The usual description of inflationary fluctuations uses the framework of quantum field theory (QFT) in curved spacetime, in which quantum fluctuations are superimposed on a classical background spacetime. Even for large fluctuations, such as those envisioned during a regime of eternal inflation, this framework is frequently used. In the present work we go one step beyond this description by quantizing both the scalar field and the scale factor of the universe. Employing the Lorentzian path integral formulation of semiclassical gravity we restrict to a simplified minisuperspace setting by considering homogeneous transitions. This approach allows us to determine the dominant geometry and inflaton evolution contributing to such amplitudes. We find that for precisely specified initial scale factor and inflaton values (and uncertain momenta), two distinct saddle point geometries contribute to the amplitude, leading to interference effects. However, when the momenta of both scale factor and inflaton are specified with sufficient certainty, only a single saddle point is relevant and QFT in curved spacetime is applicable. In particular we find that for inflaton transitions up the potential, meaningful results are only obtained when the initial uncertainty in the inflaton value is large enough, allowing the dominant evolution to be a complexified slow-roll solution down from a comparatively unlikely position higher up in the potential.