Top 10 things I wish I knew before starting IVF
IVF can be a lengthy, challenging, and expensive journey. Don’t go into it blind. Walk through this list of 10 lessons many women learn while going through the IVF process. The more you know, the better equipped you will be to navigate the terrain.
1. You will need to be at the clinic a lot!
Doing IVF involves taking fertility medication in the form of injections daily for typically 10 to 12 days, but can be up to 3 to 4 weeks depending on the protocol that your doctor puts you on. In order to see how you are responding, we do an ultrasound (typically vaginal) and bloodwork every two to three days and sometimes even daily towards the end of your stimulation cycle. These require visits to the fertility clinic, usually in the morning.
Ideally, you will be in and out before your workday starts, and many patients do not tell their employers that they are doing fertility treatment. But the truth is that there will be days when you will be late due to a busy clinic or because of delays in getting your bloodwork, ultrasound or injection. So, definitely be prepared to be in the clinic for up to a few hours. If possible, try to have a relaxed schedule or even take a few weeks off during the IVF process to make the process easier on you.
2. The shots are not as bad as you think.
Many women are petrified at the thought of injecting themselves every day, but it’s not as bad as it seems. The needles are small, and oftentimes they can be injected subcutaneously in the belly, and you can do them on your own. If not, your partner or even a friend can help with the injections. (Many partners joke, saying they welcome the thought of jabbing their spouses.) :-)
Fertility nurses are spectacular at explaining how to do the injections, and most clinics have a teaching class or online videos to show you exactly what to do, so that you feel comfortable and confident with the injections. Worst case scenario, most clinics welcome patients to come in daily to get their injection from the nurse.
3. You will feel bloated and moody and even look pregnant.
While the goal of IVF is to grow multiple follicles (ideally, 10 to 20 eggs), this can cause some side effects. These include bloating, nausea, breast tenderness, and some mood changes. Usually, these are mild and abate with the end of the IVF cycle. In some ways, it is preparing you (hopefully) for a pregnancy in the near future, when you might experience similar symptoms! If the symptoms during IVF seem more bothersome, talk to your doctor, because occasionally if you are over-responding to the medication, the symptoms can be more severe.
4. The egg retrieval will go fine!
The egg retrieval is the culmination of the IVF cycle. You have survived the weeks of injections, successfully grown a bunch of follicles, and feel nine months pregnant, and you are ready to get some good eggs out! The egg retrieval is a mini-surgery, but it is not considered dangerous. There is a less than 1% risk of bleeding infection or any other complications.
This is the first “procedure” or “surgery” for most young women, so they are nervous, which is understandable! You will be sedated and get pain medication, so don’t worry; you should not feel pain. The procedure should last at most about 30 minutes, after which you will recover from the anesthesia medication for about an hour and then go home.
5. IVF is expensive!
While you have made the decision to do the fertility treatment with the highest success, don’t be mistaken: It’s a pricey endeavor. One IVF cycle with cycle costs, medication, and additional procedures such as ICSI, PGS, and so on can add up to over $10,000. Many women will require more than one cycle. It is important that you discuss the finances with your partner, family, or supports, and also with the business team at the clinic, so that you feel comfortable with the fees.
Many clinics can help to arrange financing and set up payment plans. We are lucky in Ontario that women under 43 with a valid OHIP card are eligible for funding for one IVF cycle (not including medication or additional IVF procedures). Check with your insurance company if your drug plan can help to cover medication.
6. It’s OK to ask for support!
Undergoing fertility treatment is not easy. The injections are hard, and they’re way harder on the woman than on the man! The fact is that we women are used to being in control and figuring out how to get things done, but dealing with infertility can leave us feeling helpless and even isolated. And once you start IVF, it seems like a very controlled process, but it is normal to still feel out of control.
Remember that you are not the only one going through this! Infertility is common, and many women have been through treatment, success and failures. It is OK to ask for support from your family, partner, and friends. Many clinics have support groups and counsellors available to help you through the process. And, as always, remember that your fertility doctor has your back!
7. There are no silly questions!
It is always OK to ask questions or for clarification of instructions. This is an important process you are going through and often very complicated, with the shots, the timing, the monitoring, and the entire process. Especially after the first visit, when you are armed with a package of medications, and you think you understand what to do, so many questions come up, and that is OK!
Not to mention all of the medical lingo and terms: What is PGS? ICSI? Hatching? Fresh versus frozen transfers? No one expects you to understand everything. Ask your nurse or doctor about any questions you need to clarify the process. There is no question not worth asking, and we welcome any questions or concerns a patient has that can help them through the process.
8. Trust your doctor
Choosing a fertility doctor is an important step. Make sure you choose a physician whom you trust and get along with, because they will be with you throughout the process. They will make a plan, including planning for the IVF stimulation medication, protocols and treatment plans for each month, and you should feel comfortable with these plans and decisions because there are many options you can choose from when it comes to fertility treatment.
In the end, trust your doctor, because they will be with you until you conceive and will tailor the treatment based on your individual clinical situation. Schedule follow-ups as needed to talk to your doctor about changes in the treatment plan and to review prior and upcoming cycles and the test results. IVF is a different ride for everyone. There are so many options to choose from, and your doctor will help you to navigate them. “Do I do a fresh or frozen transfer? Do I do PGS?” “Is time-lapse worth it?” “How many IVF cycles do I need to get pregnant?” Trust your doctor’s advice.
9. Talk to your doctor about family planning.
Every woman or couple has a different life plan. Some women want to freeze their eggs because they are pursuing a career path that will involve schooling for five years then an intense job for three years; some couples want to travel the world before having kids, so embryo freezing would make more sense; and some women want to start having kids in their late 30s, but they want two or three, so IVF might be better than IUI. Talk to your doctor not just about your immediate plans for fertility, but also about your family planning and fertility goals, so that both of you can work together to make a plan that fits your life and treatment goals.
10. You are stronger than you think, and you got this!
Taking charge of your reproductive health and fertility is the first step, and you did it! Now you are undergoing a great tried-and-true treatment in the hopes of conceiving, so great job! You can do this. You have a team of people to support you for anything you need.