IVF AND IUI
What happens in IVF, day by day? Your plan at Jananam.
IVF feels less frightening when you know what comes next. This is the plan we give our own patients, step by step, with the days, the instructions and the points where the plan can change.
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- Your IVF plan day by day
Key takeaways
- An IVF cycle takes about 4 to 6 weeks from the first scan to the pregnancy test.
- Injections run for about 8 to 12 days, with scans and blood tests that decide each dose.
- Egg collection is done 34 to 36 hours after the trigger injection, at Neelankarai.
- Most of our embryo transfers are frozen, done in a later cycle when the womb lining is prepared.
The short answer
An IVF cycle at Jananam Fertility Centre, Chennai, starts on day 2 of your period with a scan and blood test. Then come about 8 to 12 days of injections with scans, a trigger injection, and egg collection 34 to 36 hours later. Embryos grow in our lab, and most are frozen and transferred in a later cycle.
01What happens before the first injection?
Both of you are tested, anything treatable is corrected, and you get the plan in writing.
We check her egg reserve (AMH and a scan), his semen, and the womb, plus routine blood tests. Thyroid, blood sugar, blood pressure, weight and vitamin D are corrected first, and folic acid is started. The egg reserve result shapes the whole plan. If reserve is low, we may plan more than one stimulation from the start rather than raise the dose.
Egg accumulation and individualised stimulation, including dual stimulation, rather than simply higher doses. (Dr Vani Sundarapandian)
02What happens in the injection days?
You have daily hormone injections for about 8 to 12 days, with blood tests and scans that tell us how to adjust the dose.
Call us on day 1 of your period. On day 2 you have a blood test (FSH, LH and estradiol) and a scan; injections start once the lining is thin and there are no cysts. After 5 days of injections you have a fasting blood test, and on day 6 your first scan. Scans then follow about every 2 days. When the largest follicle reaches about 14 mm, a second injection (the 'antagonist') is added to stop the eggs being released early; this is why it is called an antagonist protocol. Please avoid sex during the treatment cycle.
Ovarian stimulation: what the injections do03What happens on egg collection day?
Egg collection takes about 20 minutes under light anaesthesia, 34 to 36 hours after the trigger injection, and you go home the same day.
When the follicles are ready, a trigger injection ripens the eggs; its exact time decides the time of collection. Come in at 7am, or the night before if you live far away. After collection you may have mild tummy pain and a little bleeding. You can eat and drink about 4 hours later, and you receive one dose of antibiotic. His semen sample is given the same morning. He should ejaculate once about 3 to 4 days before, then not again until the sample.
04What happens to the eggs and embryos in the lab?
The eggs are fertilised the same day, and we tell you the next day how many fertilised.
Fertilisation is by conventional IVF or ICSI, chosen for your reason. The embryos then grow in our lab at Neelankarai, and many are grown to day 5 or 6 (blastocyst). We tell you how they are developing and what their grades mean. Not every egg is mature, not every mature egg fertilises and not every embryo reaches day 5; the numbers drop at each step, and that is normal. Where it is indicated, embryos are tested (PGT) in selected cases, discussed with you, and then must be frozen while results come back.
ICSI should not simply be viewed as automatically better IVF. (Dr Vani Sundarapandian)
05Fresh or frozen transfer, and how many embryos?
Most of our embryo transfers are frozen, and we never transfer more than two embryos.
Stimulation pushes hormone levels well above normal, which in some women may make the lining less ready. Freezing lets us prepare the lining in a calmer, later cycle. Freezing all embryos is also safer for women at risk of overstimulation, often with PCOS, and it is needed if embryos are tested. A fresh transfer on day 3 or day 5 is still used in selected cases. On transfer day come with a full bladder; there is no anaesthesia, you lie down for about 10 to 30 minutes, then go home.
We do not transfer more than two embryos under any circumstance. Single embryo transfer is preferred for tested euploid embryos at any age, and usually under 38 with a good blastocyst. (Dr Vani Sundarapandian)
06What happens after the transfer, and when is the test?
You go back to normal life, keep taking the progesterone as prescribed, and have a blood pregnancy test on the date we give you.
Bed rest is not needed after the transfer and does not raise the chance of pregnancy. The blood test (beta hCG) is usually about 12 days after a blastocyst transfer and 14 days after a day-3 transfer.
Couples wait too long to resume treatment after a failed cycle. (Dr Vani Sundarapandian)
The same plan, explained.
