First-Time IVF: Everything You Wish Someone Had Told You

Bottom line up front: Your first IVF cycle feels overwhelming because there is so much information and so many unknowns. But the process itself is straightforward: stimulate your ovaries, retrieve eggs, fertilise them, grow embryos, transfer the best one. Millions of people have done this. You are going to be fine. Here is everything you actually need to know.

Before You Start: The Testing Phase

Before any IVF cycle begins, your clinic needs a clear picture of your fertility. If you are doing IVF in Colombia, most of this testing can be done at home before you travel. Your Colombian clinic will tell you exactly which tests they need.

For the Egg Provider

• AMH (Anti-Müllerian Hormone): A blood test that estimates ovarian reserve — how many eggs you have left. This is the single most important predictor of how you will respond to stimulation.
• FSH and Estradiol: Blood tests drawn on day 2 or 3 of your menstrual cycle. These assess baseline ovarian function.
• Antral Follicle Count (AFC): A transvaginal ultrasound that counts the small follicles visible on your ovaries. Combined with AMH, this gives your doctor a good picture of expected egg yield.
• TSH and Prolactin: Thyroid and hormone levels that can affect fertility and need to be optimised before cycling.
• Infectious disease screening: HIV, Hepatitis B and C, syphilis, rubella immunity. Standard requirement.

For the Sperm Provider

• Semen analysis: Count, motility, morphology. This tells the clinic whether standard IVF or ICSI is recommended.
• Infectious disease screening: Same panel as above.

Step 1: Ovarian Stimulation (Days 1–12)

In a natural cycle, your body produces one egg per month. IVF stimulation uses hormone injections to encourage your ovaries to produce multiple eggs in a single cycle — because more eggs mean more embryos, and more embryos mean more chances.

What You Will Take

Your clinic will prescribe a personalised protocol, but most involve a combination of FSH (follicle-stimulating hormone) to grow follicles and a GnRH antagonist to prevent premature ovulation. These are injectable medications — small subcutaneous needles that you administer yourself (or your partner can do it). The injections go into the fatty tissue of your belly and are less painful than most people expect.

What It Feels Like

The first few days feel like nothing much. By day 5–6, you may notice bloating, fullness in your lower abdomen, and mild tenderness around your ovaries. By day 8–10, the bloating can be noticeable — think "first trimester" feeling. Your ovaries are enlarging as follicles grow, which can cause a heavy, pressured sensation. Mood swings are common. Fatigue is common. All of this is normal and temporary.

Monitoring Appointments

Every 2–3 days during stimulation, you will visit the clinic for a transvaginal ultrasound and blood work. The ultrasound measures your follicles (the fluid-filled sacs containing eggs) — their number and size. Blood work checks your estradiol level, which rises as follicles mature. Your doctor uses this data to adjust your medication doses and determine when you are ready for retrieval.

Step 2: The Trigger Shot and Egg Retrieval (Days 12–14)

The Trigger

When your follicles reach the right size (typically 18–20mm), your doctor will instruct you to take the "trigger shot" — a precisely timed injection that initiates the final maturation of your eggs. Timing is critical: the retrieval must happen exactly 36 hours after the trigger. If your doctor tells you to inject at 10pm on Tuesday, your retrieval will be at 10am on Thursday. Do not miss this timing.

Egg Retrieval

The retrieval itself takes 15–30 minutes. You will be under light sedation — comfortable and pain-free during the procedure. Using ultrasound guidance, your doctor inserts a thin needle through the vaginal wall into each ovarian follicle and aspirates the fluid containing the egg. You will not feel this.

Afterwards, you will rest in the recovery area for 30–60 minutes as the sedation wears off. Most women feel crampy and tired for the rest of the day. Some have spotting. Within 24–48 hours, most feel close to normal. Take the rest of retrieval day off — no plans, no obligations, just rest.

The First Call

Later that day or the next morning, the clinic will call with your fertilisation report. They will tell you how many eggs were retrieved, how many were mature, and how many fertilised. This is an emotional call. Prepare yourself for any number. Some eggs do not fertilise — this is normal. What matters is that you have embryos developing.

