Please note: in this article, I will be referring to IVF as a general term. There are other methods that can be used besides IVF, and we personally went through ICSI, which is when the egg is fertilised in a tube before being transferred for implantation in the uterus. Just for you to know. And I’ll explain more below as well.
There are many mixed feelings about IVF and the education we’re getting is coming from doctors. From a certain prospective, it’s great, but I find it makes a big difference when we’re feeling more in rapport with the person who’s describing the process to us. Hence why I wanted to write this article for a long time, and just found now the time and drive to do it. There’s so much to say about IVF, and it’s taken me a while to organise my thoughts and share them with you in a format that I hope will help.
My personal experience with IVF / ICSI
If you’ve been following me for a while, maybe even when I started LotusPowerHealth.com, then you know I had endometriosis. I say “had” because all symptoms have now disappeared and I feel better than ever! With endometriosis, and blocked tubes, comes a diagnosis of infertility. That never helps you to feel better about yourself when you feel that your body is actively preventing you from becoming a mother, whether you’re ready for it or not…
So I went through two surgeries, and a completely lifestyle and nutrition overhaul, to get out of pain from endometriosis and optimise my chances to get pregnant. Yet it took us a while to discover that, as many of you reading must know, that’s not only the woman we should look at, but the man as well.
So my husband did some tests, and we discovered that while my health was better than ever, he had azoospermia, which would make it somewhat of a miracle if we ever got pregnant. Azoospermia means that there is no to very little spermatozoid production, and that the spermatozoid that you get might not be in their best of health themselves. So sperm count was low. Now we needed to check motility (how well they moved) and morphology (their shape).
Long story short: I got diagnosed with endometriosis in 2011. By the time I worked on my health and felt good enough to think about starting a family, it was 2013. We discovered about a year later that my husband had azoospermia, and we thought all chances were gone of us ever having a family. By the time we started the IVF / ICSI process, it was 5 years since my diagnosis of endometriosis. We got pregnant on the first round in May 2016. And I gave birth later that year on December 20, 2016 to our beautiful twin boys.
To give you a few numbers, here is what you should know. Technically, I had endometriosis with tubal infertility, which gave a success rate of 22.6%. When retrieving spermatozoids the day of the fertilisation, the medical team retrieved 8 spermatozoids.
Not 8 million.
Normal circumstances would be several million of spermatozoid roaming freely, but we didn’t have that.
A history of endometriosis + tubal infertility + azoospermia… If I had to calculate the odds of us ever getting pregnant, I’d say they were very low. In fact, we didn’t think that it would work and were ready to try IVF once, and then let go of the idea when it wouldn’t work. We had very little expectations.
That’s why we implanted two embryos.
Both of them implanted, grew and became the two beautiful little boys who are now part of our family.
Thanks to the work of a wonderful team supporting us.
Thanks to the preparation work that WE BOTH did before even starting IVF. With regards to nutrition, lifestyle, stress management, detoxification, etc.
That’s what I saw my clients experience as well. When they did the preparation work, the success rate of their IVF procedure went up dramatically. Understanding what to expect, feeling understood and having someone to go to when they had questions also helped them. They felt they weren’t alone going on this journey.
For now, I want to make sure that if you’re going through an IVF treatment, you’re equipped with tools and resources to help you feel more confident and trustful of the process.
Having personally gone through a round of IVF, I can say there were many fears and questions that went through my mind – and my husband’s. When I spoke to my clients, it was similar questions that came through their minds. Often, being able to guide them and alert them to specific symptoms to watch out for helped them face side effects they weren’t warned they could have (like OHSS, which I talk about below).
Additionally, when you understand better what you’ll be going through, this helps reduce your stress levels, which helps improve the success rate of the procedure.
What is IVF?
IVF stands for In Vitro Fertilisation.
