Morning everyone, Heidi here from the blog Dooley Noted Style.  I wanted to chat a bit today about a very personal subject, our path to parenthood and what I wish I knew before starting the IVF process.

A little background on my story can be found hereherehere and here. But for those who want the cliff notes version, it goes a little bit like this…after an early miscarriage last Spring and almost two years of trying conceive my husband and I were told having a successful pregnancy the good old fashioned way was unlikely due to a low egg count I had, IVF was our best option to have a family. Last summer we started the first round and by February of this year I had a positive pregnancy result from our second round of IVF. I am now five and half months pregnant expecting our son this fall.

So now that we are acquainted let’s get to the bits that no one talks about, ya know the nitty gritty details of IVF.  I am going to share pieces from my experience as well as from the community of infertility women warriors that I connected with on our journey to become parents. I am by no means an expert or have any medical background but I am a success story and feel that being totally open about the process could potentially help another family heading into this daunting process. So let’s get started shall we?!


The IVF Process {skip to the next part if you have been through all this already, I felt it important to include for those who didn’t know much about it like moi}

To be a good candidate for the IVF process you will start with a slew of blood tests, invasive exams and numerous questions about your health and families health history to ensure all the correct panels are ordered on you to get a full understanding of what the doctors will be dealing with and most importantly to ensure that you and your partner are both in tip top shape to start this process.

When you meet with your Reproductive Endocrinologist {RE} they will likely go over all your options based on your health. Due to my age {37 when I started} and how much my miscarriage impacted me emotionally we went in knowing we wanted the plan with the best results and reduced risk of miscarrying ever again. Skipping right over the option to do an IUI and went right to IVF. We also added in genetic testing to help with risk mitigation {will touch more on that further down}.

What I wish I knew before IVF

The Steps in the IVF process will likely look something like this:

You will likely start birth control to put the ovaries in “sleep mode” so to speak to help control your period and get them where they want before you start the drugs that stimulate them. The thought process is that the ovaries sometimes respond better to the stim drugs having been “calmed down” in the beginning. However not every clinic does this.

What I wish I knew was that birth control can make you feel terrible. I was very depressed on it and while I would 100% suffer through it again, let your doctor know if you too have adverse reactions to  the pill. There may be one that could work better for you. 

Your RE will put together your plan for all the medicines right for you. This may include oral medicine as well as injections. Sometimes multiple times a day, it will last somewhere around 9-18 days depending on how your body reacts to the meds. The amount of time you are on the meds will vary person to person.

What I wish I knew was that all your medicine arrives one day in a giant box with no instructions. Just basic instructions from your doctor on dosage. I had no idea which needle went with what, what medicines could be mixed to reduce the amount of injections or how to inject myself.  It was really overwhelming. My advice, ask your clinic if they offer classes on how to administer the meds as well as any helpful videos that you can watch on it at home. We watched several provided by the fertility pharmacy that provides the medicine. Also, don’t panic if your meds and doses are different from other women going through the same process. You & your doctor know your health history best and will customize the plan that is best for you. Also based on how your follicles are growing your doctor may change the dosage in the middle of a cycle. 

During your follicle development you will have several transvaginal ultrasounds to measure the growth of those follicles growing on your ovaries. The exams are usually pretty quick and while they are a bit uncomfortable I didn’t find them painful. When the doctor is pleased with your growth you will be instructed to take your “trigger shot” and usually thirty six hours later you will be in your clinic’s office for your egg retrieval.

What I wish I knew was that towards the end of your stim cycle you will likely be visiting your clinic daily for vaginal exams. Another unpleasant side effect I wasn’t aware of is the weight gain, sometimes as much as ten pounds in this two week period. You will be tired, bloated and perhaps on an emotional roller coaster. Remember everyone reacts to medicines differently. 

Going into your retrieval you will arrive about an hour early before the actual procedure, meet with an anesthesiologist and the nurses who will tend to you before and after as well as the RE who will be performing the procedure. To read more about the actual egg retrieval procedure, please read here.

Your partner will likely be giving their sample at the clinic at the same time, so you may want to provide them with something pleasant to look at ; ). Remember they are in a bright lit ugly doctor office having to provide a sperm sample, it’s not ideal.  Magazines are usually provided but don’t be shy in asking your partner to bring something from home to help get the job done.

