Last updated on Sep 11th, 2015 at 01:38 pm
Not a day goes by when I am not grateful for in-vitro fertilisation (better known as IVF).
The privilege of living in the age of IVF was brought home to me recently while watching a television drama set in the 1950s. One of the characters was diagnosed as infertile and her despair was profound. It made me realise that until recently, being “barren”’ was often a life sentence.
It could have been me. My husband had had a vasectomy during his first marriage and by the time we married it was too late to reverse it. We would not have been able to conceive without IVF. The procedure gave us hope and then the greatest gift imaginable, a son.
So if I am singing its praises, why do I describe myself as an “IVF survivor” and why was undergoing IVF the hardest thing that I have ever done?
The answer is simple—because it is hard.
We did have one positive IVF, but it was followed by four failures. And successful or not, navigating the process is always challenging.
Understanding how difficult IVF is and preparing to manage it, are two of the most important strategies for making it through.
With that in mind, here are my top tips for coping with IVF:
1. Get help from an expert (as soon as possible)
Infertility is defined as: “a failure to achieve pregnancy after 12 months or more of regular unprotected intercourse in women under the age of 35, or 6 months if you are over 35.”
Hidden in this definition are two important principles. Firstly, the time frame for establishing infertility is relatively short—unfortunately, our fertile years have a limited duration. Secondly, there is a call to action: seek help if you have not achieved a pregnancy in that time.
My advice (from personal experience) is that the moment you realise you are struggling to conceive, you should consult a fertility expert—the best one that you can afford. Why? Because infertility is a specialised field,because the waiting rooms at fertility clinics are full of women who have spent their most fertile years implementing bad strategies, resulting from well-meaning but often inaccurate advice and, because your problem might be relatively easy for an expert to fix.
Remember that as a rule of thumb, the older you are, the more the quality of your eggs will become a factor (in addition to any other problems that you might be experiencing).
If possible, don’t wait too long to get help.
2. Slow down and manage your stress
Telling you to slow down may seem odd given my warning about the age of your eggs and the danger of decreasing fertility. But, psychologists have established a specific personality type that is often linked to infertility—a time urgent, perfectionistic personality.
If this is you, your high stress approach towards life may be a factor in your struggle to conceive so it is worth taking this stress test to find out.
After my second laparoscopy (a procedure to identify and remove endometriosis), I woke up in the recovery room and heard another patient in the bed next to me—who had just had the same operation—commanding the nurse to tell her when she could start IVF. I sincerely hope that the doctors slowed her down—after all, they had seen it all before. Without help though, she was a perfect candidate for an IVF failure.
But, even if you don’t have this personality type, IVF is incredibly stressful.
Be sure to get support during the process, find ways to manage your stress, and do your best to clear other stressors from your life.
3. Try less invasive fertility strategies before you start IVF
We knew from the start that our only option for conceiving was IVF. But, if that isn’t the case for you, IVF shouldn’t be your first strategy for having a baby.
Good fertility specialists use proper diagnostic tools to identify all of the factors involved in your infertility and treat them systematically.
It may be with medication, counselling, operations or other interventions, but the goal is always for you to fall pregnant naturally.
Only if those strategies fail, will your clinic suggest IVF. If your doctor bypasses the diagnostics and the treatments and tries to rush you into IVF, it may be best to look for another specialist.
IVF shouldn’t be your first strategy for having a baby
4. Ensure that you and your partner are in agreement
Bottom line, this is something that you have to do together.
Your partner will also have to undergo a medical assessment to establish if his fertility is a factor. And, if you do undergo IVF, he will need to produce sperm (usually on the day) for the clinic to fertilise your eggs.
You cannot do this without him, which is good thing because IVF is hard and expensive and you both need to be committed to have the best chance of success.
You cannot do IVF without your partner
5. Seek emotional and psychological support
Infertility and IVF can be a lonely journey.
