I was going to call this post a survival guide, but after some consideration I decided that I didn’t just want to survive this experience but rather that I wanted to thrive during this experience.
I put this guide together as a means of collecting the enormous amounts of research that I have been doing online, from books and from simply talking with other women. Although there are so many pieces out there about the IVF process with various tips and tricks I wanted to put together the ultimate guide where everything is in one place.
So below is what I have found to not only survive IVF but to thrive despite its challenges.
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The Pointy End Of It
Having to stab yourself with a needle or perhaps a few at the end of a long day is not an ideal situation. The injections can often be the most scary and daunting part for most women. However there are ways to make the pointy end a little more pleasant;
Θ Try numbing the area with an ice pack before your needle and then putting a warm towel on after the shot. Remember to use your alcohol swap before injecting
Θ Remember to keep breathing, take a deep breath in while the needle goes in, hold for the count of 5 and then breath out as the needle comes out
Θ Follow up your needles with a little reward, a square of dark chocolate, a warm bath or a cup of herbal tea
For more excellent tips on taking your shots click this link
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Getting The Drug Protocol Right
What to take, how much and when can be confusing when some protocols involve a cocktail of drugs. Use the following tips to keep it under control and get it right;
Θ Take a notepad with you to your doctors and clinic appointments and write down instructions and doses
Θ Make up a spreadsheet of dates, doses and drugs with a tick box that way you will know exactly what you have taken and when
Θ When you are starting a new drug in the cycle call the clinic and double check the instructions you have
Θ Don’t be afraid to ask questions about what you are taking and why and the possible effects its has
Θ If your drugs or routine has been changed you have every right to question why and be given an explanation
Θ You are paying a lot of money for treatment if something doesn’t feel right or you don’t understand it, talk to your doctor or the nurses at the clinic. If you are feeling vulnerable or emotional get an advocate or close friend to speak on your behalf
Click this link to read and amazing story of a woman who wishes she had spoken up and asked more questions
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In Or Out of The Closet
It is a very personal decision about whom you tell and don’t tell about your IVF treatments. On the one hand talking about your experience gives others some insight and you some leeway should you be feeling emotional or drained. However once people know they have a stake in your experience and can approach you with questions or stories you might not want to hear;
In the Closet
Θ Perhaps form an IVF posse – an inner circle of people you can count on for support
Θ If you are working at least let your manager know, so that you don’t have to explain late mornings for appointments or sick days
Θ Be kind to your partner and yourself as you are mostly relying on each other for support
Out of the Closet
Θ Find a few concise and clear websites, pamphlets or books about the IVF process, having something on hand to give your family and friends can take the burden off you having to explain a complicated procedure
Θ Give them my article 10 Ways Family and Friends can help with pre-fertility
Θ Set up the terms of communication, if you prefer to tell rather than be asked then let people know
Θ Email or text results as a group rather than having to repeat the same painful information to different parties
Θ For people in your outer circle you might want to tell them you doing IVF but be vague about your schedule
Θ People may at times say insensitive things particularly at a time when you are feeling very sensitive, remember that this has more to do with them and their lack awareness than you and your situation
Θ When you are receiving unwanted or pressuring advice sometimes no response is the best response. Silence can convey volumes and helps to keep you calm, just switch of and think of England
Θ If someone approaches you and you are not up to talking about it, let them know that you are grateful for their interest and support but just not up to talking about it today
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Be Informed
Read up on the treatments, drugs and procedures you are about to go through. This gives you an insight into what your doctors and clinic are doing and the ability to ask questions about what is happening and why.
Θ Look up peer reviewed and impartial sites on the internet, go to your public library check out some books
Θ Nearly everyone knows someone who has been through IVF, approach other women and ask for their advice
Θ Take notes during your meetings with your doctors and the clinic and ask for all your results to be fully explained and to have a copy for your own file
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The FSH Phase
Follicle Stimulating Hormone is the drug that is given to get the eggs growing in a stimulated cycle. The consensus on most boards is that these drugs match our natural hormones pretty closely and so the side effects are minimal. However there are few things that make this stage of IVF a little bit more comfortable
Θ Most FSH drugs tend to dehydrate you so it s a good idea to drink 8-10 glasses of a water a day
Θ The dehydration can also cause headaches, so drinking more should help with this issue, but you can also check with your clinic about safe painkillers if they are getting a little intense
Θ Bloating and a heaviness around the ovaries is common, to relieve the discomfort try going for a walk or using a mild heat pack placed at you’re lower back or on your stomach
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Ovarian Hyper Stimulation Syndrome
If you are having symptoms such as pain at the region of your ovaries, distension of the abdomen, nausea and vomiting, dehydration, difficulty in breathing these could be signs that you are experiencing OHSS and you should contact your doctor immediately.
