Journey

The IVF journey, stage by stage.

IVF moves through nine stages, with a branch for when plans change. Follow the path to see what patients go through at each stage, and what OvaFlow helps the clinic team keep track of.

Walk the journeyNew to IVF? Start here

The path

Read it top to bottom, or open any stage

Each stage has a line for patients and families, and a line for clinicians on what OvaFlow tracks there. The dashed branch is part of the journey, not a failure state.

Tip: use the arrow keys to move between stages, Enter to open one.

Stage 01
Referral & intake
For patients and families
Your clinic learns why you are seeking care, who is involved, and what has to happen first.
What OvaFlow tracks here
OvaFlow tracks the reason for care, each person's role in the plan, and urgent preservation windows with an owner on both teams.
Stage 02
Workup & readiness
For patients and families
Tests, consents, coverage and medications are lined up before a cycle begins.
What OvaFlow tracks here
OvaFlow tracks each person's workup, the sperm-source prerequisite, PGT-M preparation, consent, benefits and allergy reconciliation, with clinical and financial readiness shown side by side.
Stage 03
Stimulation & monitoring
For patients and families
Daily injections help several follicles (fluid-filled sacs that may each contain an egg) grow at the same time, with regular scans and blood tests to check progress.
What OvaFlow tracks here
OvaFlow tracks expected outside results, monitoring notes and their save check, dose changes handed to the clinic's own e-prescribing, and pharmacy fulfillment before stim.
Stage 04Flagship story
Trigger
For patients and families
A timed injection finishes egg maturation, so the retrieval about 36 hours later lines up.
What OvaFlow tracks here
OvaFlow tracks the signed trigger instruction across changes and the daylight-saving clock change, the right chart, the publication outcome, the patient's reported time, and who owns the evening callback.
Stage 05
Retrieval & recovery
For patients and families
Eggs are collected in a short procedure, and the care team checks in on your recovery afterward.
What OvaFlow tracks here
OvaFlow tracks the whole procedure team's commitment, anesthesia questions, a named discharge owner, post-retrieval symptoms, outside emergency visits and a change to freeze-all.
Stage 06
Embryology & PGT
For patients and families
In the lab, eggs are fertilized and embryos develop; some families also choose genetic testing.
What OvaFlow tracks here
OvaFlow tracks PGT-M readiness, lineage across biopsies, development endpoints, amended PGT reports, label and barcode stops, and culture-media lot recalls.
Stage 07
Transfer
For patients and families
An embryo is placed in the uterus, fresh or after freezing, on a date your clinician confirms.
What OvaFlow tracks here
OvaFlow tracks provisional versus signed transfer dates, exact-embryo warming authorization, day-of deferral, failed-survival decisions and attempt-specific clearance.
Stage 08
Pregnancy & OB graduation
For patients and families
After a positive test, the clinic follows early pregnancy until your obstetric team takes over.
What OvaFlow tracks here
OvaFlow tracks the positive beta, pregnancy of unknown location, viability and the luteal plan, and an OB transfer that counts only when the OB accepts.
Branch
When plans change
This branch can open at almost any point. A return happens on the patient's timing, often to planning, a frozen transfer, or long-term storage choices.
For patients and families
If treatment pauses, stops or doesn't work, your care team changes the plan with you, at your pace.
What OvaFlow tracks here
OvaFlow tracks cancellation, conversion to freeze-all, unsuccessful cycles, loss, a chosen pause and a patient-led return, and stops prompts that no longer fit.
Stage 09
Cryo & long‑term
For patients and families
Frozen eggs or embryos can stay in storage for years, and the clinic keeps in touch with you about your choices.
What OvaFlow tracks here
OvaFlow tracks shipment versus clinical-use clearance, arrival reconciliation, contact history, conflicting disposition instructions, donor health updates and emergency relocation.

Clinical cadence & handoffs

How an IVF episode moves across time, teams and systems

An IVF episode is not a single visit—it is a sequence of timed handoffs between the patient at home, nursing coordination, the clinic's own EMR, the embryology lab, and outside genetics or obstetric care.