It is an Assisted Reproductive Technology (ART). IVF is the process of extracting eggs, retrieving a sperm sample or sperm samples, and then manually combining an egg and sperm in a laboratory tube. There comes the terminology of tube baby that was given birth to in the 1980s… The fertilised embryo(s) is then transferred into the uterus.
IVF is usually used to treat infertility in the following patients:
- Male factor infertility (that includes decreased sperm count, or sperm motility) (like my husband had);
- Women with ovulation disorders or premature ovarian failure
- Women with endometriosis, PCOS, fibroids
- Women with blocked or damaged fallopian tubes
- Women who had their fallopian tubes removed but still have their uterus
- Men or women with a genetic disorder
- Unexplained infertility
What is important to note is that even though IVF is used for both male and female infertility, it affects the woman most since she’s the one undergoing the treatment and then going through the pregnancy. You surely know that already, but clients of mine insisted I insist on this point, so I do 🙂
If you’d like more information on IVF, check out the Wikipedia definition.
How do I prepare for in vitro fertilisation?
Before beginning IVF, you will first go through ovarian reserve testing. This is when your Follicle Stimulating Hormone (FSH) is being tested. This will help your doctor understand better the size and quality of your eggs and determine the best course of treatment.
The uterus will also be examined to assess how the eggs can be transferred and if there is any specific reason why you should delay your IVF treatment or shouldn’t even start with it in the first place.
Men will be tested for their sperm: count, motility and morphology.
What’s involved with in vitro fertilisation?
As I progress into describing more about IVF, please be aware that I will be sharing from my own personal experience and the ones of my clients. As such, things might be different for you with regards to preparation length, the type of medicine used, stimulation time, number of embryos transferred, etc.
In fact, it depends on countries, hospitals or clinics, and doctors.
Here are the five steps in an IVF and embryo transfer process:
Step 1: Getting started with IVF, preparation leading to ovary stimulation
A blood sample is taken to check out hormones levels, and a trans-vaginal ultrasound is done at least one cycle before you decide to start IVF, to check out normal egg production and determine how much medicine you’ll be given to help stimulate egg production. It also helps check your own health to see if you might need additional work done before starting in the process. For example, if you have ovarian cysts, this might delay the start of your IVF treatment.
Plus, additional ultrasounds are done to check the progress of the egg production.
The first official day of your treatment cycle is when you’re getting your periods. You might have started already with medications before then though.
During the preparation phase, you’re taking fertility medications for about two weeks to help you ovulate and stimulate egg production. These might be oral medications and/or injectable follicle stimulation hormones. The goal is to get as many eggs as you can without leading to ovary overstimulation (OHSS), so that there are enough eggs and spermatozoids for your doctor to play with and match, to increase your chances. Please note that some eggs will not develop or fertilise after retrieval.
At a specific time that will have been calculated / decided by your doctor, the final maturation of the eggs will be triggered through you taking human Chorionic Gonadotropin (hCG), which is a hormone produced by the placenta after implantation. This will be followed by the ultrasound egg retrieval, which will be scheduled for 36 hours later.
Step 2: Egg retrieval
This is a small procedure where you’re given pain killers and have an IV in your arm to help manage the pain while eggs are being retrieved. It is also possible to have full anaesthesia. This depends on your doctor and her preferences. If you have the choice though, remember that any drug you have going through your system stays in your body for at least 6 months, so the fewer drugs you take, the better it is for your future child.
Egg retrieval is when a very thin needle is used to pierce the upper vaginal wall to go into the follicles to remove the eggs.
This can be quite painful. So, if you can:
- Ask your partner to be there to help you stand up, walk, and go back home. You will be able to walk but the process itself might have given you a case of bad PMS and it’s nicer when you know someone is there to take care of you.
- Take a couple of days off from work to prepare for the next step. This will help your body recover faster from the egg retrieval phase, and reduce the amount of stress it is under. Having this time for yourself to rest, relax and prepare your body mentally and physically for the embryo transfer will also increase the chances of successful implantation.
