What is IVF? Here are some basics…
So, let’s chat a bit about IVF.
If you had asked me five years ago, whether I could have seen myself as being an IVF patient, I would have almost certainly told you, “No”. At that time, I erroneously only related the term IVF to married or partnered women struggling with fertility…neither of which applied to me. I was unaware of the details of it all and also never considered that others, including single women such as myself, would be able to undergo and benefit from this process.
After being advised that IVF could be a viable option for me as a single woman—which took some convincing…initially, I was not sure it was an adventure I wanted to embark on to begin my family journey, especially reluctantly solo—but I went ahead and got to work in search of more info.
I’ll share some facts and thoughts below so you can read more about the process, but I must say, actually going through the motions of IVF, for me, was pretty mind-boggling.
For starters, there’s so much to do and familiarize yourself with like:
· Finding the right doctor and team for you
· Undergoing relevant testing based on your consultation with that doctor and team (this can include, but not be limited to genetic testing, fertility testing, and if you have a male partner, sperm analysis, etc.)
· Checking to see your financial options (will insurance cover this, will I have to pay out of pocket, is there a payment plan, etc.)
· Choosing a donor, if necessary, that fits your criteria, desired characteristics, and genetic compatibility (this can be a sperm donor or egg donor)
· Cooperating with your team to formulate an individualized treatment plan. This can include:
Whether it makes sense to go straight to IVF or try IUI, also known as, Intra-uterine insemination first
Tracking your menstrual cycle for accurate timing
Determining your medications
How to administer your injections (and there are A LOT of them)
As well as tons of other information relevant to your specific treatment.
And this just barely scratches the surface...there’s much more to it… but we’ll get to more and dive deeper in subsequent posts, but just know that the process can honestly be intense!
Also, do note that there is so much nuance to everyone’s particular circumstances. I’m just sharing mine.
So, let’s get to the basics…
What Exactly is IVF?
IVF or In vitro fertilization is a procedure that has supremely revolutionized reproductive medicine over the past few decades. Very simply stated, eggs are extracted from a woman’s ovaries and fertilized with sperm in a sterile, laboratory setting. Embryos that are formed as a result can be transferred back into the woman's uterus in the hopes of achieving a successful pregnancy.
Let’s go a bit more in depth and review the steps involved, discuss some risks and side effects, and fill you in on the success rates. Plus, we’ll go over some reasons why you might want to try IVF and chat about some tips on preparing for the procedure.
Get Ready to Put In the Time and Energy
IVF is a lengthy process that can be arduous and take several weeks (or months or even years for those who face challenges). It involves different critical stages to make it work:
Ovary stimulation: Women are given medication to help their ovaries produce more than one egg, giving them a better chance of pregnancy success.
Egg retrieval: When the eggs are mature enough, they are collected from the ovaries using an ultrasound-guided, very thin needle. (Don’t worry…it sounds scary, but you’ll be under anesthesia and will not feel a thing!)
Sperm preparation: At this point, steps will have been taken to ensure that the sperm from the male partner or donor will be ready for fertilizing the embryos.
Fertilization: The sperm and eggs are in a dish in the lab, and the embryos are inspected for a few days (usually 3 or 5) to guarantee they're developing suitably.
Embryo transfer: The best embryo(s) are picked and transferred back to her uterus using a small catheter (again…don’t worry, you’ll barely feel it!)
Who Can Benefit from IVF?
Well, there are tons of people who might consider in-vitro fertilization. Heterosexual couples who have been trying to conceive for a while but haven’t had any success may choose this route, as well as same sex couples, or even those that are single and have the desire to become parents independently (like yours truly). The science behind IVF is an option for all to try to have children and start a family on their terms.
How Does One Prepare for IVF?
This is a loaded question since everyone’s journey is quite unique. In my experience, preparing for IVF felt a bit overwhelming, but was so much easier with the assistance of my medical team who expertly made the process more manageable. They ran like a well-oiled machine, with everyone involved moving in sync. Here are (some of) the major steps I went through:
● The initial consultation and testing are crucial to determine whether IVF is a good choice for you, so I did my research on top doctors and IVF specialists and once I found one I wanted to explore some more, I made an appointment to meet with her. She was (actually is) an experienced reproductive endocrinologist/obstetrician and gynecologist.
● At my first appointment, the doctor reviewed my medical history, discussed any fertility concerns, and completed an exam which will included blood tests and an ultrasound. We also spoke about donor selection (more about this in a future post) and I was provided with varied options and considerations for how to go about making a good donor choice for me.
● Considering the costs associated with IVF is essential, as it can be a significant financial investment with limited insurance coverage. I was lucky that for my initial rounds of IVF, I was working for the City of New York and my insurance covered about 95% of the cost. Nonetheless, at the first appointment, I also met with the IVF Finance Coordinator to discuss my coverage. NOTE: Remember it never hurts to ask about some financing options or discounted packages. You may be surprised at what some doctor’s offices may offer to help ease your financial burden!
● Some people prepping for IVF may also meet with a wellness team that may go over individual or couples counseling; a genetics counselor to help them better understand their risk of inheritable genetic conditions; or a nutritionist for additional support. While not a part of my initial visit, I did go through some therapy sessions prior to starting IVF that was made available by my insurance. I opted for this since I am a BIG proponent of therapy (I think everyone can benefit from it) and was a tad anxious about the IVF experience. I only attended about 3 or 4 times, but it did help ease some of my tension and apprehension.
