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14 Things I Wish I Knew Before Starting IVF

It's a marathon, not a sprint

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To celebrate National Infertility Awareness Week, I’m sharing what I wish I knew before starting IVF (in-vitro fertilization). “Celebrate” might be the wrong word. I can count on one hand the number of things my husband and I have genuinely celebrated since last March when we first met with our fertility clinic. However, I realized recently that simply coming out of every appointment, procedure and follow-up call alive is a cause for celebration. This process is physically, emotionally and mentally exhausting. But I’m doing it, one day at a time. If you are in it too, or are about to be in it, or are considering it, I’d like to share some things I’ve learned doing IVF.

Another reason I’m sharing my experience is that everyone’s process is different. When I started fertility stuff, I Googled “what to know before IVF” and found hundreds of different warnings, tips and tools. Some have been spot on for me, others were way off. So, if even one part of my unique experience makes you feel less alone during this process, mission accomplished. If none of them ring true, that’s OK.

Finally, here’s where I’m coming from: I’m a 36-year-old cis white woman who started trying when I was 34. My husband is the same age. We’ve done three intrauterine insemination (IUI) procedures, three rounds of IVF with embryo banking and one unsuccessful transfer. We have five embryos left in the bank, four of which look good. We’ve been diagnosed with “unexplained infertility,” which means the clinic cannot point to any factor, male or female, preventing me from getting pregnant.

I’m writing down what I’ve learned to remind myself and hopefully to encourage others going through it. 

1. Everyone’s Getting Pregnant—Except Me

While trying to get pregnant, it feels like literally everyone is getting pregnant before me. My younger sister and one of my best friends had babies a week apart while I was in my third IUI cycle. Another friend got pregnant naturally twice in less than two years. Two ex-boyfriends became doting fathers. At first, I felt fine about other people’s milestones (I get to be an aunt!). As time went on and I kept encountering set-backs, seeing pregnancy announcements—childhood friends, cousins—started to sting.

It’s OK to be upset when other people get pregnant. Yes, they are allowed to celebrate their moment (who knows how long they tried before a successful pregnancy?). You’re also allowed to feel sad, angry, annoyed or any combination of emotions. When I heard about an acquaintance who got pregnant after a one night stand and embraced becoming a mother, I felt offended at how unfair it was.

2. Edit Those Social Media Feeds…

I recommend unfollowing or muting any of these people on social media. If someone’s content becomes triggering because it’s all about their pregnancy, baby or #momlife, you are allowed to remove this content from your daily feed. Some people might drive you crazier than others! Remove those who elicit negative emotions in you.

(Also, don’t guilt trip anyone. It’s not your fault you can’t get pregnant, and it’s not their fault they can.)

3. …But Prepare for Emotional Surprises

You can’t edit real life, and there are babies and pregnant women everywhere. I’ve learned to clock it when I see it and either tell myself, “That’ll be me someday,” or ignore it. Sometimes I get lucky and there’s a dog in the stroller.

4. It’s a Marathon, Not a Sprint

I imagined getting pregnant after one round of IVF and calling it a day. I didn’t realize most patients have to do several full rounds to get pregnant. The data on this isn’t great because there are so many variables that lead to a live birth, among women and within a single individual. One major study out of the U.K. found that after six rounds of IVF, 65.3 percent of participants had a live birth. But, this was from 2015 and IVF technology is changing all the time.

Basically, don’t put all the pressure on one cycle. This is a long con, not tableside magic. Our clinic quoted us a 70 percent success rate for IVF based on our situation, but didn’t make it clear that this meant after three or more full cycles. Which brings me to my next point.

5. Be Proactive with the Fertility Clinic

I trust our clinic, but there have been some communication issues, and they don’t offer up extra information. It drove me nuts at first when they would ask, “Do you have any questions?” We didn’t know what we didn’t know, so how could we know what to ask?! Since that first cycle, I’ve done my own research so I have a better reference point. I ask open-ended questions like, “How pleased are you with that estrogen level?” I also track my own numbers.

6. Keep Track of Everything

When the nurse calls me after every monitoring appointment, I ask her how many follicles I have and what their measurements are. I log that, alongside my hormone levels, in a spreadsheet. This way I can see my progress through each IVF cycle.

A huge variable in IVF is the human body. Every month, we start from a new place. Our follicle counts, hormone levels and external stress factors are different. Data became my friend because it gave me a sense of control—and accomplishment. I can also refer back to the spreadsheet in preparation for follow-ups: “Is it a problem that my estrogen level went down mid-cycle? Why do you think my right ovary is producing more follicles than my left?”   