OHSS is associated with taking hCG (human chorionic gonadotropin) and happens with blood vessels in the ovaries react to FSH injections by swelling with fluid.
The following is from Wikipedia;
Symptoms are set into 3 categories: mild, moderate, and severe.
Mild symptoms include abdominal bloating and feeling of fullness, nausea, diarrhea, and slight weight gain.
Moderate symptoms include excessive weight gain (weight gain of greater than 2 pounds per day), increased abdominal girth, vomiting, diarrhea, darker urine and less in amount, excessive thirst, and skin and/or hair feeling dry (in addition to mild symptoms).
Severe symptoms are fullness/bloating above the waist, shortness of breath, urination significantly darker or has ceased, calf and chest pains, marked abdominal bloating or distension, and lower abdominal pains (in addition to mild and moderate symptoms).
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All The Things You Can Do In Bed
During the FSH stage right through to the transfer it is advised that you should abstain from sex, but this doesn’t mean that you can’t have a whole lot of fun anyway. Think of this time as a chance to be close and intimate without the pressure of baby making.
Θ Loll in bed, cuddle, talk and laugh. Bring each other breakfast and lounge about with the papers
Θ Act like teenagers and do everything but….I will leave the rest to your imagination
Θ Give each other a massage, it is sensual but can also ease some of the stress you are feeling
Θ Get into your favourite pyjamas and watch old movies and relax
Θ You will need to store up the lust as our Doctor recommended that we have sex for 3 nights starting on the night of our egg transfer. Studies have found that exposure to semen around the time of embryo transfer helps in the rate of implantation and embryo development
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The Egg Retrieval
Once the egg follicles reach a certain size, most clinics like them to be about 16mm before they are ready to be retrieved. The procedure is done either under general or local anesthetic, basically your doctor goes in with an internal ultrasound probe so he can see the ovaries and locate the follicles. Then a needle punctures each follicle and a gentle suction is applied to remove the fluid with the egg in it. Then the embryologist examines the fluid and locates the egg.
Θ You will get instructions from your clinic on how to prepare for the procedure, things like not eating or drinking 6-10 hours before hand
Θ For a few days before hand it is a good idea to have some high fibre foods and juices as the procedure does seem to cause constipation for most women. Also stock up on some these foods and perhaps some natural laxatives for after the procedure
Θ On the day try not to wear any perfumes, hair sprays or heavily scented lotions as the eggs can be adversely affected by the chemicals in perfumes
Θ I had local anesthetic and although I was hazy I could feel the pain and my husband had to ask the doctor to provide more pain relief, thank fully my husband knows my pain threshold and is one to speak up. I also felt pain immediately after I came out and was given pain killers
Θ The consensus seems to be the level of discomfort you will feel afterward will be in direct relation to how many eggs you have retrieved. I was extremely uncomfortable for about 5 days after the operation
Θ The main discomfort was the bloating, I looked like I was 6 months pregnant and felt like I had a beach ball in my stomach
Θ Make sure you have very loose comfortable clothes to wear for several days, including underwear. My bras were so tight I could barely breathe
Θ Eat very small meals and avoid anything too heavy, spicy or salty
Θ Drink lots of water but take small sips over the course of the day, a lot of liquid in your stomach makes the bloating feel much worse
Θ You are not going to feel much like leaving the house after the retrieval so get prepared before hand, stock up the fridge, get a whole bunch of DVD’s, borrow some books and don’t make any major plans
Θ Remember that more eggs is just more, all it takes is one so don’t be disheartened if you don’t get as many eggs as you wished for
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More Needles – Acupuncture
I started seriously seeing a fertility acupuncturist on the day of my egg retrieval. I had seen a few acupuncturists in the past that had all promised miracles but actually made me feel uneasy. Although I had heard that acupuncture could be a real support when doing IVF my past experience had put me off. Thank fully I had a naturopath from heaven and she recommend that I see a specialist and I have never looked back.
