You’ve made the decision to seek the help of a fertility specialist – which is a huge step towards achieving your family-building goals.
At this point, you are likely eager to get the process started, leading you to wonder: how long does the IVF process REALLY take from start to finish? As Illume Fertility's Director of Nursing with many years of fertility nursing experience, I'm here to break it all down for you and - hopefully - make it a little less intimidating.
Before we dive in, let's talk about some actionable steps you can take right now to help prepare for fertility treatment! As any fertility patient will tell you, getting ready for treatment takes time - lots of communication, consultations, phone calls, and decisions happen well before you do your first injection.
The IVF cycle itself takes around four weeks, the length of a normal ovulation cycle.
Treatment begins only after initial fertility testing is completed. Fertility testing often includes assessing your ovarian reserve or egg quality, uterine cavity evaluation, and semen analysis.
What fertility testing do I need to complete before IVF?
In addition, we want to make sure you are at your healthiest before conceiving. This will involve a medical evaluation that looks at everything from your potential genetic carrier screening risks to mild or moderate elevations with your blood sugar.
Certain medical conditions may warrant lifestyle modifications that will optimize a future pregnancy and make it easier for you to conceive.
Why is the 90-Day Preconception Health Regimen Included in the IVF Timeline?
To put it simply: a healthy body has the best chance of success.
Even small changes to your nutrition and lifestyle in the months before IVF can aid in a successful IVF cycle and healthy pregnancy. For this reason, the ideal time to start incorporating a preconception checklist is three months before the start of an IVF cycle.
During this time, you should begin your physician-approved program, which will likely include taking prenatal vitamins, increasing your water intake, improving your sleep hygiene, and eating a balanced and nutritious diet. Limiting alcohol and caffeine, ceasing smoking, and incorporating low-impact exercise will also prepare your body for the rigor of fertility treatment and pregnancy.
Another important tip: now is an excellent time to identify your emotional support network as well as inquire about your insurance benefits. Your fertility doctor will also begin testing you for various risk factors.
Okay, so what's next?
30 days before your IVF cycle, your doctor will begin pre-treatment tests.
Common IVF pre-testing includes a comprehensive blood panel (including checking titers to see if you need immunization boosters and genetic carrier screening), a saline sonogram to ensure your uterine cavity is healthy before the embryo transfer, vaginal ultrasounds, screenings for infectious diseases, and male fertility testing.
Male fertility issues account for up to 40% of infertility problems. Testing male fertility includes a semen analysis, where the quantity and quality of sperm are evaluated. As sperm is produced every 64 days, the preconception checklist applies to the male partner as well. Sperm is evaluated for count, morphology, and motility.
Finally, the IVF cycle begins! It can take up to six weeks until a pregnancy blood test can detect a pregnancy.
Learn what to expect from a semen analysis:
What Are the Stages of IVF?
Once diagnostic testing is complete, the IVF cycle begins.
Stage 1: Oral Contraceptives - Birth Control
Although it may seem counterintuitive, IVF patients must take oral contraceptives for 10-14 days before starting fertility medications. When taken before ovarian stimulation, studies have shown that oral contraceptives can increase the number of eggs available for retrieval, ensure follicles grow as a cohesive group, and support ovarian health throughout IVF.
Stage 2: Fertility Medication - Stimulation
After completing a course of oral contraceptives, IVF patients begin injections of fertility medication for approximately 9-11 days. These fertility medications consist of naturally occurring hormones that help develop and mature your follicles (eggs are housed within the follicles).
The number of follicles and their size determine how many mature eggs will be available for retrieval. During this time, you should plan to be in your fertility program’s office approximately every other day for a vaginal ultrasound and monitoring via bloodwork.
Illume Fertility monitors the growth of the embryos in our own lab onsite. An embryologist cares for them and watches them divide and multiply for five days, at which point they transition from the "zygote" stage to the "blastocyst" stage.
Research supports that transferring embryos into the uterus at the blastocyst stage yields higher success rates than transferring them on day three (when they're still in the less mature "zygote" stage).
Stage 4: Embryo Transfer
After fertilization, the embryo will be transferred back to the uterus on day five. (Egg retrieval day is considered day zero.) The embryo transfer is also a one-day procedure that should take approximately 20 to 30 minutes.
You will be awake for this painless procedure, and you will not require any anesthesia. Following this is a waiting period to see if the embryo implants in the uterus, which typically takes 9-10 days depending on the maturity of the embryo at the time of transfer.
Studies show that having laser acupuncture before and after your embryo transfer can increase implantation rates by up to 15%! Find out more here.
We will help determine your level of coverage, out-of-pocket expenses, and review with you the specific details of your plan. Our goal is to help you understand your benefits before you start treatment.
Why Do I Have to Start IVF the Month Before My Egg Retrieval?
An IVF cycle corresponds with the length of a normal ovulation cycle, which is about a month long. Ovulation occurs when a mature egg is released from the ovary and pushed down the fallopian tube where it can be fertilized, or in the case of IVF, retrieved.
The goal of IVF is to prepare and stimulate the ovaries to produce many mature eggs for retrieval and ready your uterus for implantation. Ovarian preparation and stimulation occur at the start of and during the ovulation cycle.
How Long Does it Take for an Embryo to Implant After Transfer?
Depending on the maturity of the embryo, it can take between 1-5 days after the transfer.
But you won’t know if you are pregnant until taking a pregnancy blood test in the office about nine days after the transfer.
Learn what to expect on the day of your embryo transfer:
Sometimes the body doesn’t respond as expected to IVF medications and stimulation, which can delay or cancel your IVF cycle.
For example, there might be a delay or cancellation if a lower number of follicles develop in the ovaries than expected, meaning fewer eggs were produced.
Reason #2: Suboptimal Hormone Levels
Sometimes hormone levels are not ideal for continuing an IVF cycle, and delaying can lead to better odds of success. Although this can be emotionally difficult news to receive, every cycle is diagnostic as well as therapeutic. Your fertility doctor will gain knowledge throughout each cycle, increasing your chances of success for the next cycle.
Keep in mind: a poor hormonal response from this round of IVF does not mean you'll have the same fate should you decide to continue with IVF treatments. Sometimes, it just takes a little time to figure out the right protocol for your body.
Another reason the IVF cycle can take longer than expected is the decision to have the embryos undergo genetic testing before embryo transfer.
Preimplantation genetic testing for aneuploidy (PGT-A) is the newest iteration of this type of testing. PGT-A can offer the highest degree of certainty for a genetically healthy child, particularly when partners are known carriers or at higher risk for passing on genetic diseases. PGT-A testing might add 4-5 weeks to the process.
Whatever the cause for delay, Illume Fertility understands that fertility treatments can be challenging and upsetting. Should there be a delay or cancellation, your doctor and the rest of your team will review your case and make necessary adjustments - and will be with you every step of the way.
IVF and Your Experience
So you've had your consultation, your diagnostic testing, and you're about to start your IVF journey. This is a huge step, and you're doing whatever it takes to prepare your mind and body. Simply by reading this article, you've got a foundation of expectations. Remember: everyone's journey is unique and involves constant communication with your fertility team (and partner, should you have one).
You might also be wondering about things like: "Can I have sex during IVF?" or "Can I get my hair and nails done?" We answer all your lifestyle and IVF questions so you can lose the everyday worries and just focus on taking care of your body and your future.
We at Illume Fertility wish you all the luck in your family-building journey and hope these resources help you feel as prepared as possible for your IVF experience.