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Fertility Treatment | IVF

In-Vitro Fertilization (IVF): Your Step-By-Step Guide from a Nurse

May 24th, 2022 | 13 min. read

In-Vitro Fertilization (IVF): Your Step-By-Step Guide from a Nurse

Kirsten Hennigan

Kirsten has been a nurse for 18 years. She earned her Bachelor of Science in Nutrition from Cornell University in 1999 and went on to earn both her Bachelor and Master of Science in Nursing from the University of Pennsylvania in 2002. Her entire nursing career has been in women’s health, first as a nurse practitioner in general gynecology in Philadelphia. She moved to London in 2006 and worked as a fertility nurse on Harley Street. After a move to Tokyo and a short stint as a nurse practitioner in Manhattan, she landed at Illume Fertility in 2014. Kirsten’s favorite part of working at Illume is helping patients gain trust in us and watching their transition from feeling broken to feeling empowered with options. She feels very privileged to play a part in that transition. The most shocking fact about Kirsten is that she doesn’t watch television. She hears all about different shows during morning monitoring but has never seen a single episode!

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We recognize how stressful it can be to A) need fertility treatment to conceive, and B) have to undergo an IVF cycle. While we can’t take the stress away completely, we can give you the tools and information that you need to tackle this journey with a clear head, a sound plan, and the comfort of knowing you have a supportive team rooting for you.

Read on for an overview of what to expect in a typical IVF cycle (think of this as a “zoomed out” picture of the IVF process). Rest assured, your doctor, nurse and patient navigator will help you “zoom in” with specific guidance for your situation before you get started.

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A quick note: This IVF breakdown is specific to Illume Fertility's protocols and procedures. If you are undergoing treatment at a different clinic, your steps may vary slightly. However, they will typically follow this same general timeline and plan.

At Illume Fertility, we equip you with a full team of people to personally help you throughout your entire journey. This includes your doctor, nurse, patient navigator and an insurance and billing advocate. I will reference these members throughout the process, as they are relevant during your IVF journey.

The best thing about having a team? You will never be alone for any of this and will always have a close-knit team in your corner, cheering you on.

What is the IVF process like?

You probably already have some idea of what IVF treatment involves. However, let's break it down, step by step, so you can feel more educated and empowered about the journey ahead of you!

1. The Diagnostic Cycle

At a glance:

  • Purpose: To determine your specific fertility diagnosis
  • What to expect: 2-3 office visits
  • Time: 4-6 weeks

The first step is for us to get to know your fertility story. This is called a “diagnostic cycle.”  You will be asked to come in 2-3 different times during your menstrual cycle for various blood tests, ultrasounds, and studies. We are assessing how strong and well-functioning your ovaries and reproductive organs are and confirming that you are healthy and fit for pregnancy. Depending on where you are in your menstrual cycle, it can take 4-6 weeks to complete this step.

FYI: You’re not alone in this process! If you have a male partner, we will ask that he come in for a semen analysis and bloodwork as well.

While gathering diagnostic information, we may find something that we want to address before proceeding. For example, you may have a thyroid level that is not ideal for pregnancy or a blood sugar level that is concerning. Often, these are minor things that can be fine-tuned quickly. Other times, we may recommend that you delay trying to get pregnant until your health concerns are addressed.

At this point, you might be thinking that this first step is a lot. A lot of testing, a lot of waiting, a lot of visits…and it is. I understand the frustration. But here's some good news: the more prep work we do prior to starting IVF, the higher your chances of success.

You might also be thinking that this all these appointments are going to require a lot of time management. Once again, you’re right! But please don’t worry. 

Your Dedicated Fertility Support System

At Illume Fertility, we have a unique way of supporting you: your comprehensive Care Team! This team not only includes your doctor, but a whole slew of individuals devoted to your success.

The team also includes a patient navigator who will assist you in the management of your journey, making sure you check off every box along the way. They will be your “go-to” person. They will help you schedule appointments, remember important tasks and dates, and field your questions when you don’t know who to reach out to.

They are available to support you by phone or email, and you will likely be chatting with them often.


Learn more about how we support you:

Meet Your Care Team


2. The Follow-Up Consultation

At a glance:

  • Purpose: To determine your specific cycle protocol
  • What to expect: 1 virtual consultation via Zoom
  • Time: 1 hour

Once you have completed your diagnostic cycle and we have all of the necessary info, your doctor will sit down with you for a follow-up consultation. Together, you will decide if IVF is right for you, and if it is, she/he will customize a protocol to your needs.

