When I Can Start IVF Treatment?

In Vitro Fertilization (IVF) is an assisted reproductive treatment in which eggs and sperm are fertilized in a laboratory and the resulting embryo is transferred into the uterus.

Many couples ask:
“When should I start IVF treatment?”
The answer depends on age, diagnosis, previous treatments, and reproductive health history.

IVF is not started randomly. It follows a structured medical evaluation and individualized planning.

What Is IVF Treatment?

IVF treatment includes:

• Ovarian stimulation with hormonal medication
• Egg collection (OPU – Oocyte Pick-Up)
• Fertilization in the laboratory
• Embryo development
• Embryo transfer into the uterus

Fertilization may occur using:

• Conventional IVF (eggs and sperm placed together)
• ICSI (Intracytoplasmic Sperm Injection), where a single sperm is injected directly into the egg

How Is Conventional IVF Performed?

In classical IVF:

• Eggs collected from the woman are placed in a special culture medium.
• Sperm cells are added to the same environment.
• Fertilization occurs naturally in the laboratory setting.
• The healthiest embryos are selected.
• One embryo (or more depending on clinical and legal criteria) is transferred into the uterus using a thin catheter.

How Is ICSI (Microinjection) Performed?

ICSI (Intracytoplasmic Sperm Injection) is preferred in cases of:

• Low sperm count
• Poor sperm motility
• Abnormal sperm morphology
• Previous fertilization failure

In ICSI:

• A single high-quality sperm is selected.
• It is injected directly into the egg using micromanipulation equipment under a microscope.

ICSI is also commonly used in cases such as prior vasectomy or severe male factor infertility.

Evaluation Before Starting IVF Treatment

Before IVF begins, both partners are evaluated to determine the cause of infertility.

For Women:

• FSH, LH, Estradiol (E2), TSH, Prolactin levels (usually measured on day 2–3 of menstruation)
• Ultrasound examination of ovaries and uterus
• Assessment of ovarian reserve

For Men:

• Spermiogram (sperm analysis)
• Evaluation of sperm count, motility, and morphology

Treatment planning depends on:

• Woman’s age
• Ovarian reserve
• Sperm quality
• Cause of infertility

Only after this evaluation is IVF started.

When Should IVF Treatment Be Started?

There is no single answer.

IVF May Be Recommended Immediately If:

• There is a genetically inherited disease requiring embryo testing
• There are infectious diseases such as HIV or hepatitis (to prevent transmission)
• There is severe male factor infertility
• Fallopian tubes are blocked
• Ovarian reserve is critically low

IVF Is Usually Considered If:

• Women under 35 cannot conceive after 12 months of regular unprotected intercourse
• Women over 35 cannot conceive after 6 months

If testing reveals no serious obstacle, other treatments (ovulation induction, IUI) may be tried before IVF.

Do I Need to Be on My Period to Start IVF?

The first consultation and evaluation can be done on any day of the menstrual cycle.

However:

• Hormone tests are usually performed on day 2–3 of menstruation
• Ovarian stimulation medications are typically started during menstruation

IVF Protocols: When During the Cycle Does It Start?

IVF stimulation is performed using either:

Short Protocol

• GnRH analog starts on day 1 of menstruation
• Ovarian stimulation (FSH/hMG) begins around day 2–3

Long Protocol

• Pituitary suppression begins in the previous cycle (around day 21)
• Ovarian stimulation begins on day 2–3 of the new cycle

Both protocols suppress natural hormone signaling first, then stimulate controlled follicle development.

Your physician chooses the protocol based on age, ovarian reserve, and previous response.

Stages of IVF Treatment

Stage 1: Pre-Treatment Evaluation

• Medical history
• Hormonal testing
• Ultrasound
• Sperm analysis

Stage 2: Ovarian Stimulation

• Hormonal medication stimulates multiple follicles
• Monitoring with ultrasound and blood tests

Stage 3: Egg Collection (OPU)

• Performed under sedation
• Guided by transvaginal ultrasound

Stage 4: Fertilization

• IVF or ICSI performed in laboratory
• Embryos cultured for 3–5 days

Stage 5: Embryo Transfer

• Usually performed on day 3 or day 5 (blastocyst stage)
• Quick, typically painless procedure

Implantation usually occurs within 48 hours after transfer.

Beta hCG becomes detectable in blood approximately 10–12 days later.

Frequently Asked Questions (FAQ)

When can I start IVF treatment?

IVF can begin after a complete fertility evaluation. Most stimulation protocols start during menstruation (day 2–3).

Can IVF start immediately after diagnosis?

In certain urgent cases (low ovarian reserve, genetic conditions, severe sperm issues), IVF may begin without delay.

Do I need to wait for my period to see the doctor?

No. The first consultation can happen at any time in your cycle.

How long does IVF treatment take?

A typical IVF cycle lasts about 2–3 weeks from stimulation to pregnancy test.

When is the pregnancy test done after IVF?

A Beta hCG blood test is done about 10–12 days after embryo transfer.