After the retrieval you will be told how many eggs were harvested. They then will be sent to the lab to be introduced with your partners sperm and hopefully fertilize into an embryo. We opted for ICSI to help the process along. Then you will be called a few days post retrieval to see what embryos progressed to blastocyst stage and if you are doing a fresh transfer or not. We opted to freeze them & send to Genetic Testing. I can’t speak further for fresh transfers as I didn’t go that path.

What I wish I knew, if you are prone to nausea from anesthesia tell your doctor. They can likely give you a patch to wear which helped me greatly. Your ER may not be the doctor performing the retrieval. I didn’t know this and wasn’t comfortable with the doctor who did my first retrieval. After the procedure you will wake up and have a small snack {wheat thins and gingerly for me} use the bathroom and be asked if you feel well enough to head home. Take the day off, you will be tired. Maybe even two days if you can. 

What I wish I knew before IVF

Genetic Testing 
When I polled friends in the IVF community their biggest piece of advice was with astounding agreement that PGS testing was a game changer. Does it guarantee implantation, no. But it definitely increases your odds of pregnancy knowing a healthy embryo has been transferred. Embryos that make it to blastocyst stage are biopsied and sent to genetic testing for any chromosomal abnormalities. The results usually take up to three weeks to hear if any embryos are viable for transfer.

What I wish I knew, PGS really is testing for any major chromosomal abnormalities such as 1318 21. Any micro deletions will likely not be detected. It also can test for specific carriers of diseases like cystic fibrosis.  It’s also likely it won’t be covered by insurance, however I cannot speak for others but I am 100% for taking this route to help avoid miscarrying again. However there is a risk of damaging the embryo in getting a sample for testing but we felt it was worth it. Younger candidates may not need to do this as their egg quality may be just fine but I still am a huge advocate for doing this at any age to ensure a healthy embryo is transferred.  Finally, the waiting on these results was so hard. Try to keep yourself busy with whatever interests you. Soul Cycle was my therapy. 


Frozen Embryo Transfer {FET}
Your embryo is “thawed” and prepared for transfer. You are awake and it’s very quick. I think I was in and out of Boston IVF in a half hour with no pain. You can read the logistics of the entire process here. You will start a new regimen of meds. Some include suppositories {no needle} or some include progesterone in oil {PIO} {which include an intramuscular needle}. In about two weeks you will be called back into your clinic for your first pregnancy test and can expect to go back a few time to make sure your HCG keeps doubling every few days. You should also know that if you do get a positive pregnancy test and HCG looks good, the progesterone treatment can go on for several weeks into your pregnancy. {I was told to stop at week ten of my pregnancy.} 

What I wish I knew, the embryo is so small, when its entered into your uterus you will really only see the puff of air that placed it there, nothing else. Ask for a photo if you want to document every stage of your IVF process. I didn’t do that & wish I had. Finally, the waiting for a positive pregnancy test is the longest two weeks of your life. 

What I wish I knew – All the lingo associated with IVF. Good lord, I couldn’t understand what people were talking about half the time. Here’s a little beginners chart I constantly went to for guidance.  Here are a few of the most commonly used terms.

2WW – two week wait {between ovulation and period}
AF – Aunt Flo
BCP – Birth Control Pills
BFN – Big Fat Negative {in regards to a pregnancy test}
BFP – Big Fat Positive  {in regards to a pregnancy test}
DPO – Days past ovulation
DPR – Days past retrieval
HPT – Home Pregnancy Test
TTC – Trying to Conceive

What I wish I knew before IVF


Ok so all the medical bits and pieces above was a lot to get through huh?! Let’s chat about the emotions of it all, because honestly infertility is friggin hard and draining on every level. Some friends in my IVF community perfectly summed up what they wish she had known before starting IVF and with their permission I am so honored to share the following from their experiences with a few of my own mixed in.

I wish I knew to take one day at a time. It’s all overwhelming and if I thought of the process as a whole I felt weighed down and scared.

I wish I knew to take some time off post transfer. Taking long walks and enjoying being back with your embryo is a special time.

I wish I listened to myself and my body and spoke more freely to my doctor about things I was experiencing.

