An IVF (In Vitro Fertilization) cycle brings together several procedures over approximately four to six weeks — from stimulating the ovaries to producing multiple eggs, to retrieving those eggs, fertilising them in the laboratory, growing the resulting embryos, and placing the best embryo into the uterus. Each step is monitored and adjusted by Dr Bhavana Nallapu in real time based on your individual response.
Understanding exactly what happens at each stage removes the uncertainty that makes IVF feel overwhelming for many couples. This page walks through every step of the IVF procedure in plain terms — what happens, how long it takes, and what to expect at each point.
Who this is for — common clinical scenarios
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Scenario 1 — Blocked tubes after investigation
A 33-year-old with two blocked fallopian tubes confirmed on HSG. Natural conception and IUI are not possible with blocked tubes. IVF bypasses the tubes entirely — eggs are retrieved directly from the ovaries and the embryo is placed directly into the uterus, making tubal status irrelevant to the process.
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Scenario 2 — Low ovarian reserve at 36
A 36-year-old with AMH of 0.6 ng/mL and an antral follicle count of 4 — indicating diminished ovarian reserve. IVF with a tailored, gentle stimulation protocol gives the best chance of retrieving available eggs before further decline. Waiting another year significantly reduces the number of eggs available.
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Scenario 3 — Three failed IUI cycles
A 31-year-old with unexplained infertility who has completed three IUI cycles without success. The cumulative success rate of continued IUI falls sharply after three attempts. IVF offers a significantly higher per-cycle pregnancy rate and also provides diagnostic information about egg quality and fertilisation that IUI cannot.
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Scenario 4 — Severe male factor infertility
A couple where the male partner's semen analysis shows 2 million/mL sperm count with 5% motility. IUI is unlikely to succeed at these sperm parameters. IVF with ICSI — where a single sperm is injected into each egg — can achieve fertilisation even with very few motile sperm, providing a realistic path to pregnancy.
The IVF procedure — phase by phase
1
Pre-Cycle Preparation (2–4 weeks before)Baseline investigations: Day 2–3 blood tests (AMH, FSH, LH, oestradiol, thyroid), antral follicle count ultrasound, semen analysis, and uterine assessment. The stimulation protocol is planned based on these results. Supplements and pre-cycle medications may be started.
2
Ovarian Stimulation — Days 1–12Daily self-administered injections (gonadotropins) stimulate the ovaries to grow multiple follicles simultaneously. The dose starts conservatively and is adjusted at each monitoring visit. Monitoring scans and blood tests take place every 2–3 days to track follicle size and oestrogen levels.
3
GnRH Antagonist (if used) — Days 5–12A GnRH antagonist injection prevents premature ovulation during stimulation. It is added once the lead follicle reaches approximately 13–14mm. The timing prevents the cycle from being cancelled due to early ovulation.
4
Trigger Injection — Day 11–14When the lead follicles reach 18–20mm, a trigger injection (hCG or GnRH agonist) is given to complete egg maturation. Egg retrieval is scheduled precisely 34–36 hours after the trigger.
5
Egg Retrieval — Day 13–16A 20–30 minute procedure under light sedation (intravenous). A thin needle is guided by vaginal ultrasound into each follicle to aspirate the fluid and egg. No incisions. You are awake but comfortable — not in pain. Same-day discharge. Results (number of eggs retrieved) shared the same day.
6
Fertilisation — Day 0 (Retrieval Day)Retrieved eggs are examined for maturity. Mature eggs are fertilised using conventional IVF (placed with thousands of sperm in a dish) or ICSI (one sperm injected per egg). The choice depends on sperm quality and prior fertilisation history. Fertilisation is confirmed the following morning.
7
Embryo Culture — Days 1–5Fertilised eggs (embryos) are cultured in the embryology lab under controlled temperature, pH, and oxygen conditions. Dr Bhavana's team provides a daily update on embryo development. At Day 3, embryos are at the 6–8 cell stage. By Day 5, the best embryos reach blastocyst stage — the preferred stage for transfer.
8
Embryo Transfer — Day 3 or Day 5The best embryo is selected and transferred into the uterus through a thin catheter — no sedation required. The procedure takes 10–15 minutes. You leave the clinic shortly after. Remaining good-quality embryos are vitrified for future use.
9
Pregnancy Test — Day 14 After TransferA blood test (beta hCG) confirms whether the embryo has implanted. Dr Bhavana reviews the result with you and plans the next steps — whether that is antenatal care after a positive result, or a cycle review if the result is negative.
Pain, Risk & Safety
Is IVF painful overall?
The stimulation injections are self-administered under the skin — most patients describe them as a mild pinch. Monitoring scans are transvaginal ultrasounds — equivalent to a standard gynaecological scan. Egg retrieval is performed under sedation — patients are comfortable and do not remember discomfort during the procedure itself. Post-retrieval cramping settles within 1–2 days. Embryo transfer is no more uncomfortable than a cervical smear.
