So You Need to Do IVF
Starting your first IVF cycle (also known as in vitro fertilization) can be both an exciting and nerve-wracking experience. At least, I know it was for me. I had trudged through several years of infertility to become a mother. In fact, I had never even seen a positive pregnancy test. When my doctor finally told me I would need to do IVF for a chance at becoming a mom, I grieved intensely. This was never in my plans. I never thought it would be difficult for me to become pregnant. IVF was something other people had to do, not me. I also had no idea what to expect with IVF. I was constantly on Google, searching for things like: What is IVF like? What can I expect with my first IVF cycle? IVF step-by-step guide. How long does IVF take?
So now that I have gone through my first full IVF cycle and I do know what it’s like, I want to pay it forward and share what I know. I know what it’s like to be in your shoes right now, with a path before you that you didn’t likely choose, and a million questions swirling through your head about IVF cycles and treatments.
⭐️Related Posts You May Find Helpful⭐️
- 12 Things You Need to Know Before Starting IVF
- What to Expect with a Frozen Embryo Transfer: A Step by Step Guide
And if you are in the midst of IVF or about to start, you will love my IVF Printable Planning Bundle. It comes with 36 different printable sheets to help keep you organized while going through IVF.
Click here to grab the planner bundle!⤵️
So with that, here’s a step-by-step guide on what to expect when you start your first IVF cycle.
Step 1: Preparing for Your First IVF Cycle
Initial Consultation
The first step in your IVF journey is an initial consultation with a fertility specialist. During this appointment, the doctor will review your medical history, perform a physical examination, and discuss your fertility goals. Expect to undergo several tests, including blood work and ultrasounds, to assess your ovarian reserve and overall reproductive health. This usually has an out of pocket cost, depending on your insurance coverage and treatment center. We paid about $500 for this appointment.
Personalized Treatment Plan
Based on the results of your tests, your doctor will develop a personalized treatment plan tailored to your specific needs. This plan will outline the medications, procedures, and timeline for your IVF cycle. Your doctor will likely discuss your IVF chances of success, how many embryos they recommend you transfer, and any genetic testing that may need to be done on the embryos before the transfer, if any.
Financial Planning
IVF can be expensive, so it’s essential to discuss the cost with your clinic and explore your insurance coverage and financing options. Some clinics offer payment plans or financial assistance programs. Most insurance plans do not pay for IVF. For our first round, we had zero fertility coverage and it cost us roughly $17,000 dollars out of pocket. There are some organizations and even churches who will assist with the cost of IVF, so be sure to look at all your options if you do not have insurance coverage for IVF treatments.
Step 2: Ovarian Stimulation
Medications
Ovarian stimulation involves taking fertility medications to stimulate your ovaries to produce multiple eggs. These medications typically include injectable hormones such as follicle-stimulating hormone (FSH) and luteinizing hormone (LH). I had to special order mine from an online pharmacy and have them shipped to my home. Your clinic will walk you through this process and help you figure out where and how to get your injectables.
Depending on your treatment plan, you will have to take some sort of medication daily for about 2 weeks (some you will continue to take the entire cycle month and even longer if you become pregnant). I highly recommend using a pocket chart like this one to organize your medications and supplies. I used stickers to number mine from 1-31 for every day of the month (we did IVF in July). Then, I placed alcohol wipes and packaged syringes in each one (1 for every shot I had to take that day).
For encouragement, I also place a small piece of Dove Chocolate or an Andes Mint in each pocket for every day, even if I didn’t have to take a shot or a medication that day. If I had to take multiple shots, that meant multiple pieces of chocolate. It was a fun way to encourage myself and keep going on the harder days.
Monitoring
During this phase, you will have frequent visits to your IVF clinic for blood tests and ultrasounds to monitor the growth and development of your follicles. This monitoring ensures that your ovaries are responding appropriately to the medications. I had an ultrasound and blood draw every few days leading up to the egg retrieval to ensure I had growing follicles and that I was responding to the medications.
Potential Side Effects
Some common side effects of ovarian stimulation medications include bloating, mood swings, and mild abdominal discomfort. Your doctor will closely monitor you to manage any adverse reactions. Be sure to ask your doctor about any symptoms or side effects you are feeling. Ovarian Hyperstimulation Syndrome (OHSS) is a serious side effect that could happen so your doctor needs to know if something doesn’t feel right. I was fortunate that I did not experience this, and just felt a little bloated and uncomfortable during this time.
Step 3: Egg Retrieval
Trigger Shot
When your follicles have reached the optimal size, you will receive a “trigger shot” of human chorionic gonadotropin (hCG) to induce final maturation of the eggs. This shot is typically administered 36 hours before the egg retrieval procedure. My doctor gave us a very specific day and time to administer this shot after our last ultrasound and blood draw appointment before the retrieval. It’s important that you do this shot at the exact time your doctor tells you, otherwise you may ovulate before your retrieval and the cycle will have to be cancelled. I had to take my shot a little after midnight so my husband and I set alarms and woke up to make sure I did the shot at the right time.
