Assisted reproductive technology such as in vitro fertilization (IVF) has helped individuals and couples suffering from infertility to conceive. The steps of IVF include ovarian stimulation for egg production, egg retrieval, lab fertilization with sperm, and subsequent embryo transfer to the uterus.
This is a detailed weekly guide to expect during the remission stage to embryo transfer.
Pre-Treatment (Before IVF Cycles Begins)
Consultation & Tests
Prior to beginning the IVF cycle, an expectant partner undergoes routine blood tests, ultrasounds, and semen analysis. Baseline reproductive health tests will help devise an individualized care strategy tailored to their age, medical condition, and previous childbearing history.
Ovarian Stimulation (Cycle Starts)
Fertility treatment commences with the IVF cycle, which includes a customized plan to encourage multi-ovulation through hormonal therapy. This is done early in the menstrual cycle. Around day 3, you will receive ultrasound and blood work to further assess the effectiveness of stimulation therapies.
Week 1: Ovarian Stimulation (Days 1-7)
During this period, one or more follicles will be injected with ovulatory
hormones (FSH, LH, and hMG).
Monitoring: You will most likely have multiple clinic appointments to ultrasound and blood test to track the progression of your follicles’ growth.
Possible side effects: Due to the hormone therapies, your treatment will lead to some degree of side effects including: ovarian swelling, volatile temper changes, severe migraines, and drowsiness.
Weeks 2 – Days 8 – 14 – Ovarian Stimulation Continues: The follicle growing phase
Monitoring: You will continue to undergo regular monitoring.
Trigger Shot: Once the eggs are primed for collection (typically between day 12 and 14), you will receive a dose of hCG (human chorionic gonadotropin) injection, which enhances the growth of the follicles, thus ensuring that they develop to completion.
Egg Retrieval: You will go through a procedure popularly termed egg collection or aspiration approximately from 34 to 36 hours post the hCG trigger injection. This is conducted while you are sedated, where the practitioner will carefully extract the eggs from your ovaries using a syringe.
Week 3: Fertilization & Embryo Culture
Subsequent to egg collection, the laboratory will conduct insemination by introducing testosterone-containing sperm to the harvested oocytes. In the event that there is a problem of male infertility, you will undergo a procedure called ICSI (Intracytoplasmic Sperm Injection).
After fertilization, embryos that are deemed toomer are cultured in the lab for a couple of days (estimate between 3 to 5 days), during which their development will be tracked.
Embryo Quality: Doctors will implant the embryos of selected quality on day 3 (cleavage stage) or day 5 (blastocyst stage) based on the assessment of their quality.
Week 4: Embryo Transfer
The schedule is that on the 5 sample day selected for implantation, the patient is expected to have multiple embryos implanted into the uterus.
This is a painless, relatively straightforward procedure that does not require anesthesia.
You will be able to leave once you have rested for a short period of time. Some physicians may advise bed rest; however, most do not require it.
Progesterone Support: To prepare the uterus for embryo transfer, you will receive an injection or suppository of progesterone.
Week 5: Early Pregnancy and Implantation
Implantation Window: The embryo should try to implant into the uterine lining approximately 6-10 days after being transferred.
Pregnancy Test: Your doctor will plan a blood test (beta hCG) 10-12 days after the transfer. A positive test result means implantation has possibly taken place due to the
detectable hCG levels.
Symptoms: Spell fatigue alongside mild cramping and bloating as side effects to medications. Breast tenderness may also occur.
Week 6-7: Confirming the Pregnancy
With a positive pregnancy test, additional blood tests will be taken to ensure an appropriate level of hCG is present, confirming successful implantation.
Ultrasound: You will need an ultrasound in 6–7 weeks to check for the gestational sac and fetal heartbeat.
Morning sickness is common during this time, although there is plenty of room for variety as well.
Weeks 8-10: Milestones within First Trimester
Your First Trimester: Nausea, change in mood, fatigue are amongst the many early symptoms of pregnancy you may be feeling.
Your Heart Rate: It is possible that your doctor is still checking the frequency of your hCG levels alongside ultrasounds to make sure the progression of the pregnancy continues to develop positively.
In Further Detail: Maybe you will need progesterone help all the way up to around 10-12 weeks.
Weeks 11-12: Initiating the Second Trimester
In Terms of Monitoring: After ultrasound validation of a viable pregnancy along with multiple hCG check-ups, the number visits may reduce in frequency. The pregnancy is now deemed stable.
Chances of Miscarriage: Miscarriages are observed to a much greater extent in the first trimester and drop significantly after the first trimester.
IVF Pregnancy: Expecting After Week 13
Celebrations are in order! Surviving until Week 13 in an IVF pregnancy is a major milestone. The first trimester, usually defined by a lack of clarity along with debilitating hormonal symptoms, is now behind you, and you are officially moving into the second trimester. This routinely comfortable period of pregnancy allows you to feel more at ease, as your body is starting to adapt to the changes that come with pregnancy.
If you are wondering what lies in store for you in an IVF pregnancy after Week 13, let me reassure you — it is going to get interesting.
Having concerns about the progress of a pregnancy is something most consider reasonable. Expecting mothers often want to know the changes that may occur in their body, the developmental milestones lined up, and the expectations set for the second trimester.
