IVF

It's difficult to know how to support friends as they go through IVF. We tried for two years to have children, then did three years of IVF and were successful and have beautiful twins, Jonah and Abigail, as a result of our fertility struggles. Here's a list of what I've recommended to a friend when they contemplated IVF, as well as some of my notes about it.

Go to the presentation
Any clinic you go to gives regular presentations of this on a weeknight to describe what the process is that they do and how it works and what the language is.  If you haven't yet, you should go to one of these presentations, even if its to a local clinic that you may not do business with.  We went to one local presentation but then went with a different clinic based on rankings and our OB/GYN's recommendation.

Live vs. Frozen cycles
Live cycle means growing a bunch of eggs in the woman's ovaries and then harvesting them out, combining them with the man's swimmers, and then either re-implanting or freezing all the good embryos.  The average is 8-12 good ones from this process.  People with low counts could go as low as 2-6, and people with high counts, can have 30+.  You don't want to be one of those.  You want to be average here.  Because, if you're lucky, there's one good egg in the whole batch.  So more isn't better, it means more trials to get to the good one.  Because initially you'll only put one back in.  Then if that doesn't work you'll try two.  Then maybe three or four.  When you freeze then thaw and reimplant later, those will be called "frozen cycles."  Your body is hormonally controlled to go through the entire same cycle except no egg production.  Then when it's at the right point the embryos are introduced and the hold your breath waiting game and HCL monitoring begins.  It's unfortunately more stressful because you've now paid a bunch of money to get to this point and it still may fail.

Live cycles are 1.0 cycles.  Frozen cycles are 0.1 cycles.  So you do a live cycle, that's 1.0.  Then, if you've frozen some embryos, when you thaw and implant those, that would be your 1.1, 1.2, etc. cycles.  Then when you do another live cycle, that's a 2.0 cycle.  So a 3-pack would be three LIVE cycles, with however many frozen cycles that ends up containing.  When they tell you that statistically if it doesn't happen by the fourth trial it isn't going to, they're talking about the fourth live cycle with an average success rate of about 25% per live cycle.

Our three year journey included 1.0, 1.1, 1.2, 1.3, 1.4, then 2.0, 2.1., then 3.0.  Each time we implanted more and took other additional "filtering" steps that try to get you to the heartiest embryos.  As a basic rule, the stronger the embryo, the more likely it will survive the thaw process, the more likely it is to result in a live birth.

This is how I wished my friends talked to me when we went through this:
You're allowed to be blue.

You're allowed to be thankful for your blessings yet still resentful of your losses.

You are officially given permission to be judgmental and pissed off at the parents who did it accidentally, easily, too young, and don't know the preciousness of what they have.

It's okay to be freaked out and worried.  I'd be concerned if you weren't!  You just went from an intimate act to enlisting an army of people to probe yours and your husbands crotches constantly!  Invasive and ego bruising.

No one's perfect.  We all have different parts that break down and age--the definition of normal is "average working order for most parts with a few of them functioning oddly but just barely within tolerance."

It's very likely the main problem is "egg quality."  It will be impossible for you to not take it personally, but try your best to remember that you just need to keep trying until one strong one survives.

Avoid the shoulda-coulda-wouldas--look forward, not back.

Or, beat yourself up that you waited til you were 40, didn't save enough, didn't leave your legs straight up long enough after the transfer, did too much strenuous exercise after, ..., and realize that beating yourself up doesn't make this easier so stop doing it.

The IVF doctors often don't mention this: the fact that you've gotten pregnant more than once via IVF means you have already beaten the odds and now you just have to wash-rinse-repeat until a good egg sticks around.

Take a day to mourn your loss with your partner when a miscarriage is pronounced.  Let yourselves embrace the loss, acknowledge it, then share your hopes and dreams and reasons for continuing. We did a ritual where we burned the ultrasound images and let ourselves cry together before talking about how--and if--we'll try again.

Remember that we guys act strong for our women but we too are experiencing loss too, and we may or may not be able to talk about it like you can.

If you need a day away from other kids or seeing newborns give yourself permission to say no to those things.  When we had a failure we had a rough time hanging out with others' little ones for a couple weeks after.

You can't speed up the waiting between a failure and your next attempt--your body has to go back to its natural rhythm and cycle.  This is where it starts to really drag out the timeline and the waiting is often the hardest part.

Money inevitably becomes a tangible factor in how many times you'll try so ask about three packs and other ways to make as many attempts as you can as you're comfortable with.

Know this, whether it happens via IVF, adoption, or other means: this new child is out there waiting for you with so much love to give and so ready and delighted to receive all the love you have.

Be patient.  With yourself.  With each other.  Give yourselves permission to be in this for all it is.

###