In Vitro Fertilization: While everyone knows the process isn’t simple, it does seem fairly straightforward, right? You retrieve some eggs, fertilize them with sperm, transfer a healthy resulting embryo into the uterus and – if all goes well – a baby is conceived. There are, of course, a myriad of steps that comprise that “straightforward” procedure and when all is said and done, the average IVF cycle takes around four to six weeks, depending on how things progress.

The IVF Cycle: A Step by Step Timeline

Here is a more detailed outline of what a step-by-step IVF cycle timeline actually looks like:

Step 1. You start your period. Not surprisingly, the start of your menstrual cycle will trigger the start of your IVF cycle as your body gears up for its natural ovulation process. Depending on what was diagnosed and/or decided at your fertility treatment consultation, you may take birth control pills for a while to control the timing of the cycle more precisely and to prevent the growth of cysts, which can also affect ovulation. These oral contraceptives are typically taken for two to four weeks.

Sperm Fertilizing Egg

During this same step, often overlapping the contraceptives, you will start using a daily injection of a medication called Lupron, which complete the pre-stimulation ovarian suppression. Lupron injections are used for two weeks.

Step 2. This is the part everyone is familiar with – ovarian stimulation. It’s time to get those ovaries primed to release multiple viable eggs as possible in order to create healthy embryos. Ovarian stimulation is done using an injectable fertility med that is determined by your fertility specialist – varied according to what your individual body needs. The most common injectable meds are Follistim, Menopur, Gonal-F, Bravelle, Repronex or a combination as your doctor sees fit.  Lupron doses will be continually lowered during this time. Ovarian stimulation lasts from between 8 and 12 days.

Throughout this step, your progress will be monitored via estrogen levels and ultra-sound. When the egg follicles are mature, you will receive an injection of human chorionic gonadotropin (HCG) to stimulate the eggs’ release. Timing is essential at this point since your eggs need to be retrieved 36-hours after your HCG injection.

Step 3.  Now it’s time for the eggs to be retrieved. The official name for this is ultrasound directed follicular aspiration (UDFA). The process is performed under anesthesia, so you will not feel any discomfort. When you wake up, we are usually able to tell you exactly how many eggs were retrieved.

Of course, we need sperm to fertilize those eggs. If you are using your partner’s sperm, he will have either already provided a sperm sample the day or two before, or may be scheduled to do so the same day as your eggs are retrieved.

Step 4. Your eggs will be fertilized within hours of their retrieval. It takes three days for embryos to mature to the point that they can be tested for genetic viability and/or gender testing. The results of these tests are available between 24 and 48 hours afterwards. If there is a viable embryo, you will be scheduled for your exciting embryo transfer.

Step 5. This is where it really gets exciting. At this point, your viable embryo (typically one, as multiple births increase the chances of pregnancy complications) will be transferred to your uterus. This typically occurs around Day 5 of embryo growth. Embryo transfer procedures require no anesthesia. The teeny little embryo will be inserted into your uterus using a very small tube. Some patients elect to have a mild sedative administered so they can relax.

If there are additional viable embryos, they will be cryogenically frozen so they can be used for future IVF transfers as needed.

You will be tested for pregnancy at days 9 and 12 after the transfer to see if the embryo has implanted. During this time, you will use a progesterone suppository (the first of which was administered after the embryo transfer). If you are pregnant (hurray!), it is recommended that you continue using the progesterone supplements throughout the first trimester.

Are you and your partner ready to get started? Contact RRC to schedule a consultation.

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Do you fall into the trap of believing your chances for conception begin the moment you and your partner agree to start trying? In fact, the dice are being shaken up and rolled out long before that. Some fertility factors, like poor ovarian function, low sperm count and other conditions that contribute to infertility are genetic and sort of “came along with your personal package.” Others such as lifestyle choices, diet, exercise and general well-being can affect your chances of fertility months or even years before you actually start trying.

Start Checking the Boxes on RRC’s Pre-Conception Preparation List

For that reason, we’ve put together this Pre-Conception Preparation List that can help you see where you are on your own fertility path. It’s a great opportunity to evaluate how you’re doing, to fill in any gaps or to point you in the right direction if a change or two needs to be made. As always, you can contact RRC if you have questions, concerns, or if you feel you and your partner may be battling infertility issues.

Ideally, you will want to get going on this checklist at least one full year before trying to conceive.

Pregnancy Check List

Review Your Health Insurance Policy. What kind of maternity coverage or reimbursements does your current health insurance policy provide? If you are 35-years or older, you may also want to review whether or not your health insurance policy covers any portion of potential fertility treatments. Once you have those facts and figures, begin shopping around. You may find that spending just a few dollars more per month will be returned multi-fold in terms of improved coverage that adds up to thousands, or even tens of thousands, of dollars depending on your future needs.

