IVF Timeline: What Happens, Week by Week

For couples who are having trouble conceiving, IVF provides a straightforward and evidence-supported way to become parents —- one that has already helped millions of families all over the world. If you know exactly what happens at each stage and when it happens, you can eliminate much of the uncertainty that makes the process feel overwhelming. A typical IVF cycle lasts about 6 to 8 weeks, from the time of your first appointment until you receive your pregnancy test result. This guide walks you through each step, week by week, so you will know what to expect before each stage.

The IVF Timeline at a Glance

Before You Start: Assessment and Prep (2 to 4 Weeks)

Before starting any treatment, your clinical team prepares a full overview of both partners. They take your medical history, including information about any previous pregnancies, existing conditions, the medications you are taking and your lifestyle before carrying out a physical examination. The female partner is assessed for ovarian reserve, hormonal balance, uterine structure, and fallopian tube function. At the same time, the male partner is examined too, since a semen analysis is always carried out at this stage, as male factors are responsible for about half of all cases of infertility, and it is necessary to understand both partners before a treatment plan is developed.

Once the team clearly understands the situation, it carries out specific investigations. A blood test for hormones, including AMH, FSH, LH, oestradiol, TSH, and prolactin, provides your medical team with an accurate picture of your ovarian reserve and hormonal conditions. A transvaginal ultrasound is performed to count your antral follicles and to examine the uterus. Both partners have their infectious diseases screened. Results are generally available within a few days, and your treatment plan is then tailored to you.

Stage 1: Down-Regulation or Antagonist Start

Before your ovaries can be stimulated, your natural cycle needs to be managed. If your body follows its usual rhythm, you might ovulate before your clinical team is ready. The first step is to either suppress your cycle or block ovulation at the right time, depending on which protocol suitsis best for you best.

Day range

If you use a GnRH agonist long protocol, you will start about 2 to 3 weeks before stimulation. This approach suppresses your natural cycle, allowing your clinical team to control the timing. The GnRH antagonist protocol, now preferred for most people and especially recommended if you have PCOS or high AMH, starts on day 1 or 2 of your period. It runs alongside stimulation, prevents early ovulation, and usually shortens the process.

What you do daily

During this phase, you will take daily injections or use a nasal spray. Your clinical team will schedule monitoring appointments to check that your body is responding as expected before stimulation begins. You might notice temporary symptoms like headaches, hot flushes, or mood changes. These usually settle once stimulation starts.

Stage 2: Ovarian Stimulation (8 to 14 Days)

This is the phase you probably think of when you hear about IVF. It can be physically demanding. Here, the goal is to stimulate your ovaries, so you develop several follicles at once. This gives your embryology team more eggs to work with than you would produce in a natural cycle.

Injections

You will give yourself daily subcutaneous injections of FSH, sometimes with LH, at home. Most people find this routine manageable after a few days. Your dose is personalised for you, based on your AMH, weight, and antral follicle count. Your team will adjust the dose as needed, depending on how your ovaries respond.

Monitoring scans

Every 2 to 3 days, you will visit the clinic for a transvaginal ultrasound and a blood test. Your team will measure the size and number of your follicles, usually aiming for several to reach 18 to 20mm. They will also check your oestradiol levels to make sure your response is on track. If needed, they will adjust your dose.

How you may feel

You may notice bloating, abdominal fullness, breast tenderness, or mood changes as your follicles grow. These are normal responses to stimulation and do not mean something is wrong. If you have rapid abdominal swelling, severe pain, or trouble breathing, contact your clinic straight away.

Stage 3: Trigger Shot and Timing (36 Hours) 

Once your follicles reach the right size, your clinic will let you know when to give yourself the trigger injection. This is usually in the evening. The trigger helps your eggs mature fully. You will need to take it exactly 34 to 36 hours before your egg retrieval.

Most people use hCG as the standard trigger. If you have a higher risk of OHSS, especially if you have PCOS or high AMH, your clinic may recommend a GnRH agonist trigger instead. This option, along with freezing all your eggs, can lower your risk of severe OHSS without affecting your chances of pregnancy. Your clinic will help you choose the best trigger based on how you respond during stimulation.

