The IVF process in India follows eight clinical stages spread across four to six weeks per cycle. It begins with ovarian stimulation, followed by egg retrieval, sperm collection, fertilisation in the lab, embryo culture, embryo transfer, the two-week wait, and finally the beta hCG test. Each stage has its own medications, monitoring schedule, and clinical markers of success.

According to Dr. Mohit Saraogi, an experienced IVF specialist at Saraogi Hospital, most couples fix their attention on the wrong stage, “they concentrate on transfer day. But the foundation is laid 14 days earlier, and small protocol gaps during stimulation end up hurting implantation.”

The first half of IVF is about preparing the ovaries and collecting mature eggs under tight hormonal control.

• Stimulation: Hormone injections are given every day for 10 to 12 days so multiple follicles grow together, not just the one egg that a natural cycle releases. Dose depends on age, AMH, and how the ovaries reacted in previous cycles, and the number gets tweaked every few days.
• Monitoring: Blood tests and transvaginal scans happen every 2 to 3 days to check follicle size and estrogen. Doctors look for under-response or over-response and adjust the dose right away, because one missed scan can mean a cancelled cycle or even hyperstimulation.
• Trigger: Once follicles reach around 18mm, a final trigger shot is given at an exact hour, usually 34 to 36 hours before retrieval. Timing isn’t negotiable. Even a short delay can mess with egg maturity, so the shot is scheduled down to the clock by the treating doctor.
• Retrieval: Eggs are collected by ultrasound-guided needle aspiration under short sedation, and the whole thing wraps up in about 20 minutes. Most patients go home the same day with mild cramps while the eggs move straight to the embryology lab.

Egg count is usually the first thing patients worry about, but quality matters far more than numbers here, which is why every infertility treatment protocol is shaped around the patient’s own ovarian reserve.

Once eggs are out, the work shifts to the embryology lab, where fertilisation and growth are monitored under controlled lab conditions.

• Fertilisation: Sperm and eggs are mixed in a dish for standard IVF, or a single sperm is injected straight into the egg when there is severe male-factor infertility through ICSI treatment. Fertilisation is checked the next morning, and about 60 to 70 percent of mature eggs usually fertilise normally.
• Culture: Embryos sit in a controlled incubator for 3 to 5 days while embryologists track cell division at set intervals. Only the ones that divide cleanly and reach the blastocyst stage get picked for transfer, because weaker embryos rarely go on to implant.
• Transfer: A soft catheter places the chosen embryo inside the uterus under ultrasound guidance. The step is short and needs no anaesthesia, and most patients leave the clinic within half an hour of arriving.
• Beta test: A blood test 12 to 14 days after transfer confirms pregnancy by measuring beta hCG levels. Home urine kits aren’t reliable this early and often give wrong results, so a blood test is the only way to be sure.

Bleeding is a common worry after transfer, and nearly 30 to 40 percent of IVF pregnancies report first-trimester spotting without it meaning the cycle has failed.

References:

• World Health Organization — Infertility overview
• National Institutes of Health — Assisted Reproductive Technology