On the shared calendar, your employee’s week looks ordinary: a team meeting on Monday, a deadline on Thursday, a client call on Friday. Underneath it runs a second calendar that nobody on the team can see, set by a clinic and by how her body responds to medication.
A full IVF cycle takes around 3 to 6 weeks, according to the NHS. This article lays that hidden calendar over the working one, step by step, so a manager can see what each stage means for work and what actually helps. If you’re new to the topic, start with our five things every HR team should know about IVF.
Why don’t IVF appointments follow your schedule?
Most medical appointments are booked weeks ahead. IVF appointments are booked by the body.
During the stimulation phase, the clinic tracks how the ovaries respond with blood tests and ultrasound scans, as the HFEA explains. Each result decides the medication dose and the date of the next visit, so the schedule for the coming week often isn’t known on Monday.
The most important date is set last. When the eggs are nearly ready, the patient takes a final “trigger” injection, and egg collection follows about 36 hours later. In practice, your employee may learn the date of collection only a day or two before it.
Short notice is built into the treatment. A manager who knows that in advance can plan around it instead of being caught out by it.
The cycle, week by week
The picture below shows the whole cycle at a glance. Only two days, egg collection and embryo transfer, are fixed days that need cover. The rest of the cycle needs flexibility and discretion.
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What follows walks through a typical cycle, one stage at a time. It is an illustration, not a medical protocol: clinics use different approaches, and no two cycles look exactly alike.
Before treatment starts
Before a cycle begins, there are consultations, blood tests and scans. These appointments are usually spread over several weeks and booked well ahead, so they are the easiest part to plan around.
Treat them like any other medical appointment. The kindest thing a manager can do at this stage is not to ask what the appointment is for.
Suppression: pausing the natural cycle
Some protocols, though not all, start by switching off the body’s natural cycle. That means a daily injection or nasal spray for 2 to 3 weeks, followed by a scan to check it has worked.
At work, this often looks like nothing at all. Your employee may need to take medication at a set time, sometimes during the working day, and will want a private moment to do it. Letting them step away without explaining is enough.
Stimulation: the busiest weeks
Next come daily hormone injections for about two weeks, to help the ovaries produce several eggs. During this time the clinic tracks progress with blood tests and scans, and each result decides when the next visit will be.
This is where most short-notice requests come from. Monitoring visits are usually early in the morning and are often confirmed only a day or two ahead. A standing agreement that your employee can start later on clinic days, without asking each time, removes most of the friction. If you can, avoid booking their key meetings first thing during these weeks.
Egg collection day
When the eggs are ready, they are collected under sedation. The procedure itself takes about 20 to 30 minutes, and afterwards your employee may feel sore or bruised. If there is a partner, they usually give a sperm sample on the same day.
This is one of only two fixed days in the cycle, and it should be treated as a full day off. The date is often confirmed at short notice, so it helps to agree on cover in advance and simply switch it on when the day is set. If the partner also works for you, they will need the day too.
One safety note: if an employee feels unwell after egg collection, for example with tummy pain or bloating, the priority is to call their clinic. The NHS lists these as possible signs of ovarian hyperstimulation syndrome (OHSS), an uncommon reaction to fertility medication.
The lab days
For the next few days, the work happens in the laboratory, where the eggs are fertilised and the embryos are watched as they develop. The clinic calls the day after collection to say how many embryos there are. (If you’re curious, here is more on what happens in the IVF lab and how embryos are graded.)
Physically, these are ordinary days. Emotionally, they can be among the hardest, because so much depends on a phone call. A lighter workload helps, and so does not asking how it’s going.
Embryo transfer
Two to five days after fertilisation, an embryo is placed in the womb through a thin tube. It is quick and usually needs no anaesthetic.
This is the second fixed day. The appointment is short, but it cannot be moved, so plan cover as you did for egg collection. In the UK, it also marks a legal turning point: from embryo transfer, the employee has the same rights as a pregnant worker, as Acas explains. Managers should know this, even if nobody has said the word “pregnant”.
The two-week wait
The pregnancy test comes about 16 days after the transfer. For those two weeks, your employee will usually work normally while living with a great deal of uncertainty.
The HFEA’s guidance on emotional support stresses how much support from others matters during treatment. At work, support mostly means restraint. Don’t ask whether there is news. If they want to share, they will.
The result
A positive test leads to a scan at around seven weeks of pregnancy. A negative test needs time to recover from, and many experts recommend waiting a couple of months before trying again.
Either way, your employee may need some time. A negative result can bring real grief, and the decision about what comes next can take a while. Offer time off without conditions, and let them decide how much to tell you. Our guide on what to do when a cycle doesn’t work explains the options they may be weighing.
Not every cycle looks like this
Many people go back for a frozen embryo transfer, using an embryo saved from an earlier cycle. There is no stimulation and no egg collection, and the transfer can usually be planned well in advance. With IVF using donor eggs, the employee’s calendar centres on preparing for the transfer, not on collecting eggs. And for intended parents through surrogacy, the pregnancy happens in someone else’s body, often in another country, so the busy weeks come at different points. We cover that in supporting employees through donor conception and surrogacy.
One 15-minute conversation that changes the whole cycle
If your employee chooses to tell you about treatment, one short conversation at the start can save weeks of awkward requests. Agree on three things:
- A flexible start to the day during the monitoring weeks. Clinic visits are often early and booked late, so a standing “come in when you’re done” removes the need to ask each time.
- A cover plan for egg collection day and transfer day. These are the only fixed days off. Decide now who picks up urgent work, so the date can land at short notice without a scramble.
- Who knows, and how they want to keep in touch. Agree who on the team, if anyone, is told, and whether they’d rather send a quick message or call when plans change.
And one rule for the whole cycle: don’t ask about the result. Wait to be told.
When managers can see the calendar, they stop improvising
A manager who understands the rhythm of a cycle doesn’t need medical details to get it right. They can plan cover for two fixed days, stay flexible for the rest, and leave the questions unasked.
At Family By Choice, we help managers have this conversation with confidence, through short guides and training for HR teams and line managers, alongside clear courses employees can use privately.
Want your managers ready for this conversation? Book a free consultation with us. We’ll show you how Family By Choice works for HR teams, managers and employees, and why it can make a hard time easier for your people. No obligation, just a conversation.
