The IVF Process: From Ovarian Stimulation to Embryo Transfer

The IVF process follows a defined sequence, from the start of a menstrual cycle through to a pregnancy test two weeks after embryo transfer.

Stimulation, retrieval and fertilisation

The patient begins two weeks of ovarian stimulation injections starting on day two or three of the cycle. Once the follicles reach an appropriate size, around 18mm, the eggs are retrieved under anaesthesia using a vaginal ultrasound probe with an attached needle, which punctures each follicle to collect both the fluid and the egg. In the lab, these eggs are exposed to processed sperm, forming embryos.

Embryo grading and transfer

Embryos are staged by day: a fertilised embryo shows two pronuclei (2PN), progressing to a four-cell stage, an eight-cell day-three embryo, and finally a day-five blastocyst, the best-quality stage for transfer. Once formed, day-three or day-five embryos (depending on quality) are transferred into the uterine cavity, and a pregnancy test follows two weeks later.

This article is based on a Jivo Masterclass session conducted by Dr. Parul Prakash, Head, Reproductive Medicine (IVF), Artemis Hospital, Gurugram. The article has been summarised with the assistance of an AI tool from the original masterclass recording. Watch the full Masterclass recording

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