Stage 4: Egg Retrieval (Day 0)

The Procedure

You will have egg retrieval under light sedation, so you will not feel anything during the procedure. Using ultrasound guidance, your doctor will pass a thin needle through your vaginal wall into each follicle to collect the fluid that contains your eggs. The whole process usually takes 20 to 30 minutes. Before you leave recovery, your embryologist will check the fluid and let you know how many eggs were retrieved.

Recovery

You may have mild cramping, spotting, or bloating for 24 to 48 hours after retrieval. Most people feel ready to return to light activity within a day. Avoid strenuous exercise and heavy lifting until your next period. If you notice rapid weight gain, severe abdominal pain, or trouble breathing, contact your clinic straight away. These can be early signs of OHSS and need prompt attention.

Stage 5: Fertilisation and the Lab (Days 1 to 5)

In conventional IVF, your eggs are mixed with prepared sperm in a dish, allowing fertilisation to happen naturally. With ICSI, which stands for intracytoplasmic sperm injection, an embryologist selects a single sperm and injects it directly into each mature egg. ICSI is used as part of IVF, not as a separate treatment. You may be offered ICSI if there are concerns about sperm quality or quantity, if previous IVF cycles have had low fertilisation rates, or if you are using frozen eggs.

Day 1 to 5 Embryo Development

You will usually find out if fertilisation has happened the morning after your egg retrieval, about 16 to 18 hours after insemination. Your embryos are then grown in carefully controlled conditions for up to 5 days, until they reach the blastocyst stage. Each day, embryologists check your embryos for important features like cell number, symmetry, and development. Only embryos that reach the blastocyst stage are chosen for transfer or freezing.

Stage 6: Embryo Transfer

“Day 3 or Day 5: How the Decision Is Made” 

On day 3, a healthy embryo will have 6 to 8 cells. In certain cases, such as when only a small number of embryos are developing or when extended culture poses a risk, your embryologist might suggest transferring at this stage. 

Nevertheless, most contemporary clinics aim to reach day 5, the blastocyst stage. At this stage, only the most robust embryos have carried on developing, so your embryologist can get a much better idea of which one offers you the best chances since blastocyst transfer is linked with higher implantation rates. In most situations, your embryologist and doctor decide together, based on how your embryos are developing.

Fresh vs Frozen

In a fresh transfer, your embryo is placed in your uterus during the same cycle as your egg retrieval. This usually happens on day 3 or day 5 after fertilisation. With a frozen embryo transfer (FET), you freeze your embryos first. You then transfer them in a later cycle, once your body is ready.

Why Many Clinics Now Freeze All

Many clinics now recommend freezing all embryos, especially if you have PCOS, high AMH, or a risk of OHSS. In a study of over 228,000 cycles, frozen embryo transfers led to a higher live birth rate: 48.3% compared to 39.8% for fresh transfers. Freezing gives your uterine lining time to recover from stimulation, which can help improve your chances of implantation.

The embryo transfer is quick and painless. A thin catheter carries your embryo through your cervix into your uterus, guided by ultrasound. The whole process takes about 10 to 15 minutes, and you do not need sedation.

Stage 7: The Two-Week Wait

You may have heard of the ‘two-week wait.’ This is the time between your embryo transfer and your pregnancy blood test. It usually lasts 9 to 14 days. The exact length depends on whether you had a fresh or frozen transfer, and whether your embryo was transferred on day 3 or day 5.

During this time, if your embryo implants, it attaches to your uterine lining and begins producing HCG. You will continue taking progesterone and oestrogen. Most symptoms you notice, like bloating, breast tenderness, or mild cramping, are usually caused by the progesterone medication, not by pregnancy itself. Try not to worry about symptoms. They don’t reliably tell you whether implantation has happened.

It is best to avoid home pregnancy tests during this time. They can give you a false positive from the trigger shot or a false negative if you test too early. Your clinic will perform a blood test at the right time to ensure an accurate result.

Stage 8: Pregnancy Test and What the Numbers Mean 

After IVF, your clinic will perform a blood test to confirm pregnancy. This test measures beta-hCG, a hormone your body produces when an embryo implants in your uterus.

• If your beta-hCG level is below 5 mIU/mL, the test is negative, indicating no sign of implantation.
• If your result is between 5 and 25 mIU/mL, this is called a grey zone. Your clinic will repeat the test in 48 to 72 hours to check if your hormone levels are increasing.
• If your beta-hCG level is above 25 mIU/mL, the result is positive. Your clinic will schedule another test in about 48 hours to see whether your levels are doubling. This is an important sign of a healthy early pregnancy.
• If your beta-hCG level is rising but not doubling, this may suggest an early pregnancy issue. Your clinic will monitor it closely and guide you through the next steps.

