Disclaimer: My IVF treatment happened in the UK under the National Health System. Some of the points may be specific to the NHS.
- Talk to someone you trust about your IVF journey. It is highly emotional - not just because of the raging hormones, and it can be strenuous for the woman going through it, for her partner and for the relationship. Clinics offer counselling, but you may also want to have a confidant to just vent about fears, hopes, frustrations, discomfort, and emotional highs and lows. (more on the benefits of talking in "When you talk to people, you may realise that you’re not alone")
- Take a moment to realise how you feel about the IVF process:
Even though I had known for 2 years that I’d be going through IVF to get pregnant, the moment I started, some unresolved feelings suddenly surfaced. It took me an angry outburst and a nice hot bath to realise that I hadn’t quite made peace with the fact that pregnancy wouldn’t happen naturally to me and that I had to go through a process that seemed mechanical and somewhat lacking in magic, instead. Of course I was thankful for the possibility, but I was sad nonetheless. I treated myself to a little ceremony to reclaim and confirm my womanhood.
- Look up the CCG (Clinical Commissioning Group) policy on fertility treatments for your council:
Every council has a different policy on eligibility, funding, and treatment. You’ll want to ensure that you do nothing to endanger your eligibility which could be, for example, to pay for a cycle privately before you start IVF with NHS. If you are unclear about the policy, discuss it with your IVF clinic.
You can find the CCG policy for your council online.
- Keep your own records:
You might be meeting with a different consultant or nurse every time you go in for an appointment. To avoid confusion, it is best to have all your treatment history and results at your own fingertips.
It’s sufficient to have a list that shows the dates, consultant’s name, tests and treatments (make sure to jot down the clinical term they use), and results. For example:
1/10/2015; Dr. Nice; ovarian egg reserve scan; left: 10, right: 7.
- Record the medical terms of planned procedures:
When you are scheduled to have a or several procedures, make sure you know the names of the procedures and what they’re for. Most likely the procedures will not be done by the person who prescribed them, and you may be asked what exactly is supposed to be done on the day of the procedure.
- “There might be slight discomfort which is normal” - say “Ouch” nonetheless!
There are several procedures where you’ll be told that you will experience a slight discomfort which is normal. For example, due to the stimulation the ovaries will swell up to unnatural size and when they are being poked during the control scan, it can be painful - it was for me when I went for my first scan. There is no way of knowing how much discomfort “normal slight discomfort” is supposed to be. I have learned that saying “Ouch” the second it hurts, generally allowed the doctor to alter the speed or vigour of what they were doing, and the pain would be drastically reduced. If they can’t be any gentler, they’ll say so. But there is no point in trying to be brave and suffer unnecessarily.
- When they give you the medication and hormones and the medication schedule, ask why you were given that particular protocol:
There are different IVF protocols. There is ‘natural’ IVF where they basically wait for an egg to grow naturally, that one egg is collected, fertilised and implanted back into the uterus. NHS doesn’t offer or pay for this protocol since egg collection is an invasive procedure and NHS doesn’t think that the risk of such an operation is warranted to just collect one egg.
At my clinic, they offered the ‘short’ protocol which starts with the stimulating hormones right after you have had your period (and I believe can get to higher hormone levels), and the ‘long’ protocol which has a preparation period where your own hormones are down regulated to give the doctors more control over your hormone levels during pregnancy. Don’t take my layman word for it, though, ask your doctors!
- When medical staff call you with any changes to your medication schedule (for example when it is time to trigger the egg release before egg collection), make sure to cover these points:
1) Tell them all the medication you’re on and when you last took each of them.
2) Ask for each medication whether you should continue/change/stop it.
3) Ask, what else (new) you should take and at what time.
Medical staff are handling many people at the same time, and what is crystal clear to them might be confusing to you. Take your time to make sure they know where your are at and that you really understand what to do. Ask more than once if you’re unsure.
- Get all the answers on the medication schedule following egg collection BEFORE the egg collection:
After egg collection, the medication schedule will change again to support a potential pregnancy. You will want to go through the new medication schedule with the medical staff before the egg collection occurs. After the egg collection, you’ll be too groggy from sedation to have any clear thoughts or to take in any type of information.
- Right after a positive pregnancy test:
Go to the GP, announce that you’re pregnant, get all the information and goodies (yes, they are goodies to being a pregnant woman), and refer yourself (online) to the antenatal clinic of your choice, where you’d like to give birth at. The referral will kick of the process of getting you an appointment with the midwife and another one for your first trimester scan at 12-14 weeks gestational age.
The IVF clinic only told me to come to them for a scan four weeks after the pregnancy. After the scan they told me to refer myself to the antenatal clinic. But by then, all appointments for midwife meeting and first trimester scan were already fully booked, and they had trouble squeezing me in on time. When I went in for my scan, they had to also consult with an expert and it was really difficult to do that within the time window, since I was already late to the first trimester scan anyways.
- And during the whole time: schedule lots of pleasant distraction and pamper yourself!