IVF involves several distinct phases, each with its own physical sensations. Some parts feel like almost nothing, others involve real discomfort, and the hormonal side effects can be surprisingly intense. Here’s what to expect at each stage, from the first injection to the pregnancy test.
The Stimulation Injections
The first phase of IVF lasts roughly 8 to 14 days and involves daily hormone injections to stimulate your ovaries into producing multiple eggs. Most of these are subcutaneous, meaning the needle goes just under the skin of your belly or thigh rather than deep into muscle. The needles are small gauge, similar to what people use for insulin. The sensation is a quick pinch or sting that fades within seconds.
Some medications burn slightly as they go in, especially at larger doses. You may develop small bruises or red spots at injection sites, particularly if you inject in the same area repeatedly. Rotating sides helps. The “trigger shot,” given 36 hours before egg retrieval to finalize egg maturation, is often described as mild and short-lived, though some formulations require a larger intramuscular needle in the hip or upper buttock. That one you’ll feel more.
The injections themselves aren’t the hard part for most people. The hormones are. As your ovaries respond and follicles grow, you’ll likely notice increasing bloating and abdominal pressure. About one in three people experience symptoms of mild ovarian hyperstimulation during this phase, including bloating, nausea, and weight gain from fluid retention. Your ovaries, normally the size of almonds, can swell to the size of oranges. By the final days of stimulation, bending over, walking quickly, or even sitting in certain positions can feel uncomfortable. Breast tenderness is common. Some people describe the overall feeling as a more intense version of PMS.
What Egg Retrieval Feels Like
Egg retrieval is the most physically invasive part of IVF. A thin needle passes through the vaginal wall into each ovary to suction out the eggs, guided by ultrasound. The procedure takes 15 to 30 minutes depending on how many follicles you have.
You won’t be awake for it in most cases. The standard approach at most clinics is conscious sedation, sometimes called “twilight anesthesia,” where you’re given medications through an IV that make you drowsy and block pain. Many patients remember nothing or very little. Some clinics use general anesthesia. In studies where patients received only local anesthesia (a nerve block near the cervix), they reported average pain scores of about 3 out of 10 vaginally and 4 out of 10 abdominally, so even without heavy sedation, the pain is moderate rather than severe for most people.
What catches people off guard is how they feel afterward, not during. As the sedation wears off, expect cramping similar to moderate period cramps. Some people feel sharp twinges on one or both sides. Spotting is normal. Most clinics have you rest for 30 to 60 minutes before sending you home, and you’ll need someone to drive you.
Recovery After Retrieval
The first three days after retrieval typically involve mild cramping and bloating. For many people this is manageable with over-the-counter pain relief and a heating pad. You’ll likely feel tired and want to take it easy.
Days four through seven are when symptoms can actually peak rather than improve, which surprises people. Bloating may feel more pronounced, and you might gain one to two kilograms (roughly two to four pounds) from fluid. This is the window where mild ovarian hyperstimulation syndrome tends to show up. Constipation is also very common, partly from the procedure itself and partly from the progesterone you’ll start taking.
Most mild cases resolve within 7 to 14 days. Your symptoms will gradually ease as your next menstrual cycle approaches, or sooner if you’re doing a frozen embryo transfer and aren’t pregnant that cycle. Watch for warning signs of more serious hyperstimulation: rapid weight gain (more than a kilogram per day), severe abdominal pain, difficulty breathing, or noticeably decreased urination. Severe OHSS is uncommon but requires medical attention.
The Embryo Transfer
After the intensity of stimulation and retrieval, the embryo transfer feels anticlimactic. Most people compare it to a Pap smear. A speculum is placed, the cervix is cleaned, and a thin, soft catheter threads through the cervix to deposit the embryo into the uterus. The whole thing takes five to ten minutes.
You may feel mild pressure or a slight cramp when the catheter passes through the cervix, but many people feel nothing at all. No sedation or anesthesia is needed. You’ll typically lie still for a few minutes afterward, then go home. There’s no recovery period in the traditional sense. Some people report mild cramping or spotting in the hours that follow, but physically this is the easiest step of the process.
The Two-Week Wait
The roughly 10 to 14 days between embryo transfer and your pregnancy blood test may be the most physically confusing part of IVF. During this time, you’ll be taking progesterone supplements, either as vaginal suppositories, capsules, or intramuscular injections in oil. These hormones are necessary to support a potential pregnancy, but they also create symptoms that perfectly mimic early pregnancy.
Progesterone can cause bloating, breast tenderness, fatigue, nausea, headaches, and mood swings. If you’re taking it orally, drowsiness is especially common. The intramuscular oil injections, given in the upper buttock, can leave sore lumps at the injection site that build up over days and weeks. Many people apply warm compresses afterward to help the oil absorb.
The cruel irony of this phase is that every symptom you feel could mean the treatment is working or could simply be the medication. Cramping might be implantation or just progesterone. Nausea might be early pregnancy or a drug side effect. There is genuinely no way to tell the difference from symptoms alone, which makes this stretch emotionally grueling even though it’s not physically the hardest part.
The Emotional and Physical Toll Overall
People often ask about IVF pain as a purely physical question, but the physical and emotional experiences are deeply intertwined. Hormone fluctuations during stimulation can cause irritability, anxiety, and sudden tearfulness that feel disproportionate to what’s happening around you. These are real neurological effects of the medications, not a sign that you’re not handling things well.
Sleep can be disrupted by bloating, injection soreness, and anxiety. The monitoring schedule alone, with blood draws and ultrasounds every one to three days during stimulation, creates a rhythm of early morning clinic visits that wears on you. Each appointment brings information that can shift your emotional state: follicle counts, hormone levels, embryo development reports.
Physically, most people describe the overall experience as uncomfortable rather than painful. The worst moments tend to be the post-retrieval bloating and the intramuscular progesterone injections over time. But the cumulative effect of weeks of injections, hormonal side effects, medical appointments, and uncertainty is what most IVF patients say they were least prepared for. If you’re going into a cycle, giving yourself generous room to rest and feel off for a few weeks is the most practical thing you can do.