In Vitro Fertilization: IVF Sample Calendar - Step by Step

The sample schedule and calendar for IVF shown below is for a stimulation using the Lupron down regulation protocol (without taking birth control pills).

The main steps in an IVF cycle are shown on the calendar. For details see:

Overview of IVF stimulation

Details about antagonist IVF protocols - using Ganirelix or Cetrotide

Details about the Lupron flare protocols - also called microflare

In vitro fertilization

IVF procedures

This sample in vitro fertilization cycle shows a schedule with the days various medications are taken and timing of ovarian stimulation monitoring and IVF procedures.

The schedule shown here if for a woman with a typical 28 day menstrual cycle. Birth control pills are not being used to control her cycle in this example.

For IVF cycles where we use a birth control pill, we usually give 12-21 days of active pills and overlap the Lupron with the last 3 birth control pills. A period starts within a few days after the last pill is taken and we start ovarian stimulation injections soon thereafter.

Key to table:

Blood and ultrasound = blood test for IVF hormone values (estrogen levels in IVF stimulation are important) and transvaginal ultrasound to measure the follicle sizes in the ovaries. These visits usually take about 20-30 minutes in our offices and can be scheduled as early as 6:30AM.

Lupron = subcutaneous injection of a medication called Lupron (GnRH agonist). This medication is taken once daily.

FSH = subcutaneous injection of a medication containing follicle stimulating hormone (FSH), which causes follicles containing eggs to develop in the ovaries.

HCG injection = subcutaneous or intramuscular injection of a medication called HCG, which causes the eggs to complete the maturation process. This is taken only once in the cycle.

Progesterone = vaginal cream or suppositories or intramuscular injection of a medication (female hormone) called progesterone. This drug helps to prepare a receptive uterine lining for embryo implantation.

Egg retrieval procedure = the procedure that obtains eggs from the ovaries

Embryo transfer procedure = the procedure that places embryos back in to the uterine cavity

The example above is a typical IVF cycle. Most patients will need about 4 visits for monitoring the stimulation (shown as "Blood and Ultrasound" on the calendar) before they get the HCG trigger shot. Some patients will need only 3 monitoring visits and some require 5 or 6 visits. It depends on the woman's response to the medications.

The duration of the ovarian stimulation process can be shorter or longer than that shown above. The example above shows 8 days of stimulation drugs (FSH shots) before the HCG trigger shot. The average number of days of taking the FSH injections is 9-10, with the general range being 7-14.

IVF Due Date Calculator

As far as calculating a due date after IVF, the most accurate method is to add 266 days (or 38 weeks) to the day of the egg retrieval. The eggs are fertilized that day, which is the same as "day 14" - the day of ovulation and fertilization in a "normal" 28 day menstrual cycle. Adding the 14 days to the 266 days gives 280 days, or 40 weeks. The due date is traditionally set at 40 weeks from the first day of the last menstrual period in a normal pregnancy (in a woman with 28 day cycles).

At our IVF clinic, we use an Excel spreadsheet to calculate the exact due date for our pregnant IVF patients. We enter the date of the egg retrieval procedure and the spreadsheet adds 266 days and gives us the "due date", or EDC (estimated date of confinement). To do this manually with a calendar - count 38 weeks from the day of the egg retrieval to get the due date after IVF.

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