Four connected care settings

How a signed change or lab result moves across home, nursing, the EMR and the lab

01Home & phone
Patient & family
iPhone, Apple Watch & companion
12-hour instructions with AM/PM and calendar date, pre-dose questions, self-reported injection times, and Lock Screen privacy.
What holdsOld links blocked · Questions never mark a dose taken
Outside genetics & OB link
Patient sees clear next steps before genetics or obstetric transitions.
02Day & on-call
Nursing coordination
Daytime & evening nursing worklists
Expected morning ultrasound and satellite hormone results, afternoon dose callbacks, and explicit shift-to-shift handoffs.
What holdsExpected labs tracked · Viewing is not accepting
Outside genetics & OB link
Nursing tracks outside lab requisitions and OB referral acceptance.
03System of record
Physicians & clinic EMR
Authoritative chart & e-prescribing
Cycle readiness sign-off, flowsheet monitoring notes, versioned trigger orders, and amended genetics report review.
What holdsWrong-chart stop · EMR save check · Prescribing stays in EMR
Outside genetics & OB link
Physicians sign off on amended PGT reports and OB graduation packets.
04Bench & tanks
Embryology & cryo lab
Electronic witnessing & tank inventory
Gamete pairing, Day 1–7 culture, two-biopsy embryo lineage, single-embryo warming, and cane-by-cane cryo custody.
What holdsLabel mismatch stop · New decision if warming fails
Outside genetics & OB link
Lab links biopsy tubes to reference genetics and remaining frozen embryos.

↺ When plans change (opens from Stages 03–08 · returns at the patient's pace)

Canceling stimulation, converting to freeze-all, repeating a biopsy, experiencing a loss, or choosing a pause cleans up future bookings and silences routine reminders across all four settings while keeping private support open.

Clinical durations and custody rules reflect published SART, ESHRE, HFEA, NICE, SMFM and ASRM guidance; individual cycles vary by protocol and medical history.

Stage-by-stage timing, patient focus & critical clinic handoff (all 10 stages)

Stage	Typical window	What patients navigate	What the clinic & lab verify	What holds before the next step
01Referral & intake	24–72h urgent · 1–3 wks routine	Sharing reason for care, family roles, and any oncology start date	Pathway selection, separate participant charts, oncology–REI window	Accepted retrieval window & role-specific charts
02Workup & readiness	2–6 wks (4–12 wks w/ PGT-M)	Hormone/infectious labs, uterine scan, consents, medication delivery	Sperm-source check, PGT-M lab acceptance, allergy & PA reconciliation	All-green readiness gate before Day 1
03Stimulation & monitoring	8–12 days · Scans q1–3d	Nightly injections, morning scans & blood draws, afternoon dose calls	Expected outside lab tracking, EMR flowsheet save check, e-Rx routing	Verified lab + saved note before dose call
04Trigger	Exact minute · 35–36h pre-retrieval	Taking the maturation shot at the exact signed evening time	DST-aware interval check, wrong-chart stop, reported-time delta, on-call accept	Signed v3 published + explicit evening callback owner
05Retrieval & recovery	15–30m procedure · 7d recovery	Sedated egg collection, recovery rest, home symptom check-ins	4-team slot commitment, named Day 1 nurse, OHSS routing & freeze-all sync	4-team commitment + named discharge owner
06Embryology & PGT	Days 0–7 culture · 1–3 wks PGT	Day 1 fertilization update, Day 5–7 blastocyst & genetic testing results	Witnessed ICSI/insemination, biopsy lineage, amended PGT sign-off, lot trace	Embryo-level biopsy lineage & physician PGT review
07Transfer	2–3 wks prep · 15m placement	Natural or programmed lining prep, ultrasound-guided embryo placement	Provisional vs signed date, exact-embryo warming ID, per-attempt clearance	Single-embryo warming auth + non-survival hold
08Pregnancy & OB graduation	9–14d beta · Wks 8–10 OB handoff	Beta-hCG blood tests, early ultrasounds, luteal taper, first OB visit	Active PUL surveillance, luteal stop dates, OB acceptance confirmation	Fertility clinic owns care until OB accepts
09Cryo & long-term	Months to 10+ years	Annual storage choices, inter-clinic shipping, future sibling planning	Shipping vs clinical-use gate, cane manifest check, conflict holds, donor updates	Shipment ≠ use + fee payment = active contact
↺When plans change	Opens anytime · Patient-paced	Stepping back, converting to freeze-all, or grieving a loss without pressure	Order/booking cleanup, prompt suppression, private callback, context return	Prompts silenced + pause kept during support

Frequently asked questions

How the IVF timeline and OvaFlow's boundaries work together

How long does a complete IVF cycle usually take from initial consult to pregnancy test?