Step 3: Sperm sample
Your partner is asked to produce a sperm sample. If the male partner is suffering from azoospermia, he will have to provide a few more samples before that, whether naturally or whether retrieved through surgery. In any case, the fresher the better.
Step 4: Insemination / fertilisation
In the case of IVF, the eggs and sperm are mixed together and stored in a tube to encourage fertilisation. In the cases when there are fewer chances that this might happen through only IVF, the following procedures might be used:
- IntraCytoplasmic Sperm Injection (ICSI) is used to increase the success rate of the procedure. This is when a spermatozoid is chosen and injected directly into the egg. This is helpful when there are very few spermatozoid, and when these might have low motility.
- Assisted hatching is when a tiny hole is made in an embryo’s outer membrane to try to increase the rate of implantation after transfer.
- Pre-implantation Genetic Screening (PGS) or Diagnosis (PGD) is used to help ensure that only healthy embryos are transferred. As genetic abnormality is a leading cause of miscarriage, this testing is used to help identify causes of miscarriages.
When this is done, the eggs are monitored to check that fertilisation and cell division are taking place. When this is the case, the fertilised eggs are considered embryos.
Step 5: Embryo(s) transfer
The embryo(s) transfer usually happens between 5 and 7 days after the egg retrieval and fertilisation. A speculum is introduced into your vagina. The embryo (less than 5 days) or blastocyst (5+ days) is then transferred via a small plastic tube placed through the cervix into the uterine cavity. In the case of an ICSI, the doctor might also decide to amp up the chances of implantation by bringing the egg directly to the uterus. Or they might decide to deposit it directly in the tube to let it be lead in the uterus as naturally as possible.
This is also a bit painful. Personally, I felt pain during and after the transfer, and so for a few days. Some of my clients did as well.
In any case, I highly recommend that you monitor how you feel!
This is a new experience. When you’re not feeling well, get checked out! Some very serious conditions can stem from the procedures and medications, and when you’re aware of it, you can safely proceed with this first step into pregnancy.
Step 6: Pregnancy test
Approximately 12 days after the embryo / blastocyst transfer. Once confirmed, you have an ultrasound planned usually 2-3 weeks after.
Setting yourself up for success and support
Who do you want to talk to about this?
Going through this process can be quite daunting. You might feel like you should be able to do this naturally and not go through IVF. It impacts you financially too, emotionally and physically. Having someone you can speak to about what you’re going through can help tremendously. Sometimes though, you might not feel like speaking to friends or family about it. It’s quite normal.
I would recommend that you find someone who understands what you’re going through and can help you go through this process. You will reduce your stress and it will in turn help makes this process as pleasant as it can be. Additionally, select carefully who you want to tell about it.
I personally help the women who come to me prepare for their IVF round already 1-3 months before they have it, so that we can optimise their chances of a successful cycle, AND make sure they are prepared physically and emotionally for it.
In any case, select carefully who you’re talking with about this.
Some people might be resentful that you’re going through this process – whatever their reasons for it.
Some people might make you feel guilty about going through this process, depending on what their ideology or religion states.
If you’re doing it by yourself, some people might make you feel like you’re doing it “wrong”.
Remember that what matters is that you’re happy with the decision that you took. And when the people you spoke with are not helpful, then make a conscious decision to focus on the ones who are! And to let go of the ones who aren’t – at least for now!
And, again, looking for someone who understands and supports you along the way can go a long way so that you don’t feel lonely AND you get to talk about how you’re feeling and what you’re experiencing so that you can increase your success rates, have a better experience, ensure you’re taken care of during the whole process, and feel supported every step of the way.
What are the side effects I should be aware of?
There can be quite a few side-effects, but let’s look at the most frequent.
Side effects from IVF / ICSI
Side effects include:
- Passing of a small amount of fluid after the procedure. This can be clear water or be tinted with blood. Considering that you just went through a small surgical procedure, as long as the amount of blood is not a lot, then this is normal. In doubt, go get checked!