This is a unique, carefully thought out “recipe” (medications, bloodwork and ultrasounds) that is very specific to YOU. You will follow your IVF protocol for several weeks, and we will carefully monitor you along the way.

3. Get Organized for Your IVF Cycle

At a glance:

  • Purpose: To enter IVF confidently with the necessary tools, expectations and skills.
  • What to expect: Paperwork, numerous phone calls and/or emails and video modules. The good news? You can do it all from your couch.
  • Time: Well, it depends. But it typically takes days or weeks to regulate your natural hormones, sign all your consent forms, get insurance approval (if using insurance to pay for treatment), and watch all of your video modules.

After your follow-up consultation, your Care Team will help you get organized for your  treatment cycle. In order to proceed with IVF, you will need to:

  • Be financially cleared by your Insurance & Billing Advocate
  • Complete and sign all consent forms
  • Learn how to mix and administer your injections
  • Have all the medications necessary to start

At Illume Fertility, your nurse will email you a series of online modules to watch. These are mandatory videos that will teach you everything you need to know about IVF at our practice. These videos cover it all – what to expect during treatment, how your body will respond, how to mix your medication, how to correctly give yourself your shots, and what to do should you have an emergency or need assistance when the office is closed.

These videos can be watched at your own pace, and in the comfort of your own home. You may find it helpful to have a friend or partner watch them with you, and if you want, you can watch them multiple times. 

Once you have watched each of these videos, you will be prompted to complete your consents. We utilize an electronic signing program which allows you (and any partner involved) the ability to sign consents electronically and submit.

Note: You will NOT be allowed to start treatment without signing those consents. We encourage you to complete ALL of these forms as soon as they are received to avoid delays.

Wait, what about insurance?

While you are watching your modules and completing your consents, your Insurance & Billing Advocate will be hard at work. They have the tricky task of getting insurance companies to approve treatments and medications. They work very closely with you so that you understand what you will have to pay along the way, with no unexpected surprises.

Once they are confident that both you and your insurance company are on board, they will give your nurse the “green light” to order your medications. Medications for IVF are ordered through specialty pharmacies – you can’t just pick them up at your local CVS or Walgreens, unfortunately. If your insurance company is paying for your meds, they will tell us which pharmacy to use.


What if I don't have fertility coverage?

How to Pay for IVF Without Insurance


Meanwhile, your nurse will coach you on how and when to start medication that will appropriately “prep” you for a treatment cycle. Our first goal is to make sure that your naturally occurring hormones don’t interfere with the IVF medications.

To achieve this, we will ask that you start birth control pills (during a menstrual period) or estrogen pills (before a period). Your nurse will instruct you on the appropriate way to do this.

So, to recap the "Get Organized" phase, once you have...

  • Been financially cleared
  • Watched your online video modules
  • Signed all treatment consent forms
  • Received medications from the specialty pharmacy
  • Been appropriately prepped with birth control pills or estrogen pills

YOU ARE READY TO GO! 

4. IVF Begins: Follicle Growth Phase

At a glance:

  • Purpose: To successfully administer meds and produce as many eggs as possible
  • What to expect: Daily injections, repeat bloodwork and ultrasounds about every other morning
  • Time: 10-12 days

So much build up, all for this!

Your nurse will give you your personal IVF calendar or IVF “protocol” to follow. It will tell you every single thing you need to do each day. It starts with when to come in for your first blood test and ultrasound. At this visit, we are ensuring that everything is “quiet” in your reproductive system (in fact, you may hear us call this visit a “suppression” or “baseline” check).

Related: In-Vitro Fertilization (IVF) Side Effects at Each Stage

We want to make sure that the lining of your uterus is thin, that your hormone levels are appropriately low, and that there aren’t any sneaky follicles or cysts growing on your ovaries. If all looks good, we will instruct you to start your injections. If something is going on that we were not hoping for, then you will be given an updated plan. 

Did you know? Most women need IVF injections for 10-12 days. The exact amount of time varies from person to person, so don’t be alarmed if you need a little less (or more) time. It’s not a race! Your ovaries will tell us when they are ready.