7. It’s Not an Exact Science

I met a woman who did seven rounds of IVF before giving birth to her daughter. She told me, “It’s an exact science, but it’s not an exact science.” This stuck with me. What fertility clinics do is incredible. Precise measurements. Strict protocols. Timing can be perfect, an embryo can be “beautiful” and your endometrial lining (the lining of the uterus where the embryo implants) can be thick and welcoming, but you might not get pregnant. If anyone guarantees they will get you pregnant by a specific date or through a specific method, take everything they say with a tablespoon of salt. No one can guarantee this.

8. Not All Days Will Be Bad Days

I did not have horrific side effects to my IVF medications. I was terrified by all the blogs I read about emotional roller coasters while doing injections. That wasn’t my experience. I had bad days when I felt left out of the baby game or rundown from early morning monitoring appointments, but most of the time I felt pretty good.

9. I Can Still Do Things My Friends Who Are Parents Cannot

At a certain point, it dawned on my husband and me that we don’t have kids, but we’re not dead. We don’t need a babysitter to go out! We love our parent-friends and their kids, but we don’t need to adhere to their schedules or limitations all the time. Take advantage of this as best you can, even though IVF presents its own challenges.

Also! If you already have kids and are experiencing secondary infertility, take advantage of that. What can you do now that will be more difficult with a baby around?

10. Making Future Plans Is Harder

Fertility clinics like to see you every few days to monitor your progress and adjust medications. Logistically, this makes traveling tricky. A couple days at a time is doable, but if the stress of packing all your gear with you is too much or you risk missing a trigger shot or screwing up retrieval day, I say skip it and plan a trip for another time. I also missed two events I bought advanced tickets for; one so I could administer my trigger shot which has to be given at a specific time, down to the minute, and the other because of my scheduled retrieval. In retrospect, I could’ve looked at my spreadsheet of data and guessed the retrieval would fall around that time. It would’ve saved me about $100 (and in case you hadn’t heard, IVF is expensive).

I will say, since you’re supposed to administer injections around the same time every day, I’ve brought mine with me to trivia nights and comedy shows to do in the bathroom (thank god there were private bathrooms at the venues and not stalls). 

11. Get Ready to Have Fun with Travel-Sized Products

Many skin and hair products are not pregnancy-safe. When we did IUI, I ran out of a salicylic acid cleanser. Salicylic acid isn’t recommended for use during pregnancy, so I bought a travel-sized version in case I got pregnant so I wouldn’t have to toss a large, expensive bottle. After my FET (frozen embryo transfer), I bought a pregnancy-safe travel-sized skincare set (The Outset, which I loved) that I used until my pregnancy test.

Christine at 15MinuteBeauty.com is a hero, and will let you know which products are pregnancy- and nursing-safe.

12. Do Not Blame Yourself or Live in Regret

After a certain point, I found it hard not to blame myself for our unexplained infertility. I drank too much in my 20s. I waited too long to start trying. I started IVF too soon (yes, I went through a phase where I wondered if we should’ve stuck it out a few more months before diving into IVF). This kind of thinking gets you nowhere. It is not your fault you have to do IVF. Be nice to yourself. In fact, indulge in major self-care. Eat well, move, breathe and engage in things that bring you joy.

When I interviewed economist and author Emily Oster about women and retirement, she told me, “Sunk costs are sunk.” She encourages women saving for retirement to focus on the future, not on the money they wished they’d saved earlier. I think the same applies here. Stop dawdling in the past. Focus on your current treatment and the future you are trying to build. Only reference the past if it gives you data to log in your spreadsheet.

13. Find Supportive Resources 

The two books I’ve found to be instructive and empowering are The Trying Game: Get Through Fertility Treatment and Get Pregnant without Losing Your Mind, by Ariel Levy and It Starts with the Egg: How the Science of Egg Quality Can Help You Get Pregnant Naturally, Prevent Miscarriage, and Improve Your Odds in IVF, by Rebecca Fett. Both offer lots of first-hand stories, encouraging advice, data-driven recommendations and more.

I also found "The Egg Whisperer" podcast with Dr. Aimee Eyvazzadeh to be enormously helpful. I like facts I can use; I’m less interested in hearing people talk about their funny experiences with infertility. Dr. Aimee, as she’s called, talks with experts about specific issues that come up in her practice.

14. I Can’t Decide What to Share or with Who—and That's OK

Going through IVF is so personal. You don’t have to tell anyone. I found that telling a few close friends has been instrumental in getting through bad days. I don’t tell them everything, but even just having them on my team is reassuring. I chose people who respect and love me and are here for whatever I want to divulge (they don’t pry, judge, pressure or belittle).

I debated writing this and putting it on the internet. But in the past year, I’ve learned how to set boundaries around my IVF and put my well-being first, so I feel well-equipped to have part of my story out there. I’m allowed to decline if someone asks me about it or to discuss it if I feel up to it.

If you’re going through IVF, I hope this helps!


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Freelance Writer

Sarah Ashley is a Chicago-based freelance journalist. She has covered pets for PureWow for six years and tackles everything from dog training tips to the best litter boxes. Her...