Θ Studies have found that women undergoing IVF are 50% more likely to get pregnant if they have the proper protocol of acupuncture on the day of their egg transfer
Θ My acupuncturist insisted that I come in immediately after the transfer to get the maximum benefit and then follow up a week later with a support treatment. Timing is everything so book in a treatment right after your transfer, as soon as you know the date and time. If your acupuncturist is a fertility specialist they will understand the timing issue and accommodate you
Θ If your funds are short it is fine to just see the acupuncturist for 2 treatments, one on the day of transfer and a follow up a week later, however I found the relationship I built up with my practitioner made me feel a lot more secure when my transfer did came up
Θ Ask for recommendations, I tried 2 other acupuncturist’s before I found Andrew, that I was not very comfortable with. It is really important to find someone you click with and who you feel cares about you. It is also important to find an acupuncturist who understands the IVF procedures and the specific fertility protocols to support IVF
Θ If you haven’t had acupuncture before please do not stress about the needles, you can barely feel them and if you have been stabbing yourself in the butt or the belly with your IVF drugs it will feel like a walk in the park
Θ Another thing I found really helpful while I was having my treatments was to repeat positive affirmations while the needles were in. The idea of acupuncture is that it removes any blockages of energy within the body, so when energy is flowing freely the body is balanced and healthy. I figured that while the energy was flowing it was a good time to imbue some positive thoughts into it. I don’t know if this helps but I always felt fantastic after my treatments
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More Lining Please
As I had a great big polyp discovered during my egg retrieval my transfer was delayed by a couple of months. When it was finally time for me to go into a transfer cycle I went in to have my first ultra sound at day 12, my lining was a dismal 5.1mm. It needed to be at least 6mm for the clinic to go ahead with the transfer and ideally between 9-12mm to support a pregnancy. My next scan was day 16 so I spent 4 days doing everything in my power to build up my lining, below is what is discovered;
Θ A diet high in fruit, vegetables, lentils, beans and soy will help to thicken your lining and quickly. For 4 days I ate platefuls of fruit and veggies, drank soy smoothies and had beans and lentils with brown rice for dinner. The lining is thickened by the hormone Estrogen, this excellent article explains how it works and gives some suggestions for improvement
Θ Although you are probably taking a cocktail of vitamins, I also took a B-complex, extra Folic acid and fish oil which all seemed to help
Θ Moderate exercise also increases blood flow, which thickens the lining, I walked every morning and did a routine of yoga stretches at night to loosen my hips and get the blood flowing
Θ Keep in mind that your uterus lining can thicken very quickly as you lead up to ovulation so don’t be disheartened if you first ultrasound does not go well, after 4 days my lining was at 9.3mm
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Embryo Transfer
The day of the embryo transfer is one of the most exciting in the whole process, my transfer happened weeks after my egg retrieval and it was the first time that I started to feel like the cycle was real
Θ I woke up that day feeling on top of the world and convinced that this cycle was going to be the one, it just felt like the stars were lining up. However when the embryologist came in things changed rapidly. During the thawing process 3 of our precious embryos were lost. I was not expecting this at all – but luckily our fourth embryo was 95% perfect and ready to go in
Θ Focus on the good things and the positive aspects, I wanted to be in top form that day so I had to keep my mourning for our 3 lost embryo’s short and sweet, I had a living growing one to focus on
Θ The procedure itself is very short, like 5 minutes short (it took me longer to get changed and pack up my stuff). This can feel very anti-climatic especially after the arduous and lengthy procedures that precede it. The only way that you know something has happened is that they show you a small air bubble on the screen sitting within your uterus
Θ There is no real pain and just a small, short discomfort and you walk out of the hospital feeling perfectly normal. You are not under any anesthetic so you can eat and drink as normal before and after
Θ Our doctor advised us to relax, eat healthy, take my supplements, have sex for the next 3 nights and that the clinic would be in touch in 2 weeks and with that we whisked away to have my acupuncture treatment
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The Emotional Roller Coaster
The emotional roller coaster that is IVF comes from several factors, firstly you are being pumped full of drugs that play havoc with your hormones and thus your emotions, the unpredictability of the outcome and the total lack of control over something that is so important. Although there is really no magic bullet for this, below are a few things that helped me along the way;
Θ Being the spreadsheet nerd that I am, I drew up a schedule for every day with the my drug protocol a tick box and my word for the day. Everyday I had a word like fantastic, great, happy, ecstatic, loved, blessed and the so the list went and I would try to use the word and live by its meaning. It gave me something to cling to and it meant that I took things one day at a time
Θ Meditation was another big factor in helping me getting through, taking 20 minutes to sit still and listen to your breathing and focus your mind can do wonders for those shaky days
Θ Exercise has always helped me control my moods and level out my depression, while is was doing IVF I swore to go for a 30 minute walk every day and followed through. Exercise releases those natural endorphins and generally makes you feel all glowy and great. Don’t do anything too strenuous or that will overheat you
Θ My naturopath also had me on a natural anti-depressant which would not interfere with my IVF drug protocol, I honestly think this saved me. When I was doing IUI I ended almost everyday in tears. I didn’t cry once during the whole IVF process. You want to go into IVF in top form, feeling optimistic and as happy as possible if you are struggling with depression try to sort this out before you start
Θ I was in a deep depression when I did IUI and the failure of this procedure took me to rock bottom. Being depressed and fertility do not mix, talk to your doctor, see a counselor, read up on depression and think through all your options. I know its tempting to think that once your pregnant all your sad feelings will go away, but addressing those feelings can actually help you to get pregnant. Check out my series on Overcoming Pre-fertility Depression for some tips and ideas
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The 2 Week Wait
Two weeks will never feel so long, for me this was the most stressful part of the whole procedure, the see-sawing between pregnant and not pregnant, the roller coaster of emotions and obviously the constant need to check my body for signs and symptoms. As this part of the whole pre-fertility ride has been my biggest challenge it is something that I have written about extensively.
