Going through fertility treatments can be a daunting process. Here’s what to expect before starting IVF.
I remember sitting in my OB/GYN’s office with tears streaming down my face, learning that IVF would be my only option to conceive. On top of dealing with the grief and fear that kind of news brings, I also realized I was pretty clueless on what IVF even was or how it worked. The only thing I really knew was that shots were involved and it was expensive.
That was almost 4 years ago, and my hope is that I can offer some insight (and comfort) to anyone starting their IVF journey today. Here are the first 4 things I wish I knew before starting IVF.
It’s overwhelming…
Everything about IVF is incredibly overwhelming, from the processes and the procedures to the insurances and medications. After a 2 hour orientation at my fertility clinic, I broke down crying to my husband and said “how in the world will I ever remember all of this stuff?” You’ll be hit with a lot of information at first, and it’s very easy to feel like you’re buried in a lot of medical details you’ll never fully comprehend.
…but you will pick things up quickly
That being said, you’ll start to figure things out sooner than you’d think. Many clinics offer orientations to new patients, and at those meetings they’ll go over ALL possible medications and ALL possible routes you can go, and ultimately only a small portion of that information will pertain to you.
Your doctor and their nursing staff will also walk you through everything, and there are plenty of helpful sites that go over how to administer the injections in thorough detail. I went through several “stims” and egg retrievals (more on that below), and at first I would sit at my dining room table and sterilize everything within a 2 foot radius before I gave myself the daily injections. By the third round of stims I was confident enough to do my shots in a comedy club bathroom (probably not the first time that bathroom has seen a hypodermic needle).
There are two main parts to the IVF process
“Egg retrievals? Stims? What does that mean?!?”
There are two main parts to IVF: Ovarian stimulation (or “stims”) and egg retrieval, and embryo transfer.
Ovarian stimulation
During ovarian stimulation, you’ll be injecting yourself with 2-3 medications nightly. These medications will stimulate the ovaries to produce multiple eggs for retrieval, while also prevent your body from ovulating too early. You’ll be coming into your fertility doctor pretty frequently so they can monitor your hormone levels through bloodwork and the size of your ovarian follicles (where those eggs are) through transvaginal ultrasounds. The closer you get to the egg retrieval part, the more you’ll be seeing your doctor (pretty much daily, for up to a week).
Around 48 hours before your egg retrieval, you’ll administer what’s called a “trigger shot.” This is what induces ovulation, and prepares your body to release the eggs inside those growing follicles.
You’ll receive a light sedative for the egg retrieval, and after the procedure your doctor will report back with how many eggs were retrieved. During that time, your partner or donor will ejaculate and provide semen (unless they’ve been approved to ejaculate ahead of time and bring in a sample). The next day you’ll find out how many of those eggs were mature (able to be used for fertilization), how many were immature (not able to be used for fertilization), and how many eggs were actually fertilized. After that, you’ll wait a few more days to see which of those fertilized eggs developed into embryos.
Be prepared for these numbers to drop. For example – say you get 15 retrieved eggs. Just for argument’s sake, let’s say 10 of them were mature. Of those 10 that were mature, you may find that only 7 of them were able to be successfully fertilized. And of those 7 that were successfully fertilized, 5 of them developed into usable embryos. This is totally normal and to be expected! Keep that in mind when you hear how many eggs your doctor was able to retrieve – 15 retrieved eggs doesn’t mean you’ll end up with 15 embryos.
Embryo Transfer
After your embryos have developed (a 3-day or 5-day process), you’ll head back to the doctor and they’ll place the embryo inside of your uterus. This is done with a tiny catheter and an ultrasound. Your doctor may elect to do a “mock” transfer, which is basically just practice for getting the embryo in the right place. Some doctors will sedate you for this part and some won’t. I was never sedated, and I never thought the procedure was painful or even that uncomfortable.
After your embryo transfer, you’ll wait between 10-14 days and then come back for a blood test. That blood test will measure your hCG levels, or human chorionic gonadotropin. A number of 100 or higher indicates a positive pregnancy result.
You (and your partner or donor) will have to go through some tests before you start
Once I learned that IVF was in my future, I wanted to start right away. Hit me with the needles and let’s get this show on the road!
But before you even think about starting stims, both you and your partner or donor will have to go through various tests. And sometimes, getting those tests (and getting the results) can take time.
Your doctor will need to examine your hormone levels, determine your ovulation patterns, check your uterus for any structural anomalies, and test you for infectious diseases like STIs or hepatitis. Your partner/donor will need to have their semen analyzed for sperm count, motility (how well the sperm move), and morphology (the sperm’s shape and size). Both of you will go through genetic testing to make sure you’re not carriers of the same genetic conditions, and you’ll also likely meet with a genetic counselor.
Going through these tests took a lot more time than I initially anticipated. I had my first appointment with my fertility specialist in August, and I didn’t start my stims until January – a full four months later. Be prepared for these important tests to keep you from starting things right away.
There’s a lot to know about IVF before you start, so stay tuned for Part 2.