Dr Vani on what IVF treatment involves.
Your IVF cycle at a glance.
Typical timings. Your own dates depend on how your ovaries respond, and we give them to you as the cycle goes.
| When | What happens | Where |
|---|---|---|
| Before the cycle | Tests for both of you, anything treatable corrected, plan in writing | Neelankarai or Thiruporur |
| Day 1 of your period | You call or message us | Phone or WhatsApp |
| Day 2 | Blood test and scan; injections start | Neelankarai or Thiruporur |
| After 5 days of injections | Fasting blood test, then the first scan on day 6 | Neelankarai or Thiruporur |
| About every 2 days after that | Scans, dose changes, antagonist injection added | Neelankarai or Thiruporur |
| About day 10 to 12 of injections | Trigger injection at an exact time | At home or at the clinic |
| 34 to 36 hours after the trigger | Egg collection; his sample the same morning | Neelankarai |
| The next day | We tell you how many eggs fertilised | Phone |
| Day 3 to day 6 | Embryos grow; most are frozen, some tested | Our lab, Neelankarai |
| A later cycle (or day 3 or 5 if fresh) | Embryo transfer, no anaesthesia | Neelankarai |
| About 12 to 14 days after transfer | Blood pregnancy test (beta hCG) | Neelankarai or Thiruporur |
| Jananam's patient instructions; stages as described by the HFEA. | ||
Egg collection day: what to do.
- Nothing to eat or drink, including water, for at least 6 hours before.
- Shower in the morning. No perfume, deodorant or powder; the lab asks for this.
- Remove all jewellery.
- Tell the nurse and doctor about any allergy to medicines.
- Empty your bladder just before the procedure.
- Bring someone to take you home; you will be drowsy.
- He gives his semen sample the same morning.
When to call us
- A swollen or very painful tummy, vomiting, breathlessness, passing very little urine or feeling faint during or after stimulation: call 108 or go to the nearest emergency department, then call us on +91 89399 94244.
- Fever, or pain that is getting worse, after egg collection.
- You missed an injection, or took it at the wrong time. Call before the next dose.
- Your period has not started when expected, or you bleed while on progesterone.
- You are not sure what a result or your embryo report means.
Questions couples ask
How long does one IVF cycle take?
One IVF cycle usually takes about 4 to 6 weeks from the first scan to the pregnancy test. A frozen transfer adds a later cycle of a few weeks.
Are the IVF injections every day?
Yes, the stimulation injections are daily for about 8 to 12 days. They are small injections under the skin, and our nurses show you how to give them.
Is egg collection painful?
No, you are asleep under light anaesthesia for the 20 minutes or so it takes. Afterwards, mild cramps and a little spotting for a day are common.
Can we have sex during the IVF cycle?
We advise avoiding sex during the treatment cycle. Ask us when it is fine again after the transfer.
Do I need bed rest after egg collection or embryo transfer?
No, bed rest is not needed after either, and it does not increase the chance of pregnancy. Rest on the day of collection because of the anaesthetic, then return to normal activity.
We live outside Chennai. Where do we stay during IVF?
Many couples stay at the hospital: Rooms on site for patients travelling from outside Chennai, with meals from the hospital kitchen. Some scans may be possible nearer home, and we plan the dates with you.
Not the question you had?
The questions people don't ask with their partner sitting beside them, answered by Dr Vani Sundarapandian.
Reviewed by
Dr Vani Sundarapandian
MD, DGO, FRCOG (UK) · Founder, Jananam Fertility Centre
Written by the Jananam team from our own patient instructions and reviewed by Dr Vani Sundarapandian, MD, DGO, FRCOG (UK), 20 years exclusively in reproductive medicine. The protocol choices described are Jananam's own.
Are Twins More Likely With IVF?
Yes, twins are more common after IVF, mainly because more than one embryo may be transferred.
Unexplained Infertility: Is IVF the Only Option?
No. When every test is normal but pregnancy has not happened, the diagnosis is unexplained infertility, and IVF is one option among several.
Balancing Work During Fertility Treatments
Balancing work during fertility treatments is genuinely demanding: research shows 87% of patients report difficulty managing IVF or other fertility treatment alongside professional commitments.
Starting IVF? Get your plan in writing.
Tell us where you are: first cycle, tests done, or a cycle elsewhere. Janvi, Jananam's companion for fertility treatment, replies straight away.
Sex selection is prohibited in India under the PCPNDT Act, 1994 and the ART Act, 2021.