Egg Retrieval Procedure
Egg retrieval is a minor surgical procedure performed under sedation in most cases. Using a transvaginal ultrasound-guided needle, the doctor will retrieve the mature eggs from your ovaries. The procedure usually takes about 20-30 minutes, and you can expect some mild cramping and spotting afterward.
This part made me really nervous but it was actually pretty easy. I was asleep the entire time and when I woke up, my doctor told me how many eggs were retrieved and able to be fertilized. I went home and rested after and didn’t really have any symptoms other than a little cramping.
Step 4: Fertilization and Embryo Development
Fertilization Process
After retrieval, the eggs are fertilized with your partner’s sperm or donor sperm in the laboratory, depending on your specific fertility treatment plan. This can be done through conventional insemination or intracytoplasmic sperm injection (ICSI), where a single sperm is injected directly into the egg.
Embryo Culture
Your fertilized eggs, known as embryos, will be cultured in the lab for 3-5 days. The embryologists will monitor their development and select the healthiest embryos for transfer. My embryologist called and gave us updates on their development, told us how many made it through day 1, how many continued to develop at the right rate, etc.
Preimplantation Genetic Testing (Optional)
If recommended by your doctor, preimplantation genetic testing (PGT) can be performed to screen the embryos for genetic abnormalities. This can help improve the chances of a successful pregnancy, especially if you have genetic factors that resulted in you needing to do IVF. We did not have any genetic concerns, so we skipped this part. If you do genetic testing, it’s common to have to freeze all embryos and not continue with a fresh transfer that cycle. You will often wait until the following month once all embryos have been tested and you will do a Frozen Embryo Transfer instead. I have a post all about Frozen Embryo Transfers coming very soon!
Step 5: Embryo Transfer
Embryo Selection
Based on the quality and development of the embryos, the best one or two embryos will be selected for transfer. They use a grading system and will determine which embryos have developed the best and will give you the best chances for success. Your doctor will discuss the number of embryos to transfer to minimize the risk of multiple pregnancies while maximizing your chances of becoming pregnant. If you are under 30, most doctors won’t transfer more than 2 embryos at a time. However, your treatment plan will be unique to you.
Transfer Procedure
The embryo transfer is a simple and painless procedure that doesn’t require sedation. Using a thin catheter, the selected embryo(s) are placed into your uterus. The procedure takes only a few minutes, and you can resume normal activities shortly afterward. It’s kind of like a pap smear where they guide the embryos into your uterus and use ultrasound to confirm they are there. This is a really simple process and you leave the office PUPO: pregnant until proven otherwise!
Step 6: The Two-Week Wait
Post-Transfer Care
After the embryo transfer, you will be advised to rest and avoid strenuous activities. Your doctor may prescribe progesterone supplements to support the uterine lining and promote implantation. If you do become pregnant from this IVF cycle, you may be advised to continue using progesterone through the end of your first trimester.
Waiting for the Results of Your First IVF Cycle
The two-week wait (TWW) can be emotionally challenging. It’s the period between the embryo transfer and the pregnancy test. Try to plan some fun activities during this two-week wait to keep you busy so you aren’t sitting around overanalyzing every symptom and twinge. Plan a dinner date with your spouse or friends, have a few good books on hand to get lost in, maybe even have a vacation or weekend getaway planned. Keeping yourself busy will help this time go by faster and before you know it, it will be time to take a pregnancy test.
Step 7: Pregnancy Test
Blood Test
Approximately 10-14 days after the embryo transfer, you will return to the clinic for a blood test to measure your levels of human chorionic gonadotropin (hCG), the pregnancy hormone. This test will confirm whether or not the cycle was successful.
Next Steps
- Positive Result: If the test is positive, congratulations! You will continue to receive monitoring and support from your clinic during the early weeks of pregnancy. I had an early ultrasound around 7 weeks and another ultrasound around 11 weeks before I was released to my primary OB.
- Negative Result: If the test is negative, you will likely feel a range of emotions. Your doctor will discuss the possible reasons and help you plan the next steps, which might include a frozen embryo transfer, another full IVF cycle, or exploring other fertility options.
What to Do After Your First IVF Cycle
Even if you did end up becoming pregnant after your first IVF cycle, that doesn’t mean everything you experienced with infertility goes away. You may have worries about loss, still feel emotional when you see others getting pregnant easily without medical interventions, and even struggle with guilt now that you are pregnant and others in your infertility circle are not.
If you did not become pregnant, you may feel angry that it didn’t work, scared to try the process again, or worried that you will never know what it’s like to be a mother. You may also feel peace along the way, hope that your time is still coming, and ready to keep trying.
Try to take it one day at a time and know that all feelings are valid on this journey. There is space for a range of emotions and it can always be both: joy and sadness, hope and fear, gratitude and grief.
Hopefully this post helped you understand step-by-step what is involved in the IVF process. Starting your first IVF cycle is a significant step toward achieving your dream of parenthood. By understanding each phase of the process, you can better prepare yourself both physically and emotionally. Remember, every IVF journey is unique, and your medical team is there to support you every step of the way. Stay hopeful and informed, and don’t hesitate to lean on your support network during this time.