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The IVF Timeline: How Long Does it Take?

By CNY Fertility Updated on — Medically Reviewed and Certified by Brandis Montez, AGACNP-BC, FNP-BC Brandis Montez, AGACNP-BC, FNP-BC
The IVF Timeline: How Long Does it Take?

Starting out on your In Vitro Fertilization (IVF) journey can be both exciting and daunting. One of the first questions couples ask is “How long does IVF take?” Understanding the timeline of the IVF process can help you plan ahead and manage expectations. 

In this article, we’ll detail a typical IVF timeline, focusing on the four stages from the start of ovarian stimulation to the embryo transfer. We’ll expand our scope to include the initial consultation, preconception fertility testing, and priming protocols through pregnancy. 

IVF Timeline Overview

  • IVF is not a single treatment but a series of linked medication protocols, procedures, and laboratory techniques. 
  • The average IVF cycle takes about 15-20 days from the start of medications to embryo transfer if doing a fresh transfer, and about 45 days if doing IVF with a Frozen Embryo Transfer. 
  • When accounting for consultations,  fertility testing, and preconception protocols, the IVF timeline can take 5 months or longer from your initial consultation to your first pregnancy test. 
  • People’s bodies can respond differently to IVF medications and procedures. Protocols may need to be updated, which can extend the timeline. 
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IVF Cycle with Fresh Embryo Transfer Timeline

Once you’ve undergone fertility testing and gone through the optional period of priming your body with a holistic preconception protocol, you’re ready to begin the IVF cycle. 

Explore our interactive IVF Timeline Calendar and details below for more information. 

 

Phase 1: Ovarian Stimulation | From Day 1 to Day 9 – 11

The first phase of the IVF Timeline is ovarian stimulation, which lasts approximately 10-12 days. The first day of medicated ovarian stimulation is considered “Day 1” of IVF but usually takes place on days 2-5 of a woman’s natural menstrual cycle.  The exact timeline may vary depending on individual circumstances. 

The goal of ovarian stimulation is to develop as many mature eggs as possible without ovulating, and it is often called controlled ovarian hyperstimulation.  Ovarian stimulation is characterized by administering various injectable medications and frequent office visits, called “monitoring” appointments to check hormone levels, along with ultrasound monitoring to measure follicle, egg, and uterine lining development. 

Below is a standard timeline of what this looks like. Do note the following dates are highly variable: 

  • Call or message the care team on the first day of the menstrual cycle. This is your first day of full menstrual flow before 12 pm (or whenever if you do not have regular menstrual cycles) 
  • Day 1 (of stimulation-not cycle day 1):  Baseline Monitoring Appointment: to obtain baseline hormone levels, follicle count and size, and endometrial lining thickness 
    • FSH (and LH): to stimulate egg growth 
  • Day 2:  
    • FSH (and LH) 
  • Day 3:  
    • FSH (and LH) 
  • Day 4:  
    • FSH (and LH) 
  • Day 5:  
    • Monitoring Appointment 
    • FSH (and LH) 
  • Day 6:  
  • Day 7:  
    • Monitoring Appointment 
    • FSH (and LH) 
    • GnRH Antagonist 
  • Day 8:  
    • FSH (and LH) 
    • GnRH Antagonist 
  • Day 9:  
    • Monitoring Appointment 
    • FSH (and LH) 
    • GnRH Antagonist 
  • Day 10: 
    • Trigger shot (Lupron and or hCG): to “trigger” the final maturation of eggs 
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Phase 2: Egg Retrieval | Day 11–12, 35-36 hours after the trigger shot

The egg retrieval is a minor, same day surgical procedure that takes place 35–36 hours after the administration of the first trigger shot.  This is usually around 12 days after you begin your hormone-based stimulation treatment. For retrieval, a thin needle under transvaginal ultrasound guidance is used to extract fluid from the mature follicles in the ovaries. Your eggs are in this fluid.  You are asleep for this procedure under IV sedation and shouldn’t feel a thing! 

Pase 3: Embryology and Development and Uterine Lining Preparation| Day 12-17 (possibly day 11-19)

After the eggs are retrieved, they are assessed by an embryologist to make sure they are mature.  

