You're doing IVF
IVF is a sequence of steps, each with its own questions, and it's much easier to manage when you know which step you're in and what happens next. This Path walks the whole cycle from the first injection to the pregnancy test, with the terms explained as they come up.
A typical cycle: 8–14 days of injectable stimulation with ultrasound and blood monitoring, a trigger injection, then egg retrieval about 36 hours later under sedation.
Then fertilization in the lab (conventional or ICSI, where one sperm is injected into each egg), 5–6 days of embryo culture, and a fresh or frozen transfer.
Optional genetic testing of embryos (PGT-A) happens before a frozen transfer. It has real trade-offs and is worth a specific conversation.
After transfer, a blood pregnancy test ('beta') is done about 9–14 days later. Numbers are usually repeated 48 hours apart to see the trend.
- Start preparing about three months ahead. That's roughly how long eggs and sperm take to develop. The full preparation list.
- Strong evidence Both of you: quit smoking. Smokers need nearly twice as many IVF cycles to conceive.
- Moderate evidence Both of you: keep alcohol low. Four or more drinks a week was linked to lower live birth rates.
- Emerging evidence CoQ10, if your egg reserve is low. Ask about it; the key trial used 600 mg a day for 60 days before retrieval. Details.
- Strong evidence Ask about blocked, fluid-filled tubes. A hydrosalpinx roughly halves IVF success, and treating it first is recommended.
- Ask which add-ons are worth paying for. Most don't have good evidence of more live births. The regulator's ratings.
Your protocol
Which medications, why this protocol for you, and what a good response looks like.Monitoring
How often you'll come in, what they're measuring (follicle count and size, estradiol), and when the trigger decision is made.Retrieval and fertilization
Expected egg numbers, conventional fertilization vs. ICSI and why, and what 'mature' and 'fertilized' numbers mean.Embryo development
What day-3 and day-5 updates mean, how embryos are graded, and how many are expected to reach blastocyst.PGT-A
What it can and can't tell you, its cost, and whether it's likely to change decisions for you.Transfer
Fresh vs. frozen, how many embryos (single embryo transfer is standard), and the medications after transfer.Cancellation
What would cause a cycle to be cancelled and what the financial policy is if that happens.
- Which protocol am I on and why did you choose it for me? What would make you change it mid-cycle?
- What number of eggs and embryos would you consider a good result for someone like me?
- Are you recommending ICSI, and if so, why in my case?
- Do you recommend PGT-A for me, what would it change, and what does it cost?
Plus 6 more on your appointment checklist.
After retrieval, the embryology updates decide the next step: how many fertilized, how many reached blastocyst, and (if tested) how many are chromosomally normal.
After transfer, the beta result and its trend decide what happens next. A positive test moves you into monitored early pregnancy (the early pregnancy Path); a negative one leads to a review conversation with your doctor, which you're entitled to have in detail.
If a cycle doesn't work, ask for a formal review: what went as expected, what didn't, and what would change next time. That conversation is often where the plan improves.
Consider another opinion if you've had two or more unsuccessful cycles without a clear change in approach; if you're offered add-ons without an explanation of the evidence; if your questions about numbers and grading aren't answered; or if you don't trust the communication. Your embryos can be transferred to another clinic. See I want a second opinion.