During the time that you are giving yourself shots (or your partner steps in to administer the injections), we will instruct you to come in for blood tests and scans regularly - typically every other day. As the follicles on your ovaries grow, we count and measure each one of them.

Count and measure, count and measure, count and measure, until TA DA! Your ovaries have their final say, and you are ready for your egg retrieval.

5. IVF Continues: Egg Retrieval

At a glance:

  • Purpose: To retrieve as many mature eggs as possible
  • What to expect: Quick procedure under anesthesia, egg count will be known almost immediately afterward
  • Time: 2-3 hours

On retrieval day, you should expect to be in our Norwalk office for 2-3 hours. You will have anesthesia through an IV that will help you sleep comfortably. The procedure typically only takes 15 minutes. Once you wake up, we will monitor you for an additional hour.

Before you go home, we will be able to tell you how many eggs were collected. You’ll be instructed to go home and rest. You may still feel crampy, bloated or tired. Tylenol is usually sufficient for any discomfort you may experience. However, if you have any concerns, always talk to your nurse or doctor!


Wondering how you'll feel after this this procedure?

Common Egg Retrieval Side Effects


6. IVF Continues: Embryo Development

At a glance:

  • Purpose: Create, foster, and monitor embryos
  • What to expect: You will receive multiple updates as fertilization and growth occurs
  • Time: 5-7 days

The day after your retrieval, a nurse will call to check in with you. She’ll make sure you’re feeling okay, and she will tell you how many of your eggs were successfully fertilized.

From there, you will get regular updates from us until we know how many of your embryos reach the blastocyst stage – which is the stage needed to achieve a pregnancy. At this point, we can either administer a fresh transfer or freeze for a future transfer.

7. IVF Concludes: The Embryo Transfer

At a glance:

  • Purpose: To transfer a healthy embryo into the uterus for implantation
  • What to expect: Simple office procedure, you’ll be awake and able to view the entire process
  • Time: 2-3 hours total

If your plan is to transfer a fresh blastocyst, it will occur immediately after the embryo development phase. If your plan is to do chromosomal testing, then we will freeze your blastocysts for future use. You might have to take more medication, including a progesterone in oil injection.

Related: 6 Things Everyone Wonders About Embryo Transfer

The actual procedure itself is painless and easy – a catheter is inserted through the cervix where the embryo will eventually be deposited through. It will rest in the uterus in the perfect spot, ready for implantation.

On the day of the transfer, we recommend laser acupuncture before and after the transfer as it has been shown to increase implantation success rates.


Get a behind-the-scenes look at the big day!

Embryo Transfer Day: Patient's Perspective


8. The Pregnancy Test

At a glance:

  • Purpose: To determine if you’re pregnant or not
  • What to expect: Occurs 8-10 days after a transfer, bloodwork and a phone call later in the day
  • Time: 1 day

You will come into the office 8-10 days post-transfer for simple bloodwork. Your nurse will call you as soon as results are received to relay that information to you.

Related: How to Cope with the Two Week Wait: FAQs, Symptoms & More

Fertility treatment isn’t a perfect science. Unfortunately, sometimes we have to give you disappointing news along the way - your ovaries didn't respond to medications the way we had hoped, the number of eggs that we get in the operating room may be less than we expected, or your fertilized eggs may not grow to normal blastocysts.

If this happens, we realize you may feel sad, disheartened, frustrated, or maybe even angry.

The good news? This news rarely sneaks up on us, and we will be communicating any concerns along the way. We also have a great team of wellness providers who are available to help you if you feel overwhelmed or need help making decisions moving forward.

The Bottom Line About IVF

Yes, IVF treatment can be intense, complicated, and prolonged. But it can also be empowering. Many people feel excited about being proactive and moving forward.

We also know that a lot of responsibility falls on our patients throughout this process, and it can feel overwhelming. We know that you will be rearranging your schedule like an executive assistant, mixing medications like a chemist and administering injections like a nurse.

But take a nice, deep breath! We will give you all the tools, skills, and support you need, and you will conquer it with confidence. We are your ultimate fans, and we will root for you as you tackle this journey. Good luck!

More IVF Resources

Want to learn more about IVF and what to expect from the fertility treatment process? We've got you covered. Explore the following articles, videos and other resources to get empowered for the road ahead.