You have reached the point in your fertility journey when it is time to decide: Do I go forward with in vitro fertilization (IVF) or not?
For most of us, this question raises even more questions. Does IVF hurt? Will it really work? What will I do if IVF fails?
In this article, we dive into some of the common, questions people have about IVF.
First, let’s address the question of pain. In vitro fertilization requires a lot of injections and many blood draws. Typically speaking, you are either blasé about needles, or the thought alone makes you run the other way.
If you’re making the switch from IUI (intra uterine insemination) cycles, or other fertility treatment therapies, chances are that by now, you are aware of how you react to being poked or prodded with needles. Most women are relieved to find that they can deal with the needles. It’s the first one that tends to be the scariest!
IVF treatment begins with you taking birth control pills or similar medication for a short period of time before the procedure to control the timing of the cycle. Once the course of pills is finished, an ultrasound is done. This is the baseline examination of your ovaries for later comparison.
When your IVF cycle begins, you will receive instructions on how to administer daily doses of a medication mixture over eight to twelve days to stimulate your ovaries to produce multiple eggs. Many fertility programs offer a class and training session to IVF patients that goes over how to use and administer medications, as well as timing of injections. Some fertility practices have videos so that you can follow step-by-step when it’s time to administer the medication at home.
You will visit the clinic approximately every other day to have blood drawn. At this time, you will also have a vaginal ultrasound to determine where you are in your reproductive cycle.
When your follicles reach the desired size, a final injection of human chorionic gonadotropin (hCG) or Ovidril, also called a “trigger” shot, will help the eggs mature fully. You may experience some bloating and minor cramping during this time, but nothing drastic.
In a very small number of cases -- no more than 1% -- a woman will experience a condition called ovarian hyperstimulation (OHSS) following the injection of hCG.
Mild symptoms might occur over the next 10 days that include abdominal bloating and a feeling of fullness, nausea and diarrhea. More intense symptoms may include weight gain, vomiting, darker urine and tender ovaries. Patients with these symptoms should notify their doctor and measures can be taken to help relieve the symptoms.
To retrieve the eggs, you will be given IV sedation for the 15-minute procedure, and so you won’t feel any pain. You most likely will be able to go home within several hours, and your eggs will be combined with designated sperm to be fertilized in the laboratory.
Within five or six days, the fertilized eggs will have developed into embryos. At this time, one or more embryos may be transferred back to your uterus. Approximately two weeks after the embryos are transferred, a pregnancy test is done. In many cases, the embryos are frozen (cryopreserved).
They can be transferred later, once your uterus develops a nice lining, either through a natural or a medicated cycle. This is called an FET (frozen embryo transfer) cycle.
For most women, it’s not a question of pain. Rather, IVF is about endurance, both physical and emotional. One way to cope is by focusing on the desired end-result.
Justine Houle, who worked at Illume Fertility and underwent fertility treatment herself, analyzed her thought process as she prepared for the egg retrieval, just as she was about to administer the final injections to herself.
“I’m not going to lie, at this point in the process, my stomach felt raw. I had small bruises at some of the injection sites, and I felt like the world’s biggest pin cushion without any space for more pokes. I truly couldn’t fathom how or where I’d be able to administer three more injections. Not to mention the emotional exhaustion finally hit me- the process had worn me down (without me even realizing it). I was ready for the retrieval to be over… The “what ifs” where would I be able to give myself three more shots? But, the “I know” won out -- I would do whatever was needed.”
Another patient said the following:
When I started the injections, I was feeling nervous but excited for the outcome! Going through this journey you have so many emotions! I felt a slight pinching sensation, but it wasn’t bad at all for me. I wouldn’t change anything about my journey because I was blessed with a beautiful, healthy boy! Love Illume and everything they did to help our family be whole.”
Each patient has a different experience mentally and emotionally for IVF treatment. Make sure that the staff you have chosen is there to help and guide you along the way.
Before you move from IUI to IVF, it’s OK to pause and assess your situation. You want to be ready emotionally, financially and in every other way that may apply to your personal situation.
Lisa Schuman, Director of Mental Health Services at Illume Fertility, is a licensed clinical social worker who offers guidance to women who sometimes feel exhausted by their treatment for infertility. Many women have a difficult time moving to IVF after undergoing a series of IUI cycles that didn’t work.
“You may need time to let this reality sink in,” Schuman writes. “We need to realize IVF is a medical intervention that is helpful in our family planning. In order to minimize the financial and emotional costs of going through endless IUI’s when our doctor advises otherwise, we need to move forward. But we’re still in shock about the current reality. So, one way to make what is uncomfortable, comfortable is to find ways to make it more real and familiar. We need to let reality absorb into a system that is fighting it.”
Schuman recommends journaling about your feelings and talking to supportive people, including a reproductive counselor, who “can help you grieve the loss over your dreams of having a child “naturally” and help you move to a place of acceptance, and lack of self-blame.”
“Soon what was formally uncomfortable is likely to become comfortable,” Schuman says.
Discussing your reality in a safe place and airing your stress and grief can release pain and help make your news more real. It’s not something you ever wanted but it may be just what you need to start getting to the business of being a parent.”
When it comes to IVF, you might also be concerned about treatment outcomes. In vitro fertilization offers the best success rate for infertile couples and individuals. However, it does not come with a guarantee.
Every two years, the Society for Assisted Reproductive Technology (SART) reports IVF success rates nationally and by clinic for the practices that submit their individual figures.
The rates reflect the percentage of live births per egg retrieval; patients should expect to have up to three IVF procedures after their eggs are retrieved. Women over 40 might especially consider using donor eggs, which increases success rates significantly.
These are the national rates reported by SART for 2016:
Given that IVF success can feel like it mimics the flip of a coin, author Rachel Gurevich answers this question -- how do so many women -- individually and with their partners -- move forward? It’s called hope. Working with the right team, and taking all the necessary steps physically, mentally and medically to succeed, the chance of bringing home a baby feels much more obtainable.
Staying calm, optimistic and ready for anything requires resilience. Options include calling a friend or relative, trying to recall what that book on fertility treatment said, or bookmarking a favorite website.
Sometimes it’s helpful just to remember that you aren’t alone. Support groups, like those offered by RESOLVE: The National Infertility Association and Illume Fertility can connect you with others facing similar feelings and experiences. Tens of thousands of women and couples have gone through fertility treatment – and IVF specifically – with great success. More than 8 million babies have been born because of IVF since 1978. Entire medical practices are set up to help you move through the process, cope with the stress, and have a baby.
When you are ready to talk about your options and learn more about IVF, the team at Illume Fertility, which includes health and wellness counselors, will answer your questions.