What you really need to know about IVF

ivf

For many, seeing a pregnancy announcement or baby photos on Facebook brings great joy.

For people struggling with infertility, however, these kind of posts can be triggers. Whether you’re getting bombarded by family and friends with questions on your reproductive status or simply seeing pregnancy announcements in your feed, these serve as painful reminders of what you don’t have.

If you’re starting your infertility journey or already well on your way, hopefully this guide helps you remember you’re not alone and makes the IVF process less scary and mysterious for you. If you’re not struggling with infertility then hopefully this guide helps you have a little more compassion and sensitivity towards those who may not be as fortunate as you in the reproductive department.

Important Disclaimer: I’m not a doctor (though I sometimes like to think I am) and this is based on my personal experience with IVF. Your mileage may (will) vary.

Let’s start with the basics. What’s IVF?

In Vitro Fertilization (IVF) is a process by which you extract eggs from a woman, fertilize them in a dish with sperm, and then return one or more embryos back into a woman’s uterus in the hopes of achieving a pregnancy. This process is known as an IVF cycle. Sounds straightforward, right?

Well, not quite. Usually women mature 1 egg per month but in the case of IVF the goal is to stimulate all your follicles (the fluid-filled sacs containing immature eggs) to grow at the same time so that multiple eggs can be retrieved at once. This is where all the medications and shots come into play.

IVF cycles vary tremendously from person to person depending on the protocol for your specific situation. In my case, which was pretty standard, I gave myself daily shots of two different medications that stimulated my follicles to mature more eggs than normal. As the eggs were maturing, I added in one more shot to prevent premature ovulation. This is because instead of naturally releasing the eggs, IVF patients go in for a procedure in which the eggs are extracted surgically, under anesthesia. Once my eggs were big enough and ready to go, I had yet one more shot to give myself that triggered my eggs to complete their maturation (known as a “trigger shot”) and soon after I went in for my surgery.

After my eggs were surgically extracted, embryologists in the lab combined them with my husband’s sperm in a petri dish and our little baby embryos developed over a period of 5 days. At that time, the best looking embryo was transferred back into my body in a procedure known as a fresh embryo transfer and the rest were sent off for genetic testing. Only one sent off for testing was deemed viable and this one was frozen for future use. I named her Elsa (from Frozen, get it?). Then I waited two weeks to find out if I was pregnant and was required to take some additional medications during that time to help create the proper environment in my body to sustain a potential pregnancy.

embryo

They printed out a picture of my “best looking” embryo before it was transferred back into me. Not quite as cute as an ultrasound photo but I’ll take it...

Daily shots… like an injection? Not the alcohol kind right? How do you give yourself an injection ?

Ok this part freaked me out in the beginning because I‘ve been known to faint even at a blood draw, but giving myself shots became so routine that by the end I didn’t think twice about sticking a needle into my body. The first couple attempts at mixing medication and injecting myself were nerve wracking, but I quickly got the hang of it and figured out how to minimize the pain (like by switching up the injection site and making sure the medication wasn’t too cold). Some people I know have had their partners give them injections. That’s also a nice way to involve your partner in the process. For me though, coordinating around when my husband would be home and available was just one more thing to keep track of so I found it easier to just do it all myself.

Ok so you mentioned something about sending embryos off for genetic testing. What’s genetic testing? Is this where you get to pick if your kid has blue eyes?

No, lol. The goal of genetic testing is to give you the best chance at achieving a healthy pregnancy and healthy baby by finding the healthiest embryos. There are two main kinds of testing, Preimplantation Genetic Screening (PGS) and Preimplantation Genetic Diagnosis (PGD). PGS testing primarily checks that your embryo has the proper number of chromosomes. This is the testing I did. Embryos with a missing or extra chromosome will usually result in miscarriage so it doesn’t make sense to transfer these embryos in most cases. During the PGS process, you can also find out the sex of embryos, though usually for most couples that’s low on their priority list for consideration when determining which embryos to transfer back.

