Steps in Fertility IVF Process

After you have finished all of your screening, your doctor will develop an individualized treatment plan. Since each patient is different, each treatment plan may vary.

Your IVF care coordinator will guide you through the process and explain each important step, procedure and medication.

Initiation of oral contraceptive pills

Some patients will receive oral contraceptives at the start of their IVF cycle. The possible benefits include:

  • Shortened use of ovarian suppressive drugs.
  • Decreased chance of developing ovarian cysts prior to starting gonadotropins.
  • Improved ovarian response during ovarian stimulation resulting in better egg recovery.

It is important to suppress your ovaries before starting stimulation medications. This helps optimize the chances of uniform follicle growth.

Baseline ultrasound

Before we start medication to stimulate the ovaries, we will perform a transvaginal ultrasound scan to examine your ovaries. We do this procedure to ensure your ovaries are not producing eggs at the moment (are suppressed). We also measure your serum estradiol level.  In some cases, women may develop cysts. If your baseline ultrasound is normal, you will begin stimulatory medication.

Ovarian stimulation

You will use injectable fertility medicines to encourage the growth of multiple follicles. Your specific stimulatory medication depends on your individual protocol (procedure). 


Along with your stimulatory injections, we will monitor you in the clinic using ultrasounds and hormone measurements. You may need to visit the clinic frequently for monitoring.  We usually see patients  every one to three days depending on follicle growth and estradiol level. Sometimes, your doctor may increase or decrease the dose of medication. Your IVF nurse will be in contact with you during this time.

Final maturation HCG

Oocyte retrieval

For most patients, 35 hours after taking your HCG injection, you will undergo an oocyte retrieval procedure. This involves removing eggs from your ovaries. During the retrieval, you will receive an IV-anesthetic and be under "conscious sedation." You must not eat or drink anything after midnight the night before this procedure.

You will be able to return home after a brief recovery from your procedure. You must have someone else drive you home.


If fertilization is planned, at this point, eggs are fertilized with sperm.

Embryo transfer

Your doctor will decide on the optimal timing for embryo transfer. Some patients have a fresh transfer the same cycle as their IVF cycle, whereas others will freeze embryos to transfer at a later time.