While every family's path is individualized, initial diagnostic workup and insurance or genetics preparation typically take 2 to 6 weeks (or 4 to 12 weeks when custom single-gene PGT-M test development is needed). Once ovarian stimulation begins, daily hormone injections and monitoring last about 8 to 12 days, followed by the trigger injection and egg retrieval 35 to 36 hours later. Embryos develop in the lab for 5 to 7 days. A fresh transfer takes place right after culture with a pregnancy blood test (beta-hCG) 9 to 14 days later, whereas a frozen embryo transfer (FET) cycle adds 2 to 4 weeks for PGT results and endometrial preparation.

Sources: [6] SART Patient Guide (2026) · [5] ESHRE Guideline Group (2026) · [7] HFEA Patient Guide (2026)

Why do so many IVF episodes involve both a retrieval cycle and a separate frozen embryo transfer (FET) cycle?

Modern vitrification (flash-freezing) allows blastocysts to be preserved with high survival rates. Clinicians frequently recommend freezing embryos and transferring in a subsequent cycle when preimplantation genetic testing (PGT) is planned, when ovarian response carries a risk of ovarian hyperstimulation syndrome (OHSS), or when hormone or endometrial factors favor letting the body return to baseline before transfer.

Sources: [8] ASRM Practice Committee (2024) · [11] Wei et al. (The BMJ) (2026) · [6] SART Patient Guide (2026)

Where does OvaFlow sit in relation to the clinic's Electronic Medical Record (EMR) and lab systems?

OvaFlow is a workflow and coordination layer that works alongside the clinic's own EMR, e-prescribing tool and embryology witnessing system. Physicians still sign orders and prescriptions in the clinic's own systems, and embryologists still witness specimens at the bench; OvaFlow tracks expected results, cross-team commitments, versioned changes, wrong-chart stops and explicit handoffs across those surfaces.

Sources: [18] ONC SAFER Guides (2025) · [9] ASRM Practice Committee (2022)

Why is 'When plans change' shown as a connected branch rather than an error state?

In real reproductive medicine, converting a fresh transfer to freeze-all, canceling stimulation for abnormal response, repeating a biopsy, or taking a personal pause after an unsuccessful attempt are standard clinical pathways—not software exceptions. Treating plan changes as a connected branch ensures downstream bookings are cleaned up, automated reminders stop immediately, and patients can return on their own timing.

Sources: [17] ASRM & ESHRE (2015–2026) · [13] NICE Guideline 126 (2026)

Primary clinical & operational references across the IVF journey (18 sources)