PGD testing, on the other hand, tests for a specific genetic disease when either of the parents (or both) are known carriers. Common examples of diseases that PGD testing can detect are Cystic Fibrosis, Tay Sachs, and Sickle Cell Disease.

Ok this all doesn’t sound so bad. Let’s do it! How much does it cost?

The national average for a single “fresh” IVF cycle is $12,000 but there are a bunch of add-ons like medication, genetic testing and storage (when you freeze embryos) that can add to the price tag. It can get pricey pretty quickly, especially when you’re paying out of pocket. And there’s no money back guarantee in the case of IVF. The cost quickly adds up if you need to attempt more than one cycle.

meds

Just one of my FedEx shipments of medication.

Woah woah. How the heck do people pay for this?

For many, the hardest part of IVF is paying for it. For some very very lucky folks like myself, some IVF treatment is covered under their health insurance. This is extremely rare. Most people in the United States have limited to no coverage and are required to pay out of pocket for everything. People dip into their savings, take out loans, borrow from family, and even crowdfund to pay for IVF.

If cost is a key factor for you, shop around. If you can travel out of state, there may be cheaper programs than your local clinic like New Direction Fertility in Arizona and CNY in New York. There’s also new programs popping up to help people manage the costs of IVF like Future Family and Nest Egg Fertility.

Will IVF turn me into a raving lunatic?

This was honestly my biggest concern. I worried that injecting myself full of strange hormones would cause me to turn into the incredible hulk or something. It turned out not to be a big issue. While you are injecting hormones into yourself on a nightly basis, it’s unlikely to cause massive changes to your body or mood. You may not even physically notice any symptoms except pain or bruising around the injection site. Every woman responds differently, but many women say IVF tends to take more of an emotional toll on them than a physical one. It can be nerve wracking to go through a process over which you have very little control and wait to hear about an outcome you care about deeply.

Can I still work / hang out with friends / take care of my family / etc?

Yes! IVF does not have to become your life. In fact, it’s really helpful mentally if you have other stuff going on at the same time. For me, that was my job and my toddler, as both really demanded my attention. At Winnie, we grew to over 100,000 users in over 3000 cities, a lot of which happened during my fertility treatments!

You do, however, need to devote some time to the conception cause. There were periods of time throughout my treatment when I was going in almost every other day for appointments before work. I put travel on hold during this entire time period because these appointments were mandatory to attend (your eggs mature on their schedule, not yours). I also needed to give myself shots at the same time every night, which required some maneuvering when I had work-related dinners and evening events.

What if it doesn’t work?

Even when you’re young and you have healthy embryos, the success rate for an IVF cycle resulting in a baby is less than 50%. There are no guarantees in this process and I’m not going to sugarcoat it: it‘s heartbreaking. It’s painful to want a child and month after month be faced with disappointment (yes, it’s still painful even when you already have a child). A few resources helped me cope that I recommend:

  1. I found two podcasts I really liked around infertility: Matt and Doree’s Eggcellent Adventure which I still listen to it every week and IVFML which is a mini-series podcast about infertility.
  2. I loved the film One More Shot. It really helped me expand my outlook on all the possible ways to grow a family.
  3. I joined a private support group. There are plenty of online groups if that’s your thing, or ask your fertility clinic if there’s an in-person group they recommend if you want real human contact.
  4. Of course I used Winnie to ask all sorts of questions and get advice (mostly anonymously because I wasn’t really ready to announce that I was trying to have a baby).

What’s the one thing you know now that you wish you knew when you started this?

The most important thing I wish I knew when I started down this path is that it takes time, and in some cases, more time than you’d like. Based on my initial plan of when I wanted to get pregnant, I should already have a baby by now! It didn’t work out that way and that’s ok. Once I stopped being so stressed about having a certain age gap between my kids and came to terms with the fact that the timing was mostly out of my control, the process became a lot less stressful for me.

Posted in Parenting ∙ Updated April 2019