How many visits, how many injections, what hurts, and when you find out. The whole sequence from workup to pregnancy test, with realistic timings.
Most of the anxiety around IVF comes from not knowing what the next six weeks will actually involve. How many visits. How many injections. What hurts. How long you will be off work. When you find out.
Here is the whole sequence, in order, with realistic timings. Details differ between protocols and between patients, but the shape is the same.
Before the cycle: assessment
Roughly one menstrual cycle. This is not part of the IVF cycle, and it is the part most worth doing properly.
- Consultation and history for both partners
- AMH and antral follicle count on ultrasound — how your ovaries are likely to respond
- Thyroid function and prolactin
- Assessment of the uterine cavity — ultrasound, and a saline sonogram or hysteroscopy where indicated
- Semen analysis, repeated if abnormal
- Screening bloods for both partners, as required under the ART Act
- Counselling and written consent; a written, itemised cost estimate
If this finds a polyp, a fibroid distorting the cavity, a hydrosalpinx or an untreated thyroid problem, that is corrected first. It delays you by weeks. Not correcting it can cost you the cycle.
Step 1: Ovarian stimulation
Around 9 to 12 days. Four to six visits.
Normally one egg matures each month. The purpose of stimulation is to bring a group of follicles to maturity together, so several eggs can be collected in one procedure.
Daily injections of gonadotrophin start in the early part of the cycle. These are small subcutaneous injections into the abdominal wall or thigh, using fine needles — most patients or their partners give them at home after being taught. A second drug is added part-way through to prevent the eggs being released early.
Progress is monitored by transvaginal ultrasound, usually every two to three days, measuring how many follicles are growing and how fast, sometimes with blood oestradiol. The dose is adjusted on those findings.
What it feels like. Bloating and a sense of pelvic fullness as the ovaries enlarge, sometimes mood changes and breast tenderness. Most women continue working. Sharp pain, rapid weight gain or breathlessness should be reported the same day — these can indicate hyperstimulation.
Step 2: The trigger injection
One injection, at a precisely specified time.
When the follicles reach the right size, a trigger injection completes final maturation of the eggs. Retrieval is scheduled about 34 to 36 hours later, and the timing is exact — a trigger given late by two hours can compromise the collection. You will be given the time in writing.
Step 3: Egg retrieval
About 20 to 30 minutes. Day-care admission of a few hours.
Under short general anaesthesia or sedation, a fine needle is passed through the vaginal wall under ultrasound guidance into each ovary, and the fluid from each follicle is aspirated and passed to the embryologist. There is no incision.
You wake in recovery and go home the same day. Cramping like period pain and light spotting are usual for a day or two. Most patients take the next day off and return to normal activity after that.
The number of eggs collected is known immediately. Not every follicle contains an egg, and not every egg is mature — this is normal and is explained to you before you leave.
Step 4: The laboratory
Days 0 to 5, with a daily update.
On the same day, the sperm sample is prepared and the eggs are fertilised — either by conventional IVF, where prepared sperm is placed with each egg, or by ICSI, where a single sperm is injected into each mature egg. ICSI is used for male factor infertility or previous fertilisation failure, not routinely.
| Day | What happens |
|---|---|
| Day 1 | Fertilisation checked. Not every egg fertilises normally. |
| Day 2–3 | Embryos divide to the 4- to 8-cell stage. Some stop developing; this is normal and is a form of natural selection. |
| Day 5–6 | Surviving embryos may reach blastocyst stage, which allows better selection for transfer. |
These days are hard, because there is nothing for you to do. Expect the numbers to fall at each stage — ten eggs does not mean ten embryos, and that is not a sign that something has gone wrong.
Step 5: Embryo transfer
About 10 to 15 minutes. No anaesthesia usually needed.
A fine soft catheter is passed through the cervix under ultrasound guidance and the embryo is placed in the uterine cavity. Most women describe it as comparable to a cervical smear. You rest briefly and go home; prolonged bed rest afterwards has not been shown to improve outcomes and is no longer advised.
How many embryos are transferred is a decision made with you, weighing the chance of pregnancy against the risks of a twin pregnancy, which are real and are borne by mother and babies.
Frozen transfer. In some cycles all embryos are frozen and transferred in a later, unstimulated cycle — where there is a risk of hyperstimulation, where progesterone rose before the trigger, or where the endometrium was not optimal. This is a deliberate decision to improve your odds, not a setback.
Step 6: The two-week wait
About 10 to 14 days.
Progesterone support is given as pessaries or injections. Normal activity is fine; heavy lifting and vigorous exercise are not advised.
A blood beta-hCG at the appointed time gives the result. Home urine tests taken earlier are a common source of false hope and false despair, because the trigger injection can still be detectable — waiting for the blood test is genuinely better.
If positive, an ultrasound at around six to seven weeks confirms the pregnancy and its location. If negative, medication stops and a period follows within a few days. A review appointment should be offered either way.
The timeline at a glance
| Stage | Duration | Visits |
|---|---|---|
| Workup | About one cycle | 2–3 |
| Stimulation | 9–12 days | 4–6 |
| Trigger to retrieval | 34–36 hours | 1 (day care) |
| Laboratory | 3–6 days | None |
| Transfer | 15 minutes | 1 |
| Two-week wait | 10–14 days | 1 (blood test) |
From the first stimulation injection to the pregnancy test is roughly four to five weeks. Including the workup, plan for about two months.
PC&PNDT notice. Prenatal sex determination is not done at this hospital and is prohibited by law under the Pre-conception and Pre-natal Diagnostic Techniques Act, 1994. All ultrasound examinations here are performed for medical indications only.
Considering IVF, or unsure whether you need it?
Cosmic Women’s Hospital & IVF Center is a Level 2 ART clinic in Naroda, Ahmedabad, registered under the ART (Regulation) Act, 2021. Consultations are by appointment, and you will be given a written, itemised estimate before any treatment begins.
77-9383-9383
3rd Floor, The Capital Corporate, Nr. Naroda Muktidham, Naroda, Ahmedabad 382330 · Book an appointment
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Cosmic Women's Hospital
Cosmic Women’s Hospital & IVF Center is a registered Level 2 ART clinic in Naroda, Ahmedabad — obstetrics, gynaecological surgery, IVF and ICSI, with ultrasound in-house and 24-hour emergency obstetric cover. Articles here are written by the clinical team and medically reviewed by Dr. Rahul Khatri or Dr. Bhargavi Khatri before publication.
