Trying. Waiting. Hoping. Praying. Failing. REPEAT.
Many of us here know the deep and intense pain that comes from the little place in your heart created for the child that never comes.
On top of the myriad of emotions brought on by battling infertility itself – there is an additional layer of stress, anxiety, and sadness you may experience while undergoing treatments like in vitro fertilization (IVF).
IVF is emotionally, physically and financially draining. But that’s not what’s at the top of your mind when meeting with your fertility doctor. Your first question will probably be something like: “How can I get pregnant and how soon can we make this happen?”
Things can move very quickly, once you realize IVF is your next step. Time is of the essence – especially when you’re in your late 30’s or dealing with premature ovarian failure. I know that I was very overwhelmed and didn’t ask enough questions. But you can and you should. Here are some of the things I wish I’d known before starting IVF:
- Do your research. I assumed the doctors knew what was best for me. But, for some doctors, the number one goal is to get you pregnant. But at what price? Things that matter to you – like your health and your baby’s health – especially long term – may not be their top priority. So you should know as much as you can about the impact of every drug and procedure, before you move forward.
- There are many different IVF protocols. IVF isn’t a one-size-fits-all treatment for infertility. What and how many prescription stimulation medications you take depends on several factors including: age, diminished ovarian reserve or PCOS. Ask your doctor what all of your options are and specifically why he/she suggests a certain protocol in your case. If I had asked my first fertility doctor more questions and done a little more of my own research, I would not have chosen the protocol he selected for my first round of IVF. He didn’t offer options and I didn’t question it.
- Know Your Fertility Clinic. When selecting your fertility doctor and clinic, ask a lot of questions. Learn about the background of the embryologist- specifically their success rates and experience. Don’t base your decision solely on the clinics success rates. The statistics they publish for pregnancy rates may not have actually produced a baby. Also, they might only be disclosing success rates for patients who are 35 and under. If you are over 35, you should ask for success rates for that particular age group, that resulted in a live birth.
- How Many Embryos? Another area understand and contemplate is how many embryos you’ll want to transfer into your uterus during IVF. Medical research and many experts recommend transferring just one embryo if you are 38 years old or younger. While it would seem like the more you put in, the better your odds. That’s actually not the case. Some couples like the idea of having multiples, especially at a later maternal age when “one and done” seems really appealing. However, there are many risks a multiples pregnancy can have on your health and your babies health.
- Natural IVF. If using fertility drugs is a concern, you might want to look into Natural IVF. This process avoids using hormone injections, by monitoring the patient’s ovulation cycle through blood tests and ultrasounds. The goal is to retrieve just one egg per cycle. So compared to traditional IVF, this protocol has lower success rates and may take more attempts to achieve pregnancy.
- Know the symptoms of OHSS. When you are injecting hormone medications during IVF, to stimulate the development of eggs in your ovaries – there is a risk of over stimulation. Symptoms of ovarian hyperstimulation syndrome (OHSS) typically occur about 10 days after you start taking the injectable drugs. A mild to moderate case might cause abdominal bloating, soreness in the area of your ovaries, sudden weight gain, nausea, vomiting and diarrhea. In a severe case, which is much more rare, symptoms include: major rapid weight gain of more than 10-15 pounds in five to ten days, and severe abdominal pain. If you experience any of these symptoms, call your doctor right away.
- Understand the numbers. With IVF there are a lot of numbers and statistics – especially when it comes to blood test results. You might have already had FSH, Estradiol and Luteinizing Hormone tests – that measure things like your ovarian reserve and egg quality. But once you start IVF, there are even more tests. After my first round of IVF, I got a call with the results of the first HCG blood test and it was only 24. The nurse said the embryo had likely implanted, so I got excited. But I didn’t hear her, or didn’t listen when she said, “it’s still early” and we’ll have to see how the second blood test result comes out. The number dropped after the second blood test, which meant this pregnancy wasn’t going to progress. The news hit me like of ton of bricks. I wasn’t prepared. Here’s what you need to know: a normal HCG level should double every 48 to 72 hours. The faster and higher those levels rise, the better. If by the third blood test, the levels are soaring into the four and five figure range, you have good reason to be optimistic.
- Fertility Drugs are really expensive. Research options for buying your fertility drugs before you start the process. Your fertility clinic may have done some of this work for you. But you should know that there are several options – and you might want to have a little time to shop around for the best price and service. Make sure to find out if the pharmacy is reachable after normal business hours. Also ask if they include literature on how to inject and mix the medications. Even though your clinic will give you a tutorial, when you are home and the office is closed, it’s really nice to have a resource or guide to help you walk through the process in the beginning.
- It’s probably going to be harder than you think. The IVF process is really, really hard on your body and your psyche. I had tunnel vision regarding infertility. My eye was on the end goal – having a baby. I wasn’t prepared, nor did my physicians warn me, about how much pain I would endure – physically and emotionally. If you don’t know anyone who has gone through it, ask questions in our forum – the supportive people in our Talking Fertility community can help.
- Line up your support before your first injection. Because of number #9 and because things move fast when your hormones start raging, meet with a therapist who specializes in treating people with infertility. It is a great idea to begin therapy before you start IVF, so you are in the right frame of mind. Then it’s extremely helpful to have a professional to talk to throughout the process – especially during the two-week wait and in case the procedure fails.
So, I’ll repeat the most important thing to remember here: IVF is not something to jump into without doing your research first. It costs too much – and I don’t just mean financially. If you spent more time researching the last car you bought, than you did on IVF or your fertility clinic – that’s not an ideal situation. While I was ultimately successful in achieving pregnancy through IVF – it took several years and several attempts. If I knew then, what I know now, after all of the research I have done for TalkingFertility.com – my journey would likely have been shorter and much less painful. But then I probably wouldn’t have felt the need to create this website – that offers support, education and the latest information. So my hope is that you can do it better and learn from my mistakes.