For most people, the decision to pursue in vitro fertilization (IVF) isn’t something they arrive at lightly. Couples or single women tend to decide to go this route after months—sometimes years—of fertility challenges, appointments, and difficult conversations.
If you’re at the point where IVF is on the table, you likely already know it’s more than a simple procedure. It’s a multi-stage medical process that affects your body and mind in ways that are rarely captured in a brochure.
This guide is designed to walk you through what to expect during IVF stages—not just the clinical steps, but also the physical realities and emotional weight that come with each one. Understanding the full picture won’t make the road easier, but it can make it feel a little less uncertain.
Phase 1: Preparation and Ovarian Suppression
Before stimulation can begin, the woman’s body needs to be prepared. This phase typically involves diagnostic testing—bloodwork, ultrasounds, and uterine mapping—to give your care team a clear baseline. Depending on your results and protocol, you may be prescribed birth control pills or GnRH agonists or antagonists. These medications suppress your natural menstrual cycle and prevent premature ovulation, essentially giving your fertility team control over the timing of what comes next.
The physical side effects of IVF start here, though they’re generally mild at this stage. Hot flashes, headaches, fatigue, and mild bloating are common responses to hormonal suppression. They’re manageable for most people, but they’re a sign of what’s ahead.
Emotionally, this phase can feel like a strange limbo. You’ve made a significant decision, you’re taking medication daily, and yet nothing dramatic seems to be happening. The “hurry up and wait” feeling is real—and so is the anxiety that builds as the first injection date approaches.
Phase 2: Ovarian Stimulation
This is where the treatment intensifies. Over a period of roughly 8 to 12 days, you’ll administer daily hormone injections—typically follicle-stimulating hormone (FSH) and luteinizing hormone (LH)—to encourage your ovaries to develop multiple follicles simultaneously. Rather than releasing a single egg as in a natural cycle, the goal here is quantity: the more mature eggs retrieved, the more opportunities for fertilization.
Monitoring is frequent during this phase. Expect ultrasounds every two to three days and regular blood draws to track estrogen levels and follicle growth. Follicles measuring more than 14 millimetres typically indicate a mature egg. Once your follicles reach the target size, a final “trigger shot”—either hCG or a Lupron-based injection—is administered exactly 36 hours before your scheduled egg retrieval to prompt final egg maturation.
The physical side effects of IVF are most pronounced during stimulation. As the ovaries expand to accommodate multiple developing follicles, moderate to severe abdominal bloating, breast tenderness, injection-site bruising, and a persistent heaviness in the pelvis are common experiences. A smaller percentage of patients develop ovarian hyperstimulation syndrome (OHSS), a condition where the ovaries overrespond to stimulation, causing fluid retention, nausea, and significant abdominal discomfort. Your care team will monitor for signs of OHSS throughout this phase.
The IVF hormonal mood swings that accompany stimulation are often compared to an amplified version of severe PMS. Sharp emotional shifts, heightened sensitivity, and general fatigue are typical. On top of that, the daily monitoring introduces what many patients describe as “follicle anxiety”—a preoccupation with whether the eggs are growing at the right rate, and a sense that every scan result carries enormous consequence.
Phase 3: Egg Retrieval
Egg retrieval is an outpatient surgical procedure performed under conscious sedation. An ultrasound-guided needle is passed through the vaginal wall into the ovarian follicles, where it aspirates the follicular fluid and collects the eggs. Each follicle is aspirated individually, and the eggs are immediately transferred to a laboratory incubator.
After retrieval, the eggs are fertilized in the laboratory using sperm from your partner or a donor, and the resulting embryos are monitored over the following days.
The egg retrieval procedure itself is brief, but recovery takes the rest of the day. Cramping, spotting, and grogginess from sedation are expected in the hours that follow. Constipation—a common but underreported side effect—can persist for a day or two, compounded by pain medication and the residual effects of stimulation hormones.
The emotional stress during IVF peaks sharply after retrieval. What follows is a series of daily phone calls from the embryology lab, each one reporting a new milestone—or a loss. How many eggs were mature? How many fertilized? How many reached the blastocyst stage?
This cascade of updates can feel relentless, and the anxiety of waiting for each call is something many patients describe as among the hardest parts of the entire process.
Phase 4: Embryo Transfer
The embryo transfer is the step most people picture when they think of IVF. In practice, it’s far quieter than the preceding weeks. A speculum is inserted, and a thin catheter loaded with one or more embryos is guided through the cervix and into the uterus under abdominal ultrasound guidance. The sensation is similar to a Pap smear, so no sedation is required. The procedure takes approximately 10 minutes.
The timing of the transfer depends on your protocol. A fresh transfer takes place three to five days after retrieval. A frozen embryo transfer (FET) happens weeks or months later—often after the body has had time to recover, or after preimplantation genetic testing (PGT) has been completed to screen embryos for chromosomal abnormalities.
After transfer, progesterone supplementation begins—either as intramuscular injections or vaginal inserts—to support the uterine lining. These medications mimic early pregnancy symptoms: sore breasts, fatigue, and bloating. It’s an odd position to be in, feeling physically pregnant without yet knowing the outcome.
The mental health toll of IVF shifts meaningfully at this point. For weeks, there has been action—injections, appointments, procedures, phone calls. Now there is nothing left to do. The profound shift from active participation to full-on waiting mode is something many patients struggle to prepare for.
Phase 5: The Two-Week Wait and the Outcome
The final phase spans nine to 14 days, ending with a quantitative beta-hCG blood test that determines whether the embryo has successfully implanted. No home pregnancy test or symptom can reliably substitute for this result—though most patients find themselves scrutinising every twinge and sensation anyway.
This period captures the full mental health toll of IVF in a way that’s difficult to overstate. The combination of progesterone side effects and hope combined with stress makes it nearly impossible to interpret what the body is communicating. Cramping could mean implantation—or it could mean nothing. Nausea could be a sign—or it could be the medication. The compulsive urge to test early is common, and the emotional exhaustion of resisting (or not resisting) that urge is very real.
When the result arrives, it brings one of two outcomes. A negative result carries its own grief—acute, and often complicated by the question of what comes next. A positive result brings relief and joy, but for many patients, it also brings a new layer of anxiety. The worry doesn’t simply stop because a number on a blood test is encouraging.
Your IVF Support Roadmap
How does IVF affect a woman’s body?
The honest answer is: The treatment’s effects are significant, and across every phase. The hormonal demands, the physical side effects, the surgical procedures, and the prolonged uncertainty place an extraordinary burden on the body—and the mind.
That burden deserves to be met with equally robust support. A few practical steps worth considering as you prepare:
• Connect with a fertility counsellor or therapist. Psychological support before, during, and after IVF can help you process the emotional weight of each stage, and research shows that the psychological impact of treatment can persist long after the cycle ends.
• Build a support circle. Open communication with your partner, a trusted friend, or a community of people who have navigated fertility treatment firsthand can make an enormous difference during the harder phases.
• Advocate for yourself at the clinic. Ask questions about your protocol. If something feels unclear or unexpected, raise it. Your care team is your partner in this process.
• Give your body grace. Low-impact movement like walking, swimming, or gentle yoga can support your wellbeing during treatment—but listen carefully to your body and your care team’s guidance on activity restrictions, particularly during and after stimulation.
At ONE Fertility Kitchener Waterloo, knowing what to expect during IVF stages is something we believe every patient deserves—before they walk into the treatment room. Our team offers personalized fertility care plans, counselling, and ongoing support at every step of the process. Book a consultation with one of our fertility specialists today.