Θ Taming the Two Week Wait is my series about wrangling that sucker into shape and keeping your sanity, it is packed with ideas about how to fill those long fourteen days. Click here for Part 1, Part 2 and Part 3
Θ More recently I wrote an article on my Two Week Wait Rules, which was basically tips and tricks to stop the crazy from reaching fever pitch, you might want to add a few of your own
Θ Another thing I found comforting was reading the Two Week Wait Diaries on Belly Belly, there was just something deeply reassuring to know that so many women before me have experienced the same thing and came out the other end
Θ It is one of my suggestions on the series on Taming the Two Week Wait, but joining a support group whether physically or online really was my savior – there is nothing like talking to people who are going through the same thing that you are. I took it even further by posting a discussion on Resolve asking for women whose BETA results were coming in on the same day as me
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Peeing on a stick
The temptation to take a home pregnancy test has never been so high as during a IVF two-week wait, not only have you got your dreams of a baby on the line, but lot a money and effort;
Θ Personally mental health is more important to me than the temporary relief that a pregnancy test will give you, if its negative it will dash your hopes when in fact you could very well be pregnant
Θ However if temptation is going to get the better of you try and hold off until the day of your BETA result or the day before so you don’t have to stew for so long
Θ After a small fortune spent on pregnancy tests, I decided that I would never use one again and proof of this is that I have one that doctor gave me for free about 6 months ago which has been untouched
Θ Pregnancy tests always seem ambiguous to me because although their rate of false positives is less than 1%, their rate of false negatives is much higher, in fact that last time I was pregnant I got 2 false negatives. For this reason I prefer the finality of the phone call from the clinic or doctor as difficult as that is to take at times
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B-Day – The BETA Result
The day of your BETA result is one of high anxiety, the tension has been building for 2 weeks, and a release is coming shortly of either the ecstatic or devastating kind. There is no real advice that I can give you to make this day any easier, anything is say is born of my own limited experience
Θ If you can have a day off work try and wrangle it, your mind is a million miles away from work and anything remotely tethered to the earth. Better just to give into it than spend the day trying to fight it
Θ Having said that staying busy during that day is really important, clean the house, go shopping, meet a girlfriend for lunch – your mind will be on the result but at least the body will be busy
Θ I found the shock of hearing the results far too much, especially coming from a stranger whose voice was full of pity, I asked my husband to take the calls and then break the news to me gently
Θ Have a plan either way, if the chips are down you might need an evening of junk food and DVD’s, a box of tissues and lots of hugs from your husband. If things go your way, go for a walk and order some dinner in and take some time to let the news sink in. From what I have read and heard even if the news is good, you won’t believe it, my friend said she kept waiting for the clinic to call back and say they have made a mistake
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Plan B
Although there is no real way to control the up’s and down’s of IVF the one piece of advice I have found solace in is to always have a Plan B, when the news is not good and you feel like you have hit a brick wall, you really need to have a light at the end of the tunnel.
Θ Personally I had it in my mind that we were going to do 3 rounds of IVF so I set up my finances and work situation to suit this, that way if the first one didn’t work then I knew where I was heading and when the end of the road was. Although this might be too harsh for you, having some sort of plan in place can make you feel a lot more in control
Θ I also made a list of things that I was going to do if I never had children, it had things like walk the Appalachian trail and get my masters degree on it – although it would never replace the joy of having children at least it gave me a sense that my life was not over and that I had other things to look forward to
Obviously everything I have written above is from my own limited perspective and experience, it is not medical advice and your doctor should be the person you check all your questions and concerns with first. Having said that I would really love to add to this post as I am sure that there are many wiser women than me out there who have experienced IVF and survived and thrived to tell the tale. As always if you have anything to add or disagree with even, leave a comment or email me at tanya@fertilehealing.com