If your result is positive, you will usually have an ultrasound about two weeks later. This helps confirm that the embryo has implanted in your uterus and checks for a heartbeat, which is often visible around six weeks.

If the Cycle Fails: What Happens Next 

A failed cycle does not mean you will not succeed next time. Most people need more than one cycle to achieve pregnancy. After your first cycle, your chance of a live birth is about 33%. This rises to about 57% after three cycles and nearly 68% after six cycles.

If your cycle doesn’t work, your doctor will review what happened. They will check how your ovaries responded, the quality of your embryos, and how the transfer went. Then, they will adjust your plan for next time. You can usually start another cycle after your next natural period, which is often 4 to 6 weeks later. If you have had several failed cycles, your doctor may suggest more specific tests, such as sperm DNA fragmentation testing, ERA assessment, or PGT-A, before moving forward.

Success Rates: A Realistic Picture 

When you look at IVF success rates, focus on your chances over several cycles, not just one. For example, one study found that about 33% of women had a live birth after their first cycle. After three cycles, this rose to nearly 57%, and after six cycles, almost 68%. If you are under 35, your chances after six cycles may be around 70%.

These numbers are averages. Your own chances depend on factors like your AMH, embryo quality, the reason for infertility, and your clinical team. Your specialist will help you understand what these numbers mean for you.

Cost: A Brief Note 

You can expect a standard IVF cycle in Singapore to cost between SGD $10,000 and $25,000. Your choice between a public hospital and private clinic affects the price. Medications usually cost an extra SGD $1,500 to $6,000. This is a significant financial commitment, but you have support. If you are a Singapore Citizen and choose a public hospital, you may be eligible for government co-funding of up to 75% per cycle. You can also use MediSave to help pay for treatment at both public and approved private clinics. You do not have to manage this alone. Getting the right financial advice before you start can make your IVF journey much less stressful.

Full Cycle at a Glance

Frequently Asked Questions

Reference: 

1. IVF Cost Singapore 2026: Subsidies, MediSave & Co-Funding. (2026, June 8). https://www.smartcalculator.sg/articles/ivf-cost-singapore-2026 0000000000000000000000000000000000000000
2. Khalife, D., Nassar, A., Khalil, A., Awwad, J., Abu Musa, A., Hannoun, A., El Taha, L., Khalifeh, F., Abiad, M., & Ghazeeri, G. (2020). Cumulative Live-Birth Rates by Maternal Age after One or Multiple In Vitro Fertilization Cycles: An Institutional Experience. International Journal of Fertility & Sterility, 14(1), 34–40. https://doi.org/10.22074/ijfs.2020.5855 
3. Ozer, G. (2023). Initial β-hCG levels and 2-day-later increase rates effectively predict pregnancy outcomes in single-blastocyst transfers in frozen-thawed or fresh cycles: A retrospective cohort study. Medicine, 102(42), e35605. https://doi.org/10.1097/MD.0000000000035605 
4. Wang, S. F., & Seifer, D. B. (2024). Age-related increase in live-birth rates of first frozen thaw embryo versus first fresh transfer in initial assisted reproductive technology cycles without PGT. Reproductive Biology and Endocrinology : RB&E, 22, 42. https://doi.org/10.1186/s12958-024-01210-0 
5. Wang, S. F., & Seifer, D. B. (2024). Age-related increase in live-birth rates of first frozen thaw embryo versus first fresh transfer in initial assisted reproductive technology cycles without PGT. Reproductive Biology and Endocrinology : RB&E, 22, 42. https://doi.org/10.1186/s12958-024-01210-0 

Anna Haotanto

Anna Haotanto is the Founder of Zora Health and a passionate advocate for women’s empowerment. Anna’s personal experiences with egg-freezing, PCOS, perimenopause and the challenges of fertility have fueled her mission to provide high-quality information, financing, and support to help women and couples navigate their fertility journeys with confidence. She is also recognised for her achievements in finance, entrepreneurship, and women’s empowerment, and has been featured in various media outlets. You can also follow her on Linkedin or Instagram.