 to 5 days for embryo to form. Usually day 5 embryo also called as blastocyst is consider to have better chances of pregnancy.

5. Embryo Transfer

Once embryo is ready then hormones and ultrasound reports are reviewed. If condition look ok for embryo transfer then it is done around 3 to 5 days after oocyte retrieval, which is also called as fresh embryo transfer. And if condition is unsuitable for embryo transfer then it is frozen and frozen embryo transfer is plan after a month or two once uterus, endometrial lining, hormones are healthy for pregnancy.

6. The Two-Week Wait

After embryo transfer you need to wait for 10 to 14 days to confirm pregnancy. After 10 to 14 days blood test called beta HCG is done. If Beta HCG value is more than 50 mIU/mL on 10th day after embryo transfer then it usually indicates successful implantation. After that  successive 3 beta HCG test are done every 48 hours to confirm rising trends of beta HCG. Then Ultrasound is usually plans after 21 days if everything is normal. Sometime if  ectopic pregnancy is suspected then ultrasound  may be planned earlier.
You may experience mild cramping, spotting, or other pregnancy-like symptoms due to progesterone supplementation during this waiting period.
Avoid heavy exercise, stress, and overthinking during this period.

7. Outcome and Next Steps

Once pregnancy is positive you will have monitoring of pregnancy with ultrasound and blood test. If it’s negative, we will review the cycle, discuss possible adjustments, and consider the next steps, including frozen embryo transfer (FET) if available.

Conclusion

The first IVF cycle is a learning experience. Success rates vary based on age, egg quality, sperm quality, and underlying health conditions. While the process can be emotionally and physically demanding, staying informed and supported can make a significant difference in your journey. Your fertility consultant will guide you every step of the way, helping you feel more in control and optimistic about the outcome.