Eliminate toxins from your diet and your world. Wow! We can’t write enough about how common chemicals, hormones and additives in food production and in the ingredients’ lists for household chemicals and health/beauty products can negatively impact fertility. Start doing your homework and cleanse your life – and thereby your body – of as many harmful chemicals as you can. Not only will you boost your chances of fertility, you’ll be creating a healthier environment for your future baby.

Find an OB/GYN you really love. When you aren’t trying to have a baby, a “meh” OB can be tolerable because researching and interviewing new ones can feel like an unnecessary inconvenience. All that changes, however, when you are ready to have a baby. Now, that same OB/GYN who you visit annually will be in your life on a monthly – and then bi-monthly basis – throughout your pregnancy. And, if all goes well, she will be the one who helps you bring your baby into the world. If you don’t love your OB/GYN, now is the time to find one you do. If you have a condition, like endometriosis, that may create fertility road blocks, or if you are an older mama-to-be, look for OB/GYNs that have positive relationships with fertility clinics in your area. RRC is happy to provide referrals if you need them.

Go off the pill. If you are currently taking a birth control pill or using another form of hormonal birth control, we recommend going off it for at least three full months (using other means of birth control such as condoms, a diaphragm, sponge, etc. in the meantime) before trying to conceive. This allows your body a chance to rid itself of synthetic hormones and get back to its natural hormonal rhythm and balance again. This can be a rather rude awakening for women who have used birth control for an extended period of time, so be prepared for irregular periods until your cycle regulates, mood swings, tender boobs and all the other symptoms that go along with a normal, healthy menstrual cycle.

Check your vaccination schedule. Odds are, if you were born in the United States or attended the U.S. public school system, you were vaccinated as a child. However, some of those vaccines expire. Examples include chicken pox and tetanus. Catching the chicken pox can cause severe disabilities and/or the miscarriage of an unborn baby and some vaccinations contain live viruses, which aren’t recommended while you are pregnant. If you want to be up to date on your vaccines, bring your vaccination schedule to your doctor and see if there are any gaps or refreshers that should be done prior to conceiving.

Lose that extra weight. By “extra weight” we are not talking about that extra 5 to 10 pounds that drives you crazy. We’re talking about the extra 20, 50 or however many pounds are pushing you over the healthy BMI figures for your age, gender and body type. Obesity and serious extra pounds are linked to infertility in both men and women, so use the year(s) before you try conceiving to develop a healthy diet and exercise program, both of which will help you lose unwanted weight and will get you in good shape to boot.

Visit the dentist and ask about your wisdom teeth. Hormonal fluctuations during pregnancy often lead to sensitive and tender gums, and can increase bleeding in your gums as well. Pair these factors with the reality that X-Rays aren’t ideal while pregnant and the more you can do to be proactive about your dental health the better. If you’ve procrastinated on getting your wisdom teeth out, get it done already. They are more prone to infection while you’re pregnant and the sedatives, pain meds, surgical procedures, recovery and so on are best avoided while you have a bun in the oven…not to mention once you have a baby or little one in the house.

Pro-Active Fertility Testing. In some cases, it’s a good idea to get fertility tests done ahead of time. Examples include:

  • You or your partner are over 35. Why waste time if there is something you should know ahead of time? Some basic fertility tests and/or semen analysis are worth it if the results save you from “six months to a year” of trying – - only to find out you’ll have a hard time conceiving on your own anyway.
  • You have suspicions. Was your husband’s brother or father diagnosed with low sperm count? Did your partner ever have a cancer treatment or take a medication that has been linked to infertility? Did you have a time in your life when you had frequent unprotected sex – - but it never resulted in a pregnancy? These are all significant causes for “suspicion,” that it may be better to get tested now.
  • You have infertility-related conditions. Do you have a condition that is linked to infertility, like PCOS, endometriosis or low ovarian reserves? Have you had trouble with hormonal imbalance, thyroid issues, diabetes or other diseases or conditions that can affect fertility? If so, fertility tests may be a good idea sooner rather than later.

There you have it folks. If you’ve checked all the boxes on our Pre-Conception Preparation Checklist, odds are you’ll be conceiving a baby in the very near future. If not, fill in the gaps and start making appointments. If you feel fertility testing or a consultation with a fertility specialist is in order, go ahead and schedule a consultation here at RRC.

Image courtesy of David Castillo Dominici at



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