- Mild cramping. This can happen because of the procedure, but also because you still have the ovary stimulation drugs in your system, which are affecting your ovaries. As long as the cramping doesn’t increase over time, this should be fine. In doubt, go get checked!
- Mild bloating. If you thought that taking hormones wouldn’t have any side effects, think again. Yes, mild bloating is part of this.
- Constipation. Oh yes, another of the side effects that finds its way into your life through IVF. To help with that, consider taking magnesium. Check with your doctor with regards to recommended amounts. Personally, I had to take magnesium the whole of my pregnancy (starting when I hadn’t even yet confirmed I was pregnant).
- Breast tenderness. As you’re moving towards pregnancy, the production of certain hormones might lead you to experience breast tenderness. That being said, if you’re not experiencing breast tenderness, it doesn’t mean that you’re not pregnant.
And here are some of the symptoms for which you should get checked out immediately: (I don’t even say call your doctor because depending on when this happens, I’d rather you got checked out immediately and then it’s ruled out that it wasn’t an emergency – better safe than sorry!!!)
- Heavy vaginal bleeding. I have personally found that the chances of vaginal bleeding when going through IVF are quite high. I went through it for about 1.5 month at the beginning of my pregnancy. It’s really scary, but when you know it can happen, and you get checked out and you know baby is fine, it does help. But in any case, get checked out immediately!
- Pelvic pain. Yes, this too can happen and if it does, get checked out immediately!
- Blood in the urine. At the risk of repeating myself, if this happens, get checked out immediately!
- A fever over 38’C (100.5’F). Again, if this happens, get checked out immediately!
Side effects of fertility medications
And here are some side effects of fertility medications:
- Mood swings.
- Abdominal pain.
- Hot flashes.
- Abdominal bloating.
- Ovarian hyper-stimulation syndrome (OHSS). When reading articles on the topic, it’s always mentioned that this is rare. Yet, 80% of the clients I worked with have had it. Which is why I mentioned before in this article that if you get some pain, and the pain doesn’t decrease, GET CHECKED OUT!!!
Risks associated with in vitro fertilisation
What are some of the risks associated with in vitro fertilisation?
The most severe risks for IVF typically come from OHSS, and include the following symptoms:
- Nausea or vomiting.
- Water retention + decreased urinary frequency. The water that you take in doesn’t find its way out. This can lead to your body drowning herself.
- Shortness of breath.
- Faintness and decrease in muscular strength.
- Severe stomach pains and bloating.
- 5 kg weight gain within 3 to 5 days.
Again, if you experience these, you should get checked out immediately!!!
With egg retrieval, you run the risks of:
- Damage to the bowel or bladder.
Multiple pregnancy is increased. Personally, we transferred two embryos and both of them implanted. In Switzerland, we could have transferred up to three embryos. My doctor didn’t recommend it so we decided to transfer only two. I am grateful of his recommendations because both implanted. Think about this as well when you discuss with your doctor. With multiple pregnancy, not only is the health of the mother put at risk, but also the health of the babies. Before taking your decision, go into a nursery ward into a hospital. This will help you make up your mind with regards to how many embryos you want implanted.
Ectopic pregnancy. This is a potential risk when the embryo is deposited into the fallopian tube and left to follow its natural course from the fallopian tube into the uterus. The Mayo Clinic reports that it’s a 2-5% risk.
You know when you start but not when you finish. Assisted reproductive technology involves a big physical, emotional and financial commitment on a family. IVF is expensive and not covered by insurances. On top of that you add in cryopreservation of the remaining embryos.
How successful is in vitro fertilisation?
This depends on a series of factors like:
- Reproductive history
- Maternal age
- The cause(s) of infertility
- Lifestyle factors
You also need to understand to differentiate between pregnancy rate vs. live birth rate. These are not the same.
If you’re looking at success rates for IVF cycles, check out this page from the European Society for Human Reproduction (ESHRE). They collect and report IVF success rate statistics from over 39 countries.
