The IVF procedure takes 4 to 6 weeks from start to finish and involves five clear stages: initial consultation and fertility testing, ovarian stimulation with daily hormone injections for 10 to 12 days, egg retrieval under intravenous sedation, fertilisation and embryo development in the laboratory for 3 to 5 days, and finally embryo transfer to the uterus followed by a 10 to 14 day wait for the pregnancy test.
If you have been told that IVF is the next step in your journey, the unknown can feel more daunting than the procedure itself. Many couples arrive at their first appointment carrying months- sometimes years- of questions, anxiety, and quiet hope. This guide walks you through exactly what happens at each stage, day by day, so you know what to expect before you begin. For the bigger picture on IVF in India- including costs, success rates, and how to choose a clinic- read our complete guide to IVF treatment in India.
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The IVF (In-vitro Fertilization) procedure is an assisted reproductive technology in which eggs are retrieved from a woman's ovaries, fertilised with sperm in a specialised laboratory, and the resulting embryo is transferred back into the uterus to establish pregnancy. The complete procedure happens in five distinct stages over 4 to 6 weeks.
For couples beginning fertility treatment, knowing what happens at each stage of IVF is not just about clinical information- it is about regaining a sense of control during a process that can otherwise feel deeply uncertain. Patients who understand the timeline, the purpose of each injection, and the realistic expectations at every stage tend to experience lower anxiety, better adherence to medication schedules, and stronger emotional resilience through the two-week wait. The IVF procedure is the same across reputable clinics in India- what varies is the protocol your doctor chooses based on your individual diagnosis, the laboratory standards, and the support you receive at each stage.
The IVF procedure is sequenced precisely so that each stage builds on the previous one. Skipping ahead, mistiming an injection, or delaying a monitoring visit can compromise the entire cycle. Here is what happens at each stage.
The IVF procedure begins long before the first injection. Your first appointment with a fertility specialist is a 45 to 60-minute conversation covering your medical history, lifestyle, previous fertility attempts, and any underlying conditions affecting either partner.
Following the consultation, both partners undergo a baseline fertility evaluation. For the woman, this typically includes blood tests for hormones (AMH, FSH, LH, oestradiol, TSH, prolactin), a transvaginal ultrasound to assess the ovaries and uterus, and screening for infections. For the man, a semen analysis evaluates sperm count, motility, and morphology. Depending on findings, additional tests such as a hysterosalpingogram (HSG) to check fallopian tubes, or genetic screening, may be recommended.
This diagnostic phase usually takes 2 to 3 weeks. Once results are in, your fertility specialist reviews them with you, recommends the most suitable IVF protocol (long, short, antagonist, or mild stimulation), and walks you through the treatment calendar. For a detailed breakdown of what each stage costs, read our guide to IVF cost in India.
The active IVF cycle begins on Day 1 or Day 2 of your menstrual period. The goal of this stage is to encourage your ovaries to produce multiple mature eggs in a single cycle, rather than the single egg released during a natural cycle.
You will be given daily hormone injections- usually FSH (follicle-stimulating hormone), and sometimes LH- for 10 to 12 days. These are administered subcutaneously using a fine needle. Most patients learn to self-inject within a day or two; nurses at the clinic demonstrate the technique at your first injection appointment.
Alongside the daily injections, you will visit the clinic for monitoring every 2 to 3 days. Each monitoring visit involves a quick blood test to measure oestradiol levels and a transvaginal ultrasound to count and measure developing follicles. These visits typically take 30 to 45 minutes. Based on how your ovaries respond, your doctor adjusts the medication dose to optimise egg development without over-stimulation. Around Day 5 or 6, a second medication is added to prevent premature ovulation- either a GnRH antagonist or a GnRH agonist, depending on your protocol.
Once the follicles reach the right size (typically 18 to 20 mm), you will be given a final "trigger" injection of hCG or a GnRH agonist. This is timed precisely- usually in the evening- because egg retrieval will happen exactly 34 to 36 hours later.
Egg retrieval, also called oocyte pick-up or OPU, is a short surgical procedure performed under light sedation. It happens 34 to 36 hours after the trigger injection, at the precise window when the eggs are mature but before they are released naturally.
You will be asked to fast from midnight the night before. On the morning of the procedure, an anaesthetist administers intravenous sedation- you remain asleep and feel nothing throughout the procedure, but it is not full general anaesthesia, so recovery is quick. The fertility specialist uses a thin needle guided by transvaginal ultrasound to gently aspirate the follicular fluid from each mature follicle. The fluid is immediately handed to the embryologist, who identifies and isolates the eggs under a microscope. The entire procedure takes 20 to 30 minutes.
You wake up in the recovery area within 15 to 20 minutes. Most patients are discharged 2 to 3 hours later. Mild cramping, light spotting, and bloating are common for 24 to 48 hours afterwards. Most women take the day of retrieval off work, and most return to normal activities within 1 to 2 days. Your clinic will tell you exactly how many eggs were retrieved before you leave.
Within hours of retrieval, the embryology team prepares both the eggs and the sperm sample for fertilisation. There are two methods, and your doctor will have decided which is appropriate based on the semen analysis. Conventional IVF is used when sperm parameters are normal- the embryologist places approximately 50,000 to 100,000 motile sperm with each mature egg in a culture dish, allowing fertilisation to occur naturally. ICSI (Intracytoplasmic Sperm Injection) is used when sperm count, motility, or morphology is suboptimal- the embryologist selects a single healthy sperm under high magnification and injects it directly into each mature egg.
The day after fertilisation (Day 1), the embryologist checks for signs of successful fertilisation. Typically, 70 to 80 percent of mature eggs fertilise successfully. The fertilised eggs- now embryos- are placed in an incubator that mimics the conditions of the human body. By Day 3, healthy embryos have divided into 6 to 8 cells. By Day 5, the strongest reach the blastocyst stage- a complex structure of around 100 cells, with two distinct cell types: the inner cell mass (which becomes the baby) and the outer trophectoderm (which becomes the placenta).
Embryo transfer is a quick, painless procedure that does not require sedation. It happens either on Day 3 or Day 5 after egg retrieval (for a fresh transfer), or weeks to months later (for a frozen transfer).
On the day of transfer, you arrive at the clinic with a moderately full bladder, which lifts the uterus into a better position. The embryologist brings the selected embryo into the procedure room in a thin, flexible catheter. Your doctor passes the catheter gently through the cervix and into the uterus, guided by abdominal ultrasound, and the embryo is released at the optimal position. The whole procedure takes about 5 to 10 minutes, and most women describe it as similar to a Pap smear.
Fresh embryo transfer happens 3 or 5 days after egg retrieval, in the same cycle. Frozen embryo transfer (FET) involves freezing the embryos after fertilisation and transferring them in a later cycle. FET is increasingly common because it allows the body to recover from the intensity of ovarian stimulation, and is associated with comparable or improved success rates in many cases. For the next 10 to 14 days, you will continue progesterone supplementation to support the uterine lining and early implantation.
The success of an IVF cycle depends on multiple variables that influence each stage of the procedure:
If your situation matches any of the above, Cloudnine Fertility offers IVF treatment across multiple cities in India, with in-house embryology labs and dedicated fertility specialists.
Source: Cumulative data from the Society for Assisted Reproductive Technology (SART) and the European Society of Human Reproduction and Embryology (ESHRE), 2022 to 2024. Outcomes at Cloudnine Fertility may vary based on individual diagnosis and protocol.
These figures represent the live birth rate per fresh IVF cycle. Cumulative success rates across three cycles are significantly higher, which is why most fertility specialists recommend planning for the possibility of multiple cycles from the outset.