People who haven’t been through it are often clumsy and embarrassed (at best), or judgemental and dismissive (at worst) when you tell them about it.
In addition, your hormones are in turmoil (think of it as PMS on steroids). It is therefore really important to get emotional support during the process to help you manage your feelings and fears.
There are plenty of options including seeing a psychologist or religious counsellor, chatting to empathetic friends or family members, or a support group. So, if one solution isn’t working, there are many others you can try.
Manage your feelings by getting emotional support
6. Think about the moral issues before you begin
In South Africa, a lot of these moral issues are governed by legislation and clinic policy.
Controversial strategies like gender selection are currently not legal and we will never have a South African “octomom” because for each course of IVF, clinics are only permitted to transfer two embryos to a young woman or three, at most, to an older one. And, even this is subject to the doctor’s judgement.
I was in my late thirties when I had my final IVF and for the first time, we made three viable embryos. I pleaded with our doctor to transfer all of them. But, believing that my frame was too small to support a triplet pregnancy, he transferred two and froze the third.
Some decisions will be up to you though. For example, will you freeze embryos and if so, what will you do with the frozen embryos you don’t “need”? And, are you open to using donor eggs or donor sperm if necessary?
Try to make decisions together before the hormones and emotions kick in and rational thought has gone out the window.
7. Develop a communication strategy
This may sound odd but knowing what to say, and to whom, is one of the hardest parts of IVF. Before you begin you should decide what you are going to say to the following groups of people: close friends and family; acquaintances; your workplace (and his) and any existing children.
My tips are:
- Choose a few people who you will tell everything to, but for the rest, share only what you are comfortable with sharing or what is necessary.
- Acquaintances really don’t need to know.
- What you share with your children should depend on their age. You should share enough so that they aren’t afraid (why is mommy having an operation?) but don’t develop unrealistic expectations. Please don’t tell them that you are having IVF so you can give them a sibling. If it goes wrong, it will result in huge disappointment and they may even blame themselves for mommy being sad (she did it for me). If in doubt, consult an expert on this one.
8. Clear your diary
The schedule for IVF is an immovable object—missing important milestones like your egg aspiration may result in you having to start all over again. So, don’t begin IVF in a month when you are starting a new project, travelling for work, moving house or doing anything else that is demanding of your time or emotional energy.
Given how challenging and expensive IVF is, it is best to clear your diary as much as possible for its duration.
9. Stick to your plan
There are two dimensions to this. The first is; to take your meds and adhere to the plan that the clinic has given you. This may be very hard if your plan involves giving up smoking, controlling your weight or cutting down on caffeine or alcohol. To get through it, think about your end-goal and remember that the clinic is doing this for you, not to you.
In addition, you need to schedule well so that you take your meds on time and are present for all of your procedures. There are many tools available to help – anything from old school wall charts to high tech diary planners. However, if you aren’t good at sticking to a plan, ask an organised friend or family member to help. Do take this seriously but do not panic if you make a mistake, just be sure to contact your clinic and ask for advice.
10. Know when to quit
No one wants to start something – especially something as hopeful as having a child – with the possibility of failure in mind.
But, it is a real factor in IVF and unfortunately, many people continue long after doctors have recommended that they stop. It is the reason that many of us have met people whose multiple failed IVFs have harmed their marriage or cost them their life savings.
IVF can become like gambling—there may come a point at which you feel that you have “too much on the table” to walk away and that if you quit now, you will “miss the jackpot”. But, sadly, this is probably the moment to stop. Trust your doctor and listen to your partner. Walking away from the possibility of a baby is tragic but not as tragic as losing everything too.
IVF can become like gambling. Know when to walk away.
I wish I could tell you that it will all be ok, and easy, but IVF often isn’t. And, preparing properly won’t necessarily give you the child you are so desperate for. But, it will ensure that you give this process your best shot. And, equally important, it will give you the peace of mind to know that you did absolutely everything to make the baby you so desperately want.