What is Ovarian Hyperstimulation Syndrome (OHSS)?
OHSS is the main risk of ovarian stimulation — the ovaries over-respond to injections, causing bloating, pelvic discomfort, and fluid accumulation. Mild OHSS is common and self-limiting. Severe OHSS (requiring hospitalisation) is uncommon. Dr Bhavana uses conservative stimulation protocols and close monitoring to minimise this risk. In high-risk patients, a freeze-all strategy avoids fresh transfer and further reduces the risk significantly.
Is IVF safe for the baby?
Over 10 million children have been born worldwide through IVF since 1978. Large studies show no significant increase in birth defect rates in IVF-conceived children compared to naturally conceived children. Any slightly elevated risks in older studies are largely attributed to parental factors, not IVF itself.
What are the other risks?
Multiple pregnancy (if more than one embryo transferred), egg retrieval infection (rare, preventable with antibiotics), ovarian torsion (very rare), and ectopic pregnancy in a small percentage of cases. All risks are discussed in the pre-cycle consent process. Dr Bhavana follows single embryo transfer guidelines to minimise multiple pregnancy risk.
Duration & Timelines
Pre-cycle investigations
Completed in one menstrual cycle before stimulation begins.
Stimulation phase
10–14 days of daily injections. 5–7 monitoring scans and blood tests.
Egg retrieval
20–30 minutes under sedation. Same-day discharge.
Embryo culture
3–5 days in the laboratory from retrieval to transfer.
Embryo transfer
10–15 minutes. No sedation. Outpatient.
Total cycle duration
4–6 weeks from first injection to pregnancy test.
Pregnancy test
14 days after embryo transfer — blood test.
Clinic visits per cycle
Approximately 7–10 visits total.
Myths & Misconceptions
Myth
"IVF babies are not as healthy as naturally conceived children."
Over 10 million IVF babies have been born worldwide. Long-term health tracking shows no significant difference in overall health outcomes between IVF-conceived and naturally conceived children. Development, intelligence, and fertility in adulthood are comparable.
✓ Fact: IVF has over 45 years of safety data. Children conceived via IVF develop normally.
Myth
"IVF always results in twins or triplets."
Multiple pregnancy rates have dropped significantly as single embryo transfer (SET) has become standard practice. Clinics following current guidelines routinely transfer one embryo and vitrify the rest — achieving good success rates while largely eliminating the risk of triplets and significantly reducing twin pregnancies.
✓ Fact: Single embryo transfer is now standard. Multiple pregnancy is not an inevitable outcome of IVF.
Myth
"IVF uses up all your eggs and causes early menopause."
Ovarian stimulation retrieves eggs from follicles that would have been lost in that natural cycle anyway — only one egg is normally selected by the body each month, and the rest disappear. Stimulation rescues those eggs before natural loss. It does not deplete your remaining ovarian reserve or bring forward menopause.
✓ Fact: IVF does not cause early menopause or reduce your remaining egg supply.
Myth
"You must rest completely for two weeks after embryo transfer."
Multiple well-designed clinical trials have found no benefit from prolonged bed rest after embryo transfer — and some evidence suggests it may be mildly harmful. Light normal activity — including office work, gentle walks, and household tasks — is safe and encouraged from the day after transfer.
✓ Fact: Normal daily activity after transfer is safe. Complete bed rest is not recommended.
Frequently Asked Questions
The injections are subcutaneous (under the skin) — a very thin, short needle into the abdomen or thigh. Dr Bhavana's team provides a full demonstration and written instructions before you begin. Most patients find the injections manageable within 1–2 days of starting. The needles are pre-filled pen devices — no mixing or drawing up of syringes for most protocols.
Yes. Most patients continue working throughout the stimulation phase and post-transfer. The monitoring visits are typically in the morning and take 60–90 minutes including wait times. You can plan these around work commitments in most cases. The only day that requires half a day off is the egg retrieval — sedation means you cannot drive and should rest for the remainder of that day.
Good-quality surplus embryos are vitrified (flash-frozen) and stored. These can be used in frozen embryo transfer (FET) cycles — which require only endometrial preparation, not a full stimulation cycle. FET cycles are significantly less physically demanding and less expensive than a full IVF cycle. Embryo storage duration and options are discussed and documented in your consent paperwork.
If the first cycle does not result in pregnancy but good-quality embryos were frozen, the next attempt is a frozen embryo transfer — not a full stimulation cycle. This is less invasive, less expensive, and the success rate per frozen embryo transfer is comparable to fresh transfer. If there are no frozen embryos, Dr Bhavana reviews what the cycle data shows before planning a second retrieval cycle — which may use a modified protocol based on your response the first time.
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Dr Bhavana will review your history and investigations, and map a personalised IVF plan from the first visit.