Mature eggs are then fertilized with sperm and stored in an incubator for 3-7 days, during which the fertilized egg undergoes cell division until it reaches the cleavage or blastocyst stage of development.

Cleavage stage is typically reached on the 3rd day of embryo development. The blastocyst stage is typically reached on the 5th day of embryo development.  Sometimes, embryos may take 6 or 7 days to make it to the blastocyst stage. 

During this time, the female usually takes daily estrogen and progesterone to prepare the uterine lining for embryo transfer and implantation. 

Here is what that looks like daily: 

  • Day 12:  (day of egg retrieval, “day 0” in terms of embryo development) 
    • Eggs are fertilized 
    • No medications taken 
  • Day 13 (Day 1 of embryo development): 
    • Embryos are checked for fertilization 
    • Estrogen and Progesterone  
  • Day 14 (day 2 of embryo development): 
    • Embryos should be 2-4 cells 
    • Estrogen and Progesterone  
  • Day 15 (day 3 or embryo development) 
    • Embryos should be 6-8 cells and could be transferred if transferring a day 3 embryo (depending on your plan) 
    • Estrogen and Progesterone 
  • Day 16 (day 4 of embryo development) 
    • Embryos should be at the morula stage 
    • Estrogen and Progesterone 
  • Day 17 
    • Embryos should be at the blastocyst stage and can be transferred if transferring a blastocyst embryo (depending on your individual plan)
    • Estrogen and progesterone 

At this point, the blastocyst embryos and uterine lining are ready for transfer. 

Phase 4: Embryo Transfer | Day 17

Embryos are transferred either fresh or frozen back into the woman’s uterus. A fresh transfer takes place on day 17, 5 days after the egg retrieval (Day 0). 

If you opt for a fresh transfer, a single embryo is transferred in a procedure that takes between 20-30 minutes. Your remaining embryos can be safely frozen and stored for later use in a process called vitrification. 

If you choose to do a frozen transfer (FET), your eggs go to blastocyst before they are frozen. Frozen embryos are typically transferred from days 19 through 21 of a patient’s menstrual cycle. 

The exact date on the IVF timeline depends on when the embryo was frozen and the day progesterone supplementation begins. For instance, if progesterone supplementation begins after day 3 or 5 post-egg retrieval, the transfer will usually take place on day 6. 9 10

Phase 5: Implantation and Pregnancy | Day 18 – 32

The embryo will typically begin to implant in the uterus a couple of days after the embryo transfer. However, it will take around 9 to 11 days from the date of transfer to detect pregnancy with a blood test called an “hCG beta.” 

It is important to note that some home pregnancy tests may be negative even though the blood test is positive, so it is important to never stop medications before being told by your team (after blood test confirmation). 

Technically, the IVF treatment ends with embryo transfer, but most patients will continue medications that support implantation and pregnancy.  

A general implantation timeline looks like this (immune protocols and add-ons may vary): 

A general implantation timeline looks like this:

  • Day 17: Embryo Transfer, progesterone, estrogen
  • Day 18: progesterone and estrogen
  • Day 19: progesterone and estrogen
  • Day 20: progesterone and estrogen
  • Day 21: progesterone and estrogen
  • Day 22: progesterone and estrogen
  • Day 23: progesterone and estrogen
  • Day 24: Blood Test, progesterone, estrogen. A blood test is used to determine if your hormone levels are within the expected range. If traveling for IVF, this test can be done at a lab closer to home. Results should be available on the same day.
  • Day 25: progesterone and estrogen
  • Day 26: Pregnancy Test, progesterone, estrogen. Another blood test will be done–at a lab or your choice– to determine if you are pregnant. Your results should be available on the same day.

Timeline From Positive Pregnancy Test

If you get a positive pregnancy test:

  • You will take another test in 2-3 days to evaluate your rising levels.   

  • 1 week later, you will have an ultrasound to identify the site where the embryo implanted and the gestational sac.  

  • An ultrasound at 6 weeks will detect the heartbeat. Once a heartbeat is detected there is a 90-95% probability that your pregnancy will continue to a live birth.  Usually, you are discharged from the IVF clinic at around 8 weeks. 

  • At around 12 weeks into your pregnancy, you will schedule routine prenatal care with your obstetrician. 

