Before day one: getting ready
Most clinics start with tests that shape the plan: blood tests and an ultrasound to estimate how your ovaries are likely to respond, a check of the uterus, a semen analysis if a partner's sperm will be used, and infection screening. These results feed into the medication protocol your doctor chooses.
Some clinics use the contraceptive pill or progestogen tablets beforehand to help time the start of treatment. The NHS (reviewed 2025) lists this as an option rather than a requirement.
The cycle, step by step
Controlling your natural cycle
The aim is to stop your body releasing eggs on its own before the clinic can collect them. In what is often called the long protocol, the NHS describes a daily injection or nasal spray for about 2 to 3 weeks, followed by a scan to confirm it has worked. In the antagonist protocol, the HFEA explains that the blocking medication is used for a few days after stimulation has already started. The HFEA says a cycle takes about 3 weeks when the separate suppression stage is skipped.
Stimulating the ovaries
Daily hormone injections, which you usually give yourself at home, encourage several eggs to mature at once instead of the usual one. The NHS describes this phase as lasting about 2 weeks. The purpose is to give the lab more than one egg to work with. Our guide to IVF medications and protocols explains what each drug on your calendar does.
Monitoring
During stimulation you have ultrasound scans, and often blood tests, every few days. These show how many follicles are growing and how fast, and the clinic may adjust your dose in response. See what monitoring bloodwork means mid-cycle for how to read the results.
The trigger injection
When enough follicles are a suitable size, you take a final "trigger" injection that completes egg maturation. Its timing is set precisely by the clinic because egg collection is scheduled from it. If you are at higher risk of over-response, ReproductiveFacts (ASRM, 2023) notes that using leuprolide rather than hCG as the trigger is one way to reduce OHSS risk.
Egg collection
A doctor passes a fine needle through the vaginal wall, guided by ultrasound, and drains each follicle. The NHS says this takes around 20 minutes; the HFEA says about half an hour. It is done under sedation or general anaesthetic. Our article on anaesthesia for egg retrieval covers fasting and recovery.
Sperm sample and fertilisation
A fresh sperm sample is usually given on the day of collection, or frozen or donor sperm is prepared. In the lab, eggs are either mixed with sperm or each injected with a single sperm (ICSI). The NHS notes the clinic calls the next day to say how many eggs have fertilised.
Embryo culture, and optional testing
Fertilised eggs grow in an incubator while embryologists check their development. The HFEA describes embryos developing for two to six days. If you have chosen genetic testing, a few cells are taken from each embryo at the blastocyst stage, and the embryos are often frozen while you wait for results.
Embryo transfer or freezing
One embryo, or occasionally more, is placed in the uterus through a thin tube inserted via the vagina, as the NHS describes it. The HFEA notes this usually needs no anaesthetic. Suitable embryos that are not transferred can be frozen for later. In a "freeze-all" cycle, every embryo is frozen and transfer happens in a later cycle instead.
Lining support and the pregnancy test
After collection, medication (often a vaginal pessary or gel, as the HFEA describes) helps prepare and support the uterine lining. The NHS says a pregnancy test is taken about 16 days after transfer, with a scan at around 7 weeks if the test is positive. The HFEA advises against testing early, because the result may be wrong.
Which steps need you at the clinic?
For people travelling for IVF, this is often the most practical question. The answer depends on your clinic's arrangements, but the pattern below is common.
| Step | Where it usually happens | Flexibility |
|---|---|---|
| Pre-treatment tests | Can often be done at home and sent ahead | Check which results, and how recent, the clinic accepts |
| Suppression and early stimulation | At home, self-injected | High, if the medication is in hand and stored correctly |
| Monitoring scans | Treating clinic, or a local clinic that sends results | Moderate; needs a reliable hand-off |
| Trigger injection | Wherever you are, at an exact time | Location is flexible, timing is not |
| Egg collection | Treating clinic | None |
| Fresh transfer | Treating clinic | None |
| Frozen transfer | Treating clinic, in a later cycle | Can be a separate trip |
| Pregnancy test | Anywhere | High |
The decisions built into each step
Each stage of the cycle comes with a choice, and it helps to know in advance when each one will be made:
- Before starting: which protocol and starting dose to use.
- During stimulation: whether to change the dose, and when to trigger.
- At trigger: which trigger medication to use, which can depend on OHSS risk.
- At fertilisation: conventional insemination or ICSI.
- During culture: how long to grow embryos, and whether to test them.
- At transfer: fresh or frozen, and how many embryos.
Asking at your first consultation who makes each decision, and when you will be told, prevents a lot of uncertainty later.
When to call your clinic
The NHS lists ovarian hyperstimulation syndrome (OHSS), multiple pregnancy and ectopic pregnancy among the main IVF risks. ReproductiveFacts advises prompt contact for symptoms such as difficulty breathing, ongoing vomiting, trouble keeping fluids down, abdominal swelling, passing less urine, sudden abdominal pain, or gaining more than 3 pounds in 2 days. Make sure you know how to reach your clinic out of hours, especially if you are away from home.
How long the whole thing takes
From the first suppression dose to the pregnancy test, the NHS estimates 3 to 6 weeks and the HFEA 4 to 6 weeks for one cycle. A freeze-all approach, or genetic testing, adds the time until a later frozen transfer. If your cycle is cancelled because of a poor or excessive response, the timeline restarts.
Embryos are not always transferred at the same stage. Our day-by-day guide to embryo development shows what is happening in the lab between fertilisation and transfer.
Keep your own record as you go
Clinics keep detailed notes, but it is worth keeping a simple record of your own, step by step. It costs nothing and is invaluable if you later change clinics, cycle abroad, or want a second opinion.
- Every medication, dose and time, including any changes made after a scan
- Each monitoring result you are given: follicle sizes and hormone levels
- The exact trigger medication and time
- Eggs collected, eggs mature, and eggs fertilised
- How many embryos developed, were transferred, and were frozen, with the day of each
- Transfer date, the support medication you used, and your test result
The Takeaway
IVF is a sequence of distinct steps, each with its own purpose and decision. Map those steps against your calendar, and note the two that cannot move: egg collection and transfer at the clinic.
Frequently asked questions
How long does one IVF cycle take from start to finish?
The NHS estimates about 3 to 6 weeks and the HFEA about 4 to 6 weeks, from the start of medication to the pregnancy test. The HFEA says skipping the separate suppression stage brings it to about 3 weeks.
How soon after egg collection will I know if eggs fertilised?
Usually the next day. The NHS notes the clinic calls to tell you how many embryos have been made.
Is embryo transfer painful?
The HFEA notes that transfer usually needs no anaesthetic, unless a particular condition is likely to make it painful. Ask your clinic what to expect on the day.
When can I take a pregnancy test?
Your clinic will give you a date. The NHS says this is about 16 days after transfer, and the HFEA advises against testing earlier, since an early result can be wrong.
Which parts of IVF can I do at home if I travel for treatment?
Self-injections and sometimes monitoring scans can be done at home or locally. Egg collection and transfer have to happen at the treating clinic, so plan to be there for those.