In vitro fertilization: IVF calendar - Step by Step

Key to table:

Blood and ultrasound = blood test for hormone levels and transvaginal ultrasound to measure follicle development in ovaries. These visits usually take about 20 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 woman's ovaries

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

The sample IVF calendar schedule shown above is an example of how the cycle stimulation may evolve. However, some women will need to be monitored more often if they have a high response to the stimulation meds - or less often if the response is slower. The schedule shown here has more than the average number of visits for monitoring the response to ovarian stimulation (shown as "Blood and Ultrasound" on the calendar). The example above is more like a worst case scenario than a typical IVF cycle. Most patients will need 4 visits including the baseline visit before they get the HCG trigger shot. The example shown above has 6 visits.

The ovarian stimulation process can be shorter or longer than that shown above. The example above shows 9 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 about 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.