The Second Trimester: From 14 to 26 Weeks
This is the time period between Weeks 14–26 and is also called the second trimester. It is often referred to as the honeymoon phase due to the “baby bump” becoming visible while the negative symptoms begin to fade away. At this stage, greater physical changes will become more noticeable, such as a visible baby bump.
Week 14 – 15: A Moving Child
The developing baby will be the size of a lemon by the start of week 14 (commonly referred to as empathetic week). The organs of the baby are maturing at a steady rate, marking the end of important phases for bodily changes. By the middle/end, expect to feel the first flutters known as quickening. Gentle movements will be faint at first, getting stronger with the passage of time.
The symptoms such as exhaustion and nausea will ease off as the second trimester begins, being replaced with ease. The most visible sign that the pregnancy is progressing is the baby bump becoming more prominent as the uterus expands with time.
Despite the first trimester putting many women into a state of exhaustion, week twelve is marked as a milestone since many report feeling quite energetic, which is accompanied by heightened metabolism and increased blood flow, something that can quite literally leave one feeling warmer than usual.
Along with these physical changes, you may notice mild stretching or cramping-like sensations as your uterus grows in size. And it is also mimicked by the appearance of stretch marks, usually around the region of hips, breasts, and belly, which signifies the change.
Week 16–18: Enjoying the ‘Glow’
What’s Happening: The pregnancy “glow” which many women report during this time is due to experiencing enhanced blood flow which increases your body temperature. Expecting mothers also tend to feel more energy during this duration because with the second trimester, things begin to ease up as blood is not directed towards the ‘master coolant’ – the heart – due to an exclusive break from the exhaustion of the first trimester.
Although still experiencing physical changes, rest assured since a lot of these modifications are met with relief. Further, as your uterus rises above the pubic bone, the belly becomes more noticeable like your hips and round ligaments, easing the moderate back pain.
Week 19–21: Feeling Baby Movements
What’s Happening: You can expect your baby to reach the size of a mango around week 19 and by week 21, the little one is expected to ramp up growth and become even bigger.
Kicking, as well as moving about, may begin to increase, and those movements may become more pronounced for you.
What You Can Expect: About now, you should feel your baby moving frequently, which is one of the most thrilling milestones in pregnancy. Some women explain it as gentle flutters or taps, while others feel more discernible movements.
Physical Changes: Your body keeps on expanding as your baby develops. Additionally, you might notice some swelling around your feet and ankles, especially if you’re on your feet a lot. Some women also experience skin changes, with dark patches known as melasma on the face and a dark line, sometimes referred to as linea nigra, which extends vertically along the midsection of the abdomen.
Week 22 The Midpoint. – 24:
What’s Happening: Now you are halfway through your pregnancy. Your baby has now grown to around a papaya and is more mobile. Increased kicking, punching, and even burping may be experienced.
What You Can Expect: If you did an ultrasound or a genetic screening in early pregnancy, the results will likely be available now. Alongside these new results, you will most likely begin a more routined schedule for prenatal appointments.
At this stage, your baby’s hearing is developing, so they may respond to sounds from the external world.
Discomfort like heartburn or indigestion is common as the uterus grows and presses on the stomach. You are also likely to suffer from back pain, leg cramps, or even pain in the sciatic nerve due to the additional weight your body is trying to accommodate.
Weeks 25 – 26: Getting Ready for the Third Trimester
What Is Happening: The baby becomes even more active than before, their skin becomes less see-through as fat builds, and they also start practicing breathing movements in preparation for birth.
What You May Expect: The kicking is likely to become much stronger and frequent; you might notice that moving around is getting harder because your belly is getting bigger.
Physical Changes: Your belly is going to be much bigger than before, and you will start experiencing Braxton Hicks contractions, which is your body’s way of practicing for labor. These are not something to be worried about, as they fade away after a while.
What to Expect in the Third Trimester:
What Is Happening: Starting from the 26th week, the third trimester is almost in sight. For the majority of women, the second trimester is considered a time for merriment due to its relative calm; however, feeling some discomforts of pregnancy is expected.
What You Can Expect: In the third trimester, focus shifts to preparing for labor, which means discussions of the birth plan begin with the doctor or midwife.
What About IVF Specific Considerations?
Although your journey in the second trimester will closely align with a naturally conceived pregnancy, do remember there are a few IVF-specific things to consider:
Additional Monitoring: IVF pregnancies typically receive more scrutiny during the early stages. By the start of the second trimester, most will be monitored less frequently, but the intervals between check-ups can still be quite abundant, particularly during ultrasound and blood testing sessions. For most patients, these sessions tend to reduce after the twelfth week, assuming the pregnancy is developing normally.
For those pregnancies that have more than one baby: The pace at which the body adapts to the numerous physiological changes needed for the healthy development of the fetuses could be immense. As a result, other physical changes and symptoms become more pronounced. Your healthcare team will monitor the status of your pregnancy more so during the second trimester.
Conclusion
Keep in mind that you are progressively getting closer to meeting your little one, which comes packed with diverse joys and challenges at every new phase.
Also make sure to enjoy personal time and praise the changes in your body — as the journey is different for every woman, the excitement of bringing new life is a universal feeling.
With this said, remember to also keep up with your scheduled prenatal appointments, take care of yourself, and enjoy the advancements of this wonderful stage of life!
