For many couples, the fertility journey is a long and windy road. After countless tests, procedures, and hopeful moments countered by heartbreak, there are times when it feels never-ending.
If you’re considering IVF, there’s a good chance you’ve already spent LOTS of time on the fertility journey… and want to know how much time IVF will add.
In this article, we’ll give you a practical timeline for each part of the IVF process according to a reproductive endocrinologist. Dr. Jason Kofinas from Kofinas Fertility Group answers your question, “How long does IVF take from start to finish?”
IVF timeline overview
In vitro fertilization (IVF) is a type of assisted reproductive technology. It involves retrieving eggs, fertilizing them with sperm, and transferring an embryo into the uterus. The main steps in IVF are:
- Ovulation induction
- Egg retrieval
- Sperm retrieval
- Fertilization
- Embryo monitoring
- Embryo transfer
An individual IVF timeline varies from one couple to the next — because no two situations are the same. Your fertility doctor will tailor an IVF protocol based on information like the underlying causes of infertility and how you respond to medications.
Consultation and testing
Before you start the official IVF steps, you’ll meet with a doctor for a consultation. Together, you’ll go over your goals for starting a family and the barriers you’re experiencing to get there.
A consultation appointment typically includes running tests to find out what’s contributing to infertility and your body’s readiness to carry a pregnancy. Dr. Kofinas says the standard initial testing includes:
- Bloodwork. Lab tests, including hormone levels, help your doctor formulate a plan for how to stimulate the ovaries.
- A sonogram. This gives your doctor a closer look at your ovarian reserve.
- A semen analysis. This test checks sperm health and indicates male fertility.
- Uterine evaluation. Also called a hysteroscopy, this test looks at the uterus and its ability to carry a baby. It’s often performed at a separate evaluation.
Overall, the consultation and testing process for a new patient takes about a month. It’s important to factor this into your timeline if you’re joining a fertility clinic for the first time. Dr. Kofinas assures the tests are extremely thorough and “allow for almost every condition that can be causing infertility to be identified.”
Ovulation induction
IVF begins with ovulation induction, which prepares your body for egg retrieval. In this stage, you’ll take fertility medication to stimulate the ovaries to develop multiple egg follicles.
During this time, you’ll go in for ultrasounds to monitor follicle growth. Once the follicles reach a desired size, you’ll take medication to trigger the release of the egg.
Dr. Kofinas says the timeframe from the start of stimulation to egg retrieval is typically about 11-13 days. “This is due to the fact that the medication is used to stimulate multiple follicles to grow,” he shares. “We typically want a few leading follicles to approach 18-20 mm before we trigger the follicles for egg retrieval.”
Egg retrieval
Your IVF team will instruct you when to take the trigger shot and come in for an egg retrieval. This is a minimally invasive procedure where your eggs are removed with a tiny needle.
It’s typically done under sedation — so plan to take the day off and have your partner or family member give you a ride. This procedure is done in one day.
Sperm retrieval
Next, your partner will provide a semen sample. If you’re using donor sperm, it’ll be thawed and prepared for use. Before the sperm is combined with the eggs, it’s washed so the highest quality sperm is used.
Fertilization
The egg and sperm are combined in a lab setting to grow into an embryo. This is done through one of two ways:
- Conventional insemination. The sperm and egg are combined and kept in an incubator.
- Intracytoplasmic sperm injection (ICSI). A single healthy sperm is injected into a mature egg. This approach is more commonly used for couples with male factor infertility or failed IVF cycles.
Embryo monitoring
The number of embryos that grow depends on many factors, like the number of eggs obtained in a retrieval, egg quality, and sperm health. The timeframe for embryo growth and development depends on which stage of development your team is attempting to achieve.
Dr. Kofinas explains, “For a day-three embryo, this occurs on day four because retrieval counts as day one. For a blastocyst (the most advanced embryo), we see them develop days six to eight.”
Some people choose to do preimplantation genetic testing (PGT) on embryos. Dr. Kofinas says the turnaround time for genetic testing is variable. “A comprehensive chromosome screening (CCS) can result in one to two weeks,” he shares.
“A single gene disorder test (PGT-M) might take up to three weeks to result. Before this, it can take 9-12 weeks to create the genetic testing probe to be used on the embryos.”
Embryo transfer
If you have multiple viable embryos, your fertility specialists will help you select which one to transfer. But first, your doctor will ensure your womb is prepared to carry a baby. You’ll take medications to thicken the uterine lining and have ultrasounds to determine the timing of the embryo transfer.
“A typical transfer cycle takes four weeks,” says Dr. Kofinas. “Sometimes people can be ready quicker if the lining of the uterus grows to the desired 7-8mm thickness before the 3-4 week mark.”
Dr. Kofinas says one of the biggest factors affecting a transfer timeline is whether you do a fresh or frozen embryo transfer. At Kofinas Fertility Group, the standard process is to do an egg retrieval and an embryo freeze. Then, you’d complete testing like a hysteroscopy before a frozen embryo transfer.
In total, this process takes approximately three months. If you do a fresh IVF transfer, the timeframe is about one month. Whichever route you go, the embryo transfer itself is a simple and quick procedure that takes under ten minutes. “Ironically it’s the most important step of the process even though it doesn’t take long to complete,” says Dr. Kofinas.
What happens if an IVF cycle doesn’t take?
While you always want to hope for the best outcome, it’s important to be prepared for common situations that result in an unsuccessful IVF cycle. Dr. Kofinas says common reasons include:
- No fertilization
- No blastocysts
- No normal embryos
- Failed implantation
Dr. Kofinas advises that each outcome requires specific testing to understand why it occurred. “At Kofinas we try to limit any variables that would hinder the success of a first transfer,” he says. “Sometimes there just aren’t enough viable embryos. If that’s the case, we need to get more embryos to test. Sometimes, that involves another egg retrieval.”
If you have a hard time getting viable embryos, the fertility clinic can do further evaluation. Kofinas does testing to rule out underlying causes like inflammation, endometriosis, insulin resistance, and oxidative stress.
Putting your IVF timeline together
It’s difficult to know how long an IVF cycle will take until you start the process. You may encounter unexpected obstacles — or you may find it goes according to plan.
In general, Dr. Kofinas says the whole process takes approximately six months from start to finish. This timeframe can change based on your situation, and it requires working with your doctor to customize your plan.
“I think it’s important that a patient and physician strike a balance between what needs to be initially evaluated and how aggressive the investigation needs to be,” he shares.
“Infertility, IVF, and treatment for pregnancy in general may not be as complicated as we fertility doctors make it out to be. However, there are clues in the medical history and initial workup that can help elucidate the path someone should take to achieve a favorable and efficient result.”
Alexa Davidson is a registered nurse and freelance health writer. She’s written for various women’s health companies, covering topics like natural hormone balance, fertility, and disease prevention. On her own fertility journey, Alexa has experienced profound loss and is passionate about supporting others with similar experiences. When she’s not researching or writing, Alexa can be found in the kitchen, where her specialty is making healthy versions of comfort foods. Nashville Hot Tofu, anyone?