[1]
ASRM Practice Committee (2026) — Fertility evaluation of infertile women: a committee opinionTailored, parallel evaluation of each participant rather than a single generic infertility intake.
[2]
ASRM Practice Committee (2026) — Fertility care and family building for LGBTQ+ individuals: a committee opinionDonor-assisted and reciprocal IVF pathways with distinct gamete-contributing, gestational and legal roles.
[3]
ASCO & NICE (2025–2026) — Fertility Preservation in People With Cancer (ASCO Guideline Update) & NICE Guideline 257Time-critical oncology referrals and coordinated retrieval windows before gonadotoxic therapy.
[4]
ASRM Practice Committee (2023) — Indications and management of preimplantation genetic testing for monogenic conditions (PGT-M)Custom single-gene test design, family DNA samples, reference-lab acceptance before stimulation, and non-portability of amplified biopsy DNA across labs.
[5]
ESHRE Guideline Group (2026) — Guideline on Ovarian Stimulation for IVF/ICSI (v2.3 update)Individualized gonadotropin stimulation, ultrasound and estradiol monitoring cadence, trigger criteria and luteal phase support.
[6]
SART Patient Guide (2026) — ART Step-by-Step Guide: Oocyte Retrieval and Embryo Transfer8–12 day stimulation window, 35–36 hour trigger-to-retrieval interval, 15–30 minute sedated retrieval, Day 5–6 blastocyst culture and progesterone support.
[7]
HFEA Patient Guide (2026) — In vitro fertilisation (IVF) and Pre-implantation Genetic Testing (PGT-M / PGT-SR)Plain-language overview of IVF stages, embryo grading, single embryo transfer and genetic testing options.
[8]
ASRM Practice Committee (2024) — Prevention of moderate and severe ovarian hyperstimulation syndrome (OHSS): a guidelineRisk factors, alternative trigger strategies, post-retrieval symptom surveillance and elective freeze-all conversion.
[9]
ASRM Practice Committee (2022) — Comprehensive guidance for human embryology, andrology, and endocrinology laboratories: management and operationsContinuous specimen witnessing, chain of custody, culture-media lot traceability, warming authorization and cryostorage records.
[10]
ASRM Practice Committee (2026) — Intracytoplasmic sperm injection (ICSI) for non-male-factor indications: a committee opinionDistinguishing selected indications for intracytoplasmic sperm injection (ICSI, injecting a single sperm into an egg) from conventional insemination.
[11]
Wei et al. (The BMJ) (2026) — Natural ovulation versus programmed regimen before frozen embryo transfer in ovulatory women: multicentre randomised clinical trialComparison of natural-ovulation and programmed frozen embryo transfer (FET) scheduling anchors, monitoring cadence and cancellation trade-offs.
[12]
ASRM Practice Committee (2022) — Recommendations for practices using gestational carriers: a committee opinionIndependent legal clearance, separate medical charts and attempt-specific clearance before embryo transfer.
[13]
NICE Guideline 126 (2026) — Ectopic pregnancy and miscarriage: diagnosis and initial management (updated June 2026)Active surveillance for pregnancy of unknown location (PUL) until definitive diagnosis, symptom escalation and compassionate loss follow-up.
[14]
SMFM Consult Series #60 (2024) — Management of pregnancies resulting from in vitro fertilizationStructured transition summary from fertility care to obstetrics, including embryo transfer details and prenatal screening counseling regardless of prior PGT.
[15]
21 CFR Part 1271 & ASRM (2024–2026) — eCFR Title 21 Part 1271 Subpart C (Donor Eligibility) & ASRM Guidance Regarding Gamete and Embryo DonationSeparation of physical transport release from clinical-use eligibility and longitudinal routing of donor medical updates.
[16]
ASRM Ethics & Practice Committees (2020–2021) — Disposition of unclaimed embryos (2021) & Cryostorage of reproductive tissues in the IVF laboratory (2020)Storage fee payment as active contact, multi-channel outreach before any unclaimed status, and holds on conflicting disposition instructions.
[17]
ASRM & ESHRE (2015–2026) — ESHRE Routine Psychosocial Care in Infertility & ASRM Recurrent Implantation Failure (2026)Structured post-cycle review, suppression of automated treatment prompts during a pause or loss, and patient-paced return.
[18]
ONC SAFER Guides (2025) — Test Results Reporting and Follow-Up & Contingency PlanningClosed-loop tracking of expected diagnostic results from order to clinician review and downtime reconciliation.

Stories

The same path, through one person's eyes

Five fictional stories follow patients and the clinic team across these stages.

Fictional patient data

Daily careOct 30, 16:45 → 20:28 PDT
One afternoon, one evening, every next step in view
A late result, a signed change, the wrong chart, an unknown outcome and an evening handoff.
8 chaptersStimulation · Trigger
Elena RiveraOne stimulation cycle
Elena: from monitoring to a change of plan
Monitoring, a changed trigger, retrieval, symptoms afterward and a move to freeze-all.
7 chaptersStimulation · Trigger · Retrieval · Plans changeIncludes a care note
Maya ChenSeveral months
Maya: a pause, at her pace
A consult, private support, an attempt that doesn't succeed, a chosen pause and a return.
7 chaptersIntake · Plans changeIncludes a care note
Jordan PatelEmbryology and genetic testing
Jordan: every sample matched to the right embryo
A label that doesn't match, an accession hold, an amended report and lineage across biopsies.
6 chaptersTrigger · Embryology · Cryo
Avery & SamAcross two transfer attempts
Avery & Sam: two people, two charts, the right consent
Separate roles, a consent form moved to the right chart, and clearance for one attempt at a time.
3 chaptersIntake · Workup · Transfer