You might also want to look further into the live-birth rate associated with repeat in vitro fertilisation treatment cycles, and the success rate based on the number of embryos implanted. In which case, check out this study from 2015. Here are the results mentioned:
“In all women the live-birth rate for the first cycle was 29.5% (95%CI: 29.3, 29.7). This remained above 20% up to and including the fourth cycle. The cumulative prognosis-adjusted live-birth rate across all cycles continued to increase up to the ninth, with 65.3% (64.8, 65.8) of women achieving a live-birth by the sixth cycle. In women younger than 40 using their own oocytes, the live-birth rate for the first cycle was 32.3% (32.0, 32.5), and remained above 20% up to and including the fourth cycle. Six cycles achieved a cumulative prognosis-adjusted live-birth rate of 68.4% (67.8, 68.9). For women aged 40-42, the live-birth rate for the first cycle was 12.3% (95%CI: 11.8, 12.8), with six cycles achieving a cumulative prognosis-adjusted live-birth rate of 31.5% (29.7, 33.3). For women older than 42 years all rates within each cycle were less than 4%. No age differential was observed among women using donor oocytes. Rates were lower in those with untreated male factor infertility compared to those with any other cause, but treatment with either intra-cytoplasmic sperm injection or sperm donation removed this difference.”
And here are additional procedures and tools that depends on countries:
- Egg donation;
- Sperm donation;
- Embryo donation.
What else to think about
With IVF, there are a few things you will need to think about, so why not already give it a thought?
- What will you do with any unused embryos?
- How many embryos do you wish to transfer?
- How do you feel about the possibility of having twins, triplets, or more babies in a multiple pregnancy?
- What about the legal and emotional issues associated with using donated eggs, sperm, and embryos?
- What are the financial, physical, and emotional stresses associated with IVF?
What to do next?
1. Revise your expectations and expect resistance
If you’re familiar with The Optimised Health Formula, then you know that Step 1 of successfully pulling out a strategy to optimise your health is to shift your mindset. We’ve looked at a few things you can do to improve your health. The ball is in your court. Yes, we all know that it takes more than just knowing what to do to actually do it.
That’s why I want to invite you to revise your expectations. Know that there will be resistance along the way. You might say to yourself “I’ll have a look tomorrow again”, “that’s not so urgent”, “I’m not sure that’s for me”, “I don’t think this will work for me”, or many other things. Often when we’re stepping out of our comfort zone (a.k.a. what we’ve been doing until now) we’re finding excuses to keep on doing what we’ve always done. The first step in success is acknowledging that. So… acknowledge where you’re at. Then…
Revise your expectations bearing in mind your goals AND your life. Not everything that I’ve shared in this blog post will resonate with you. Not everything will be applicable to you either. And that’s alright! But you’ve got to start somewhere.
So, as long as you’re clear on your goals and on your vision (Step 2 of The Optimised Health Formula), take a conscious decision of what you want to apply starting from today.
2. Carve out time, and make a plan
That’s where carving out time, and making a plan comes in. You know yourself at that stage better than I do. Use that knowledge to implement a plan of action that will help you start making positive changes into your life, that will soon bring positive changes in your health.
3. Just start
There’s no tomorrow in success. Any successful path starts today, with a small change that you keep on building onto. Commit to starting today with ONE small thing, and share with me in the comments what it is. This commitment will help you start – and keep – taking action!
4. Get support
We tend to want to do things on our own. I’m not stranger to that either. But I’ve learnt over time, and I’ve seen both with my personal coaching clients and professional mentoring clients, as well as with myself, that getting support helps to really create the change we’re after. So, if you’re stuck wondering what’s next, and you know you need help, I invite you to check out the many online resources I have created to help you reach your best of health: free articles, online community, online books and courses. If you’d like private personal coaching guidance, you can also book a call with me to discuss the personal coaching options that are available for your special needs.