Step 3: Embryo Development (Days 14–19)

Your embryos develop in the lab under carefully controlled conditions for 3–5 days. The embryology team monitors their progress:

• Day 1: Fertilisation check — did the egg and sperm combine successfully?
• Day 2–3: Embryos divide from 2 cells to 4 to 8. The clinic may update you on how many are progressing.
• Day 5: Surviving embryos reach the "blastocyst" stage — a ball of approximately 100 cells with a defined structure. Blastocysts have the highest implantation potential.

Not all embryos make it to day 5. This is normal. The lab is not doing anything wrong — embryos with chromosomal abnormalities or developmental issues naturally stop progressing. The embryos that survive to blastocyst have passed the first filter of natural selection.

Step 4: Embryo Transfer (Day 17–19)

If you are doing a fresh transfer (embryo transferred in the same cycle as retrieval), this happens on day 3 or day 5 after retrieval. Some clinics recommend a "freeze-all" approach — freezing all embryos and transferring in a subsequent cycle, which allows your body to recover from stimulation before pregnancy.

The Procedure

Transfer is quick (5–10 minutes), painless, and does not require sedation. A thin catheter is guided through your cervix into your uterus, and the embryo is gently deposited. You may feel mild pressure but not pain. An ultrasound confirms placement. Then you rest for 15–30 minutes and go home.

After Transfer

Bed rest is not necessary or recommended — normal activity is fine. Avoid strenuous exercise, hot tubs, and heavy lifting. Continue any medications your doctor prescribes (typically progesterone suppositories or injections to support the uterine lining). Then the wait begins.

Step 5: The Two-Week Wait

Approximately 10–14 days after transfer, you will have a blood test (beta-hCG) to determine if you are pregnant. This is universally considered the hardest part of IVF — not because anything is happening medically, but because you cannot influence the outcome and the uncertainty is relentless.

During this time you may experience symptoms that mimic early pregnancy (cramping, breast tenderness, fatigue) — but these can also be caused by the progesterone you are taking. You cannot tell the difference, so do not try to interpret symptoms. Home pregnancy tests can give false results at this stage, so most clinics recommend waiting for the blood test.

If It Works

A positive beta-hCG is wonderful news — but the journey is not over. You will have follow-up blood tests to confirm the level is rising appropriately, then an early ultrasound at 6–7 weeks to confirm a heartbeat. After that, you transition to standard prenatal care with an OB-GYN or midwife. The IVF clinic's involvement typically ends around 8–10 weeks of pregnancy.

If It Does Not Work

A negative result is painful. There is no way around that grief, and you should give yourself full permission to feel it. But a failed first cycle does not mean IVF will not work for you. Success rates are cumulative — each additional cycle adds to your overall probability. Your doctor will review what happened, possibly adjust your protocol, and discuss next steps when you are ready.

If you have frozen embryos remaining, a frozen embryo transfer (FET) cycle is simpler, cheaper, and does not require another stimulation and retrieval — just preparation of the uterine lining and transfer. Many patients ultimately conceive on their second or third transfer.

Doing Your First IVF in Colombia

Everything above applies whether you do IVF at home or abroad. The Colombia-specific considerations:

• Timeline: Plan 14–21 days in Colombia for a complete cycle. You can start stimulation medications at home before flying (some clinics offer this), which shortens your in-country stay.
• Medications: IVF medications are often significantly cheaper at Colombian pharmacies. Your clinic will provide prescriptions you can fill locally.
• Language: Top clinics have English-speaking coordinators and doctors. Communication should not be a barrier.
• Comfort: A comfortable Airbnb near your clinic, good food, and pleasant weather make the process less stressful than doing it in your normal hectic routine at home.
• Post-cycle: You can fly home 2–3 days after transfer. The pregnancy blood test can be done at any lab in your home country.

The Bottom Line

Your first IVF cycle will feel like a lot. It is a lot. But it is also a well-established, well-understood medical process that has helped millions of people become parents. You do not need to understand every detail of the science. You need a good clinic, a clear protocol, and the patience to let the process unfold. The hardest part is not the injections or the procedures — it is the uncertainty. And the only way through uncertainty is forward.

Read more: Cost Guide | Partner's Guide | Two-Week Wait Survival Guide | IVF and Mental Health