I wish I knew that each failed round didn’t determine my fate on parenthood. While starting over is hard, knowing I was going to be doing something to resolve the problem always helped me cope.

I wish I knew transferring a viable embryo that was genetically tested doesn’t guarantee implantation.

An IVF success story privately shared: after thirteen failed rounds her biggest surprise of what she wish she knew was the “over-time” of it all. Emotion was removed from the equation and how she became numb to the process. She remarked in the end that it felt more like a business transaction then making a baby.

I wish I had the nurse mark areas on my body where the intramuscular PIO injections went. I was always worried I was doing it wrong.

I wish I did genetic testing and didn’t suffer through multiple miscarriages.

I wish I knew IVF wasn’t a sure thing.

I wish I knew I wasn’t alone.

I wish I knew that I could handle more emotionally, physically, and financially then I ever imagined I could.

I wish I knew that I have to be my own advocate, that I have to do my own research, and that I have the right to ask as many questions and offer a team approach to my treatment.

I wish I stayed off of Google.

I wish I knew that IVF is really tough on your body, and mind, but that I was tougher.

I wish I knew how badly I would feel and that I started seeing a therapist earlier.

I wish I knew I didn’t have to feel guilty; for not wanting to be around my friends children, for not wanting to go to baby showers, for feeling jealous or angry.

I wish I knew that doctors do not all do things the same way and that’s ok. Comparison is the thief of joy so trust your doctor and if you don’t, seek another doctor.

I wish I knew that my treatment would not go as quickly as I wanted it to and that my body will be on a different schedule making me hurry up and wait.

I wish I knew that IVF doesn’t always work the first time, or the second, but you don’t have to give up.

I wish I knew about organizations who explain insurance coverages to you, and how important it is know and understand your coverage to maximize treatments.

I wish I knew that if you do become pregnant, the fear and anxiety doesn’t always go away right away, and that too is ok.

I wish I knew all of my feelings, regardless of how ugly, are valid.

I wish I knew that the silver lining of this dark journey is that by reaching out and seeing support through groups like Resolve, my RE’s office, and Instagram, I would not only receive the most amazing support and encouragement but I would make the truest and most inspiring friends.

I wish I spoke about my journey sooner, opening up about my struggles and emotions helped me through the process. Keeping it all to myself was isolating and depressing.

I wish I knew it was ok to get a second opinion.

I wish I knew that some days this would all feel like a part time job.

I wish I knew the pros and cons of the progesterone treatments. While suppositories seem easier, you discharge quite a bit and the sensation of that happening constantly reminded me of my miscarrying. My ten weeks post positive pregnancy test was filled with numerous trips to the bathroom to make sure I wasn’t bleeding.

I wish I knew that when I stopped my progesterone treatment that breakthrough bleeding can occur. It’s terrifying and while you should report to your doctor any bleeding it doesn’t necessarily equate a miscarriage.

I wish I knew the progesterone suppositories had side effects like discharge in a variety of colors. It was gross.

I wish I knew spotting doesn’t always mean bad things but should always be mentioned to your doctor.

I wish I attended conferences to educate me on everything to expect in this process. {A great event is Resolve New England}

I wish I knew that I may hear the term “unexplained fertility” and be totally frustrated that we are both completely healthy but still can’t conceive.

I wish I did fertility acupuncture through the process.

I wish I knew about the weight gain that comes with all of these meds.

I wish I did ICSI and assisted hatching to increase my chances of fertilization.

I wish I knew about vitamin supplements that could have helped the process.

I wish I researched my doctor more before jumping into the process.

I wish I knew what everything was going to cost us in this process. The financial aspect can be very stressful.

 

Good luck to all you out there on your path to parenthood. We are rooting for you all and wish you success in your IVF journey!

 

 

 

One Comment

  • Thanks for this… my husband and I are at the year mark after a miscarriage at 11 weeks and are weighing our options. The journey thus far has been emotional and long, and the road ahead looks daunting. I had no idea there were paths to take to help decrease chances of another miscarriage! This has been super helpful, and just made me feel validated in general. It’s such a tough and lonely process, but you’re right we are warriors. Best of luck in these last few months of pregnancy. Hope you’re feeling well!

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