This was all a part of my personal process, but there is more…
Before I get into it, I do want to offer a key bit of wisdom, and that is do not be discouraged by setbacks.
One day, about a year or so prior to me even considering IVF as an option, I was lying down and felt a small lump protruding from my abdomen. Of course, I was scared as h*ll, so I made a call to my doctor for an appointment. After a couple of tests, it was determined that I had a number of small fibroids in my uterus and a large pedunculated fibroid. A pedunculated fibroid is a benign tumor that is attached to the uterus on a stalk…and mine was the size of a grapefruit.
My OB/GYN discussed surgical options with me, but also advised that I see one of her colleagues for his thoughts, too, since she knew I did want to have children at some point and wanted to gain another professional opinion, particularly from an OB/GYN surgeon, which this guy, her colleague, was. So, I made an appointment to see him, and I have to say I left his office completely devastated. He told me that the only way to remove the fibroids was to perform an invasive surgery and slice (or as I envisioned it…filet) my uterus open and try to stitch it back together again, making my chances of carrying my own child incredibly difficult, if not impossible.
Upon running out of his office (literally), my head was spinning. In my mind, he should have just have ripped my fibroids out with his bare hands. (My apologies for being so brutally descriptive, but that is exactly how I felt).
There I was, on Columbus Avenue in NYC with everyone and everything buzzing around me and yet, I felt so alone. I had labored breathing and I could not focus. I had serious thoughts of self-harm. It was unlike anything I had ever experienced before, but somehow, just somehow, I was able to regain my composure and travel back home…although that journey is all a blur.
When I consulted my doctor again and told her what her colleague had shared about my surgical options, she looked at me and said, “No, that’s not what we’re going to do.” She saw the pain and fear in my eyes, and calmly explained that she was confident that the surgery to remove all of the fibroids could be done laparoscopically, or using small incisions guided by a camera to remove the fibroids in parts.
This wound up being the exact procedure that I had done and I am so grateful for my OB/GYN sharing that option with me and for speaking up on my behalf. A few years later when she delivered my son, I reminded her of this and how appreciative I was (and still am) for her support and advocacy, especially when I did not have the words or expertise to advocate for myself.
I wish that was the ending of my “before I underwent IVF story”, but it’s not. When I became more serious about undergoing IVF, my reproductive endocrinologist found more fibroids had grown in my uterus and I had yet another laparoscopic myomectomy.
Then, while healing from that surgery and waiting the recommended period of time before starting my IVF treatment, even more fibroids were discovered that had to be removed.
All in all, in order to up the odds for my IVF success, I had to undergo three, yes three, laparoscopic myomectomies.
To say that all of this was stressful and exhaustive is certainly an understatement, but as you’ll always hear me say in the same breath, it was completely worth it when I look into my little one’s eyes.
So, I reiterate: PLEASE DO NOT BE DISCOURAGED BY SETBACKS.
So, what are IVF success rates and risks?
Again, all of this depends on varied factors and the individual. However, some of the essentials that can impact IVF one’s success can include:
● Age: A woman's age is among the most critical factors determining IVF success rates. Younger women often have higher success rates, as their eggs are typically healthier and more viable. I had my first child at 41, so again it’s all variable!
● Fertility Challenges: The reason for infertility can play a role in IVF success rates. For example, couples dealing with male factor infertility may have lower success rates than couples coping with other types of infertility.
● Number of Cycles: The number of IVF cycles a couple undergoes can also impact success rates. Typically, the more cycles a couple undergoes, the higher their chances of success.
● Embryo Quality: The quality of the embryos used during IVF is also essential in determining higher success rates. High-quality embryos are more likely to implant, resulting in a healthy pregnancy.
Like any medical procedure, IVF comes with specific risks and possible difficulties. Here are some of the common risks associated with IVF:
● Multiple Pregnancies: IVF can make multiple pregnancies more likely to occur, which may result in many health risks for both the mother and the babies. My doctor would only implant one embryo at a time, so this was not a factor in my treatment. However, each doctor and facility is different. Be sure to chat with your doctor about your options.
● Ovarian Hyperstimulation Syndrome (OHSS): OHSS happens when a woman's ovaries are overstimulated during IVF. Symptoms can include bloating, nausea, and abdominal pain.
● Ectopic Pregnancy: Ectopic pregnancy is a rare but painful complication that typically happens when the fertilized egg implants outside the uterus. I am a survivor of this potentially life-threating occurrence. When trying for my second child, my first IVF implantation began to grow in my left fallopian tube. Thankfully, my doctors and medical team discovered it before the tube could rupture and rushed me into surgery the same day, but the loss was truly devastating.
● Emotional Impact: IVF can be emotionally challenging and stressful. Couples and single parents can thrive with adequate support and guidance throughout their journey. Support from my immediate family, as well as therapy played a HUGE part in my wellness when embarking on my IVF path.
This is all just the tip of the iceberg. We’ll continue to dive into more aspects of IVF as time goes on. However, for now, are you considering starting your IVF journey? Do you have more questions and need assistance getting started? Are you in need of an advocate and support system? Do you have an IVF story to share?
If so, reach out to me here .