Timeline From a Negative Pregnancy Test

If your pregnancy test is negative:

  • Your specialist will direct you regarding what medications to stop and continue. 
  • Your period will likely start in a few days. 
  • You can begin another IVF cycle as soon as you would like.

Timeline for IVF with a Frozen Embryo Transfer

The use of frozen embryo transfers (FET) has grown to account for more than half of all embryo transfers. Let’s explore how this technique impacts the length of the IVF cycle. 

Frozen embryo transfers are performed for a number of reasons, including:

  • Failed fresh transfer. 
  • Genetic testing–all genetically tested embryos must be frozen.  
  • Those who are at higher risk of developing ovarian hyperstimulation syndrome (OHSS) 
  • The uterus is not ready for embryo transfer following the stimulation cycle of IVF. 

For patients who opt not to undergo a fresh embryo transfer, the protocol is called a “Freeze all IVF cycle” in which all embryos are frozen for future FETs. 

The freeze-all process follows these steps:

  1. Stimulation
  2. Retrieval
  3. Embryology lab: fertilization, embryo development, and cryopreservation.

In the case of frozen embryo transfer the IVF timeline extends by an average of 4-6 weeks. Here’s a breakdown. 

Preparation:

  • Hormone therapy: Some patients may need to take hormonal medications to prepare the endometrial lining. This can take about 2 to 4 weeks.
  • Natural cycle or hormone replacement cycle: Depending on whether the FET is done in a natural cycle (tracking the woman’s natural ovulation) or a hormone replacement cycle (using estrogen and progesterone to prepare the lining), the preparation phase can take around 2 to 3 weeks.

Monitoring:

  • Ultrasound scans and blood tests are performed to ensure the endometrial lining is developing properly. This typically takes place over 1 to 2 weeks.

Transfer:

  • The transfer of the embryo to the uterus is a brief procedure, similar to a fresh embryo transfer. After the transfer, there is a 9-11 day wait before a pregnancy test can confirm if the transfer was successful. 

Preparation for IVF: 30-90 Days Prior to Treatment 

Once you’ve had your initial consultation (or even before), you will begin to prepare for your IVF treatment. Preparation involves two key steps: Fertility testing and your preconception regimen.

Together, these steps help your doctors tailor your treatment to your needs while you take steps in your own life to maximize your odds of a successful pregnancy.

Fertility Testing 

Before starting the IVF process, you will undergo thorough fertility testing to assess various factors that affect your reproductive health. 

Fertility testing will include 

  • Female Testing:
    • Bloodwork: panel assessing general, hormonal, and fertility health.
    • Imaging: a Hysterosalpingogram (HSG) to evaluate the health of a woman’s fallopian tubes and a Saline Sonohysterogram (SHG), a vaginal ultrasound to evaluate uterine abnormalities and the health of the uterine lining. 
  • Male Testing: 
    • Semen analysis to evaluate sperm count, motility, and morphology in a male partner when necessary

Preconception Lifestyle and Health

The human egg enters its final stage of development around 90 days before the egg is ovulated. Similarly, sperm takes about 72 days to fully develop.

Various preconception measures can be taken during this period to optimize egg, sperm, and thus embryo quality. 

Preconception measures are aimed at increasing the health of your body through nutrition, supplementation, and holistic wellness practices. 

How Long Does IVF Take? The Bottom Line

The technical IVF timeline takes around 30 days–the same as a natural menstrual cycle. It is during this time that you undergo the 4 procedures that make up the IVF treatment.

  • Ovarian Stimulation: Day 1 through Day 9 –11
  • Egg Retrieval: Day 11-12
  • Embryology: Day 11-17
  • Embryo Transfer: Day 17

When using a frozen embryo transfer technique, this timeline can be extended by 4-6 weeks. 

A more comprehensive IVF timeline takes into account the 30-90 days prior to the procedure, known as preconception, and the two weeks after implantation, where your levels are monitored through your first and second pregnancy tests. 

During preconception, you can incorporate diet and lifestyle practices that will prime your body for success. 

It’s important to remember that every person is unique and may experience alterations to their IVF timeline. If you’re new to the IVF journey and looking for expert guides to lead you on your path to parenthood, feel free to schedule a consultation with one of our fertility specialists. 

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