IVF Process Step by Step: How IVF Works at Delhi IVF

How IVF Works: A Step-by-Step Guide

If you are considering IVF for the first time, the process can feel overwhelming before you understand what is actually involved. The best antidote to that anxiety is clear information.

At Delhi IVF and Fertility Research Centre, we have guided thousands of couples through this process since 1993. This page explains every stage of an IVF cycle in plain language, detailing what happens, why it occurs, and what to expect at each stage.

How Long Does an IVF Cycle Take?

From the start of stimulation to the pregnancy test, one IVF cycle takes approximately four to six weeks. Including the initial consultation and any preparatory steps, the full journey is typically six to eight weeks.

Step 1: Consultation and Fertility Assessment

Your first appointment at Delhi IVF covers a complete medical review for both partners. Blood tests, hormone levels, an ultrasound to assess ovarian reserve, and a semen analysis for your partner. Both partners are assessed because IVF addresses both female and male fertility challenges.

Once results are reviewed, your doctor explains your diagnosis, outlines the treatment plan, and gives you a realistic picture of your chances before a single injection is given.

Step 2: Ovarian Stimulation

In a natural cycle, one egg develops. In IVF, hormone injections taken daily for 10 to 14 days encourage the ovaries to produce multiple eggs, giving the laboratory more to work with and your doctor more options when selecting the best embryo for transfer.

The injections are self-administered and use very fine needles. Most patients find this easier than expected after the first one. Your nurse at Delhi IVF walks you through the technique at your pre-cycle appointment so you feel fully confident before you begin.

Throughout this phase, you attend monitoring appointments every two to three days, combining a short ultrasound scan and a blood test. Your doctor adjusts the medication based on how your follicles are growing. This monitoring is not optional. It is how your team keeps the cycle safe, avoids over-stimulation, and ensures egg retrieval is timed correctly.

Step 3: Trigger Injection and Egg Retrieval

When follicles reach the right size, typically 18 to 20 mm, a trigger injection is given. Egg retrieval follows precisely 34 to 36 hours later.

Retrieval is carried out under mild sedation. A fine ultrasound-guided needle collects fluid from each follicle. The procedure takes 20 to 30 minutes. You rest for one to two hours and go home the same day. Mild bloating or cramping for a day or two is normal and settles quickly.

On the same day, your partner provides a semen sample. If surgical sperm retrieval was planned, this is coordinated for the same day.

Step 4: Fertilisation in the Laboratory

Retrieved eggs go directly to the embryology laboratory.

In standard IVF, prepared sperm are placed with the eggs and fertilisation happens naturally. In ICSI, a single selected sperm is injected directly into each egg. ICSI is used when sperm quality is poor or when previous cycles had low fertilisation. Results are confirmed 16 to 18 hours later, and your team calls you the following morning with the update.

Step 5: Embryo Development and Selection

Embryos are cultured for three to five days in the laboratory under conditions that closely replicate the natural environment of the fallopian tube. The goal is to reach the blastocyst stage on Day 5, when the embryo contains around 100 cells organised into two distinct layers: the inner cell mass, which becomes the baby, and the trophectoderm, which becomes the placenta.

Blastocyst transfer is associated with higher implantation rates than earlier-stage transfers because the embryo has already demonstrated stronger developmental potential before being placed in the uterus.

Your embryologist grades each embryo at regular intervals and selects the highest quality one for transfer. Remaining good-quality embryos are frozen for potential future use. Not all fertilised eggs reach the blastocyst stage, and this is entirely normal. Embryos that stop developing would not have resulted in a successful pregnancy, so selecting only the strongest one is part of what gives IVF its success rates.

Step 6: Embryo Transfer

Embryo transfer is the simplest part of the process.

The selected embryo is loaded into a fine catheter and placed gently into the uterus. No anaesthesia is needed. The procedure takes about 10 minutes and feels similar to a cervical smear. You rest briefly and go home the same day. Light activity is fine. Bed rest is not recommended.

If your doctor recommends a freeze-all strategy and transfer in a later cycle, this is called a Frozen Embryo Transfer (FET). Success rates are comparable to fresh transfers in most cases.

Step 7: Luteal Support and Pregnancy Test

After transfer, you take progesterone medication for approximately two weeks to support the uterine lining and create the right environment for implantation. This is given as vaginal pessaries, injections, or oral tablets, depending on your protocol.

Fourteen days after transfer, a blood test measures your beta-hCG level and confirms whether implantation has occurred. This is more accurate than a home urine test and gives your doctor a clear result to act on.

The two-week wait is genuinely the hardest part of the process for most couples. There is nothing more to do medically, and the uncertainty sits with you every day. Staying gently active and leaning on people who understand what you are going through matters more than most people acknowledge.

If the result is positive, an ultrasound two weeks later confirms a heartbeat and a viable pregnancy. If the result is negative, your doctor reviews the cycle, explains what the results indicate, and discusses your options clearly. A first cycle that does not result in pregnancy is not a failure. It is clinical information that helps refine the approach for your next attempt.

Why Patients Across India Choose Delhi IVF

The steps above are broadly the same at any quality IVF centre. What differs is the experience of the team performing each step, the quality of the laboratory, and how carefully your individual response is monitored throughout.

At Delhi IVF, Dr. Anoop Gupta and his team bring over three decades of experience to every cycle. Our embryology laboratory utilizes advanced culture systems and is continuously monitored. We have helped over 25,000 families from across India and more than 66 countries, and our protocols are refined regularly based on real clinical outcomes. Every patient receives a treatment plan built around their individual case.

Frequently Asked Questions

How does IVF work step by step?

IVF involves ovarian stimulation with daily hormone injections for 10 to 14 days, egg retrieval under sedation, laboratory fertilisation using standard IVF or ICSI, embryo culture for three to five days, embryo transfer into the uterus, and a pregnancy blood test 14 days later.

Is the egg retrieval procedure painful?

Retrieval is performed under mild sedation, ensuring your comfort throughout. Most women experience mild cramping or bloating for one to two days afterwards. Most return to light activity the following day.

What is a blastocyst transfer, and is it better?

A blastocyst is a Day 5 embryo that has continued developing in the laboratory. Transferring at the blastocyst stage is associated with higher implantation rates because the embryo has demonstrated stronger development potential before being transferred.

What is the difference between IVF and ICSI?

In standard IVF, eggs and sperm are placed together and fertilise naturally. In ICSI, a single sperm is injected directly into each egg. ICSI is recommended when sperm quality is poor or when standard fertilisation has previously failed.

What happens during the two-week wait after embryo transfer?

After embryo transfer, you take progesterone support and wait 14 days for the pregnancy blood test. Light activity is fine. Bed rest is not required or recommended. The two-week wait is emotionally challenging for most couples, and having support from people who understand what you are going through makes a genuine difference.

What happens if my first IVF cycle fails?

A cycle that does not result in pregnancy provides useful clinical information. If good-quality embryos were frozen, a Frozen Embryo Transfer could be arranged at a lower cost. If not, a new cycle is planned with protocol adjustments based on how your body responded.