Before you start
IVF starts with a conversation, not a needle. At your first visit we talk through your history and your goals, then order testing: bloodwork, an ultrasound of your ovaries and uterus, often an evaluation of the uterine cavity, a semen analysis if sperm from a partner is part of the plan, and genetic carrier screening. These results shape your protocol, which is the specific recipe of medications and timing we use for you.
This phase can feel slow when you’re ready to go. I get it. But the testing is how we avoid surprises later, and it’s where a lot of the real thinking happens.
Stimulation: about two weeks
Stimulation is the stretch where you take hormone medications so that several eggs mature at once. Here is roughly how it feels:
- Days 1 to 4. Mostly uneventful. The first injection is often the scariest one, and then it becomes routine. Many people do them in under a minute.
- Days 5 to 8. Monitoring visits pick up. You’ll come in early in the morning for an ultrasound and blood draw, then get a call that afternoon with any dose changes. Waiting for that call is its own kind of emotional exercise.
- Days 9 to 12. This is when you feel it. Bloating, a full or heavy feeling in your lower belly, tender breasts, and some moodiness are common. Loose clothes help. So does lowering your expectations of yourself for a few days.
- Trigger night. When your follicles are ready, you take a final “trigger” medication at a precise time. It is oddly exciting.
Retrieval day
About a day and a half after your trigger, we retrieve the eggs. You’re sedated, so you won’t feel the procedure, which usually takes around 20 minutes. Afterward, expect some cramping and fatigue. Plan a quiet day on the couch. Most patients are back at work within a day or two.
The embryology updates
Your embryology updates come from me, not from a lab you’ve never met. I’ll call you the day after your retrieval to tell you how many eggs were mature and how many fertilized. About a week later, I’ll call again with how many embryos grew to the blastocyst stage and were ready for biopsy. Not every egg becomes an embryo, and not every embryo keeps growing. That narrowing is expected biology, but it can still feel like a gut punch. I’ll walk you through your numbers on each call so you know what’s normal and what isn’t.
Some patients choose genetic testing of embryos (PGT). It can help some people, and it isn’t necessary for everyone. We’ll decide together.
Watch on Instagram: Dr. Rasouli on egg freezing
The transfer
Many transfers today use a frozen embryo in a later cycle, which lets your body recover and lets us time your uterine lining carefully. The transfer itself feels a lot like a Pap smear. There’s no anesthesia, it takes just a few minutes, and the most uncomfortable part is often the full bladder we ask you to have for the ultrasound.
In most cases, I recommend transferring one embryo at a time. It’s the safest path for both you and the baby.
The two-week wait
Then you wait about ten days for a pregnancy test. Honestly, this is the hardest part for most people. You’ll analyze every twinge. Try to keep your normal routine, lean on someone you trust, and give yourself permission to take a break from the internet. Bed rest isn’t necessary and hasn’t been shown to help.
Fewer needles, and needle-free options
Injections are the part of IVF people dread most, so let’s talk about ways to reduce them:
- Protocols built around oral medication. For some patients, pills can replace part or all of the injectable medications. These gentler protocols usually produce fewer eggs per cycle, so they fit some situations well and others less well.
- Simpler injection schedules. Some medications combine steps or come in pens that make injections quicker and less intimidating.
- Progesterone without the big shots. After transfer, progesterone support can often be given vaginally rather than as an intramuscular injection.
Needle-free IVF isn’t the right fit for everyone, but if needles are a real barrier for you, tell me. It’s a valid concern, and we’ll look at what’s realistic for your body and your goals.
You are more than a cycle
IVF asks a lot of you physically and emotionally. I care about the whole picture: how you’re eating, moving, sleeping, and coping, not just what your follicles look like. If you’re in Newport Beach, Irvine, Costa Mesa, or anywhere in Orange County, I’d love to help you through it.
Questions Patients Ask Me
How long does one IVF cycle take?
Stimulation usually lasts about 10 to 14 days, and retrieval follows shortly after. Including testing and preparation, most people go from first consult to retrieval in one to two months. If you do a frozen embryo transfer, that happens in a later cycle, often a few weeks afterward.
Do I have to do shots for IVF?
Most standard IVF protocols use injections, but there are ways to reduce them. Some patients can use oral medication protocols, and progesterone after transfer can often be vaginal instead of an intramuscular shot. Ask me about needle-free or lower-injection options at your consult.
Can I keep working during IVF?
Most people do. Monitoring visits are short and early in the morning. The day of retrieval is a rest day, and many people take the next day off as well. The transfer takes only a few minutes.
How many embryos should I transfer?
For most patients I recommend one embryo at a time. Transferring two raises the chance of twins, which carries more risk for both mother and babies, without a large boost in the chance of having a baby for most people.
What are my chances of IVF working?
Age is the biggest factor, along with your diagnosis and embryo quality. National averages exist, but I’d rather give you an estimate based on your own testing. After a cycle, we review your results together and update that estimate.
If my IVF cycle doesn’t work, did I do something wrong?
Almost never. Most IVF outcomes come down to egg and embryo biology, not anything you ate, lifted, or worried about. If a cycle doesn’t work, we review what we learned and adjust the plan.