Guide to Common Issues Women Face with IVF

Choosing to undergo in vitro fertilization (IVF) treatment is a major personal decision that will impact your physical, emotional, and financial wellbeing. The stress of undergoing IVF is often compared to that of a major life event like planning a wedding, a significant personal illness, or moving your family to a new state. When you start researching IVF online, it’s important not to fixate on just the negatives. There are a lot of exciting moments during the process, like learning you have viable embryos, or that first positive pregnancy test. That said, being informed about physical and emotional considerations, as well as the actual risks and issues that can crop up during IVF will empower you when making decisions about your treatment. Below, we’ll detail the common issues and risks you might face and provide some strategies to help you prepare for their possibility. 

Physical considerations for IVF  

Before you begin in vitro fertilization, it’s important to consider the physical repercussions you may face.  Negative outcomes are not the rule, but knowing they are a possibility will allow you to create contingency plans for how you’d like to handle them. IVF is a medical procedure, and though serious complications from IVF are rare, you want to educate yourself on the known risks and side effects of the required treatments. Having answers to the following questions will make it less stressful in the even you do experience complications.  

What are potential side effects of IVF medication? 

The injectable fertility medications typically used to help stimulate egg follicle growth in an IVF cycle can frequently cause a number of possible side effects, including mild bruising and soreness at the injection site, nausea and vomiting, temporary allergic reactions, breast tenderness, increased vaginal discharge, mood swings, sleep disturbances, and fatigue.  

Ovarian hyperstimulation syndrome (OHSS) 

While this a rare side effect of ovary stimulating medication, between three and six per cent of women will experience ovarian hyperstimulation syndrome (OHSS), which can cause the ovaries to become painfully swollen. Your fertility specialist will be monitoring closely for symptoms of OHSS during this stage of the process. If you are one of the small minority of women who experience this complication, you’ll have to postpone your embryo transfer procedure as symptoms won’t resolve until you menstruate. Otherwise, OHSS won’t have any impact on your IVF success rate. 

Are there risks with egg retrieval? 

Your doctor will use a transvaginal ultrasound to retrieve your eggs during the early stages of IVF. Like any invasive procedures, this one has some risks including post-retrieval abdominal pain, potential injury to organs, and pelvic infection. Since the procedure is done under ultrasound guidance and the needle is visible on the ultrasound, the chance of serious complications is extremely small. 

What risks are associated with embryo transfer? 

When it’s time to transfer the embryo, your doctor will place a catheter containing the embryos into your uterus. Risks associated with this procedure are minimal. When your doctor inserts the catheter through your cervix, you might experience mild cramping, or light spotting after the procedure. In rare occasions, this process may cause an infection, which your doctor will treat with antibiotics. 

Does IVF increase pregnancy complications? 

The reality is that women who undergo IVF do experience more complications during pregnancy, but a lot of those complications don’t stem directly from IVF treatment. Advancing age, weight, and types of infertility are all linked to increased risk of hemorrhage, c-sections, gestational diabetes, and pre-term labor. 

However, research suggests that the higher levels of hormones needed for IVF, as well as transferring multiple embryos do increase your risk of pre-term labor. To help reduce this risk, consider improving your overall fitness, opting for a single embryo transfer, or freezing your eggs and doing the transfer once the ovary stimulating hormones are no longer in your system.  

Does IVF cause birth defects? 

IVF is not known to cause birth defects. In some cases, having an intracytoplasmic sperm injection (ICSI) may increase the risks of rare genetic imprinting disorders. However, research suggests that this may not be the result of the procedure itself but a result of sperm defects. The benefit of IVF is that before the embryo transfer process, you have the option to use pre-implantation genetic testing (PGT) to screen for chromosomal disorders like aneuploidy and for single-gene diseases, thus removing the risk of birth defects.    

Does IVF increase the risk of miscarriage or ectopic pregnancy?  

IVF doesn’t increase the risk of miscarriage. The rate of miscarriage after IVF is roughly the same as the rate with unassisted pregnancies.  

However, IVF does increase the risk of ectopic pregnancy. An ectopic pregnancy occurs when the embryo implants inside the fallopian tube. They occur in as much as 8% of pregnancies resulting from IVF. Unfortunately, the only recourse in this situation is to medically terminate the pregnancy. Untreated Ectopic pregnancy is the leading cause of maternal mortality during the first trimester. So, it is very important that you discuss the risk with your doctor and find out how they will monitor for this.  

Is implantation failure more common with IVF? 

Implantation failure occurs when there is a lack of synchrony between the embryo and endometrium. The lack of synchrony may be due to a displaced window of implantation (WOI). As many as 30% of people who struggle with female-factor infertility have a displaced WOI. 

It’s important to remember that IVF does not cause implantation failure to happen. In fact, this is something that happens to people who conceive unassisted, they just won’t have the same awareness of it happening that IVF patients will. Thankfully, there are ways to improve embryo/endometrium synchrony. Endometrial receptivity tests (ERTs) like MIRA™ can identify precisely when your WOI occurs, ensuring that your embryo transfer is scheduled when your endometrium is most receptive. 

How to prepare your body for IVF   

Choosing to undergo IVF treatment is a courageous decision. You’re already aware that it’s likely to be a challenging experience. Improving your overall health and fitness can make the changes your body will experience during IVF treatment easier to manage. Luckily, most of the recommendations for preparing physically and mentally for an unassisted pregnancy also apply to IVF. Preparing your body for pregnancy, recognizing that the quality of your diet, exercise and emotional state can all have a positive impact on your IVF success rate. These dos and don’ts can help ensure you’re at your best. 

Nutrition 

As you prepare for IVF treatment, it helps to adopt a healthy perspective around your eating habits, while trying to avoid making drastic changes like suddenly switching to a vegan diet. It’s recommended that prior to starting your hormone treatments, you should provide your body with the nutrients it needs to generate healthy cells. 

The “Mediterranean diet” is frequently recommended by fertility doctors because of its diverse nutritional profile. Whichever meal plan you opt for, it’s recommended that you include a variety of vegetables and fruits; healthy fats; and lean proteins like fish, beans, and legumes.  

To better support your organ function and limit the disruption to your endocrine system while taking hormone medication, it’s recommended that you avoid alcohol, tobacco, and recreational cannabis. It’s also recommended that you reduce your caffeine consumption. 

Speak to your doctor, and consider consulting with a dietician about what supplements, adaptogens, and other functional support they commend at each stage of your IVF journey. 

Exercise   

Developing an exercise routine to support your fertility journey has a lot of benefits. It increases blood flow, which will help ensure nutrients are distributed throughout the body. It also helps reduce the buildup of cortisol (the stress hormone) in your system, which will have a positive impact on your chances of a successful treatment cycle. Many women also turn to exercise as a healthy way to manage the weight gain associated with hormone medications. 

Before you hit the gym, you should be mindful of certain guidelines for exercise during IVF. If you are starting to exercise regularly for the first time, make sure you start a few months before you undergo treatment. The added strain on your body can negatively impact your IVF success rate. Fertility specialists recommend engaging in low intensity exercises such as walking, swimming, or low-impact yoga. You’ll want to keep your workouts to around two and a half hours per week, and avoid twisting motions or body inversions. 

Stress management 

IVF treatment is invariably stressful for you and anyone who is on this journey with you. However, there are many ways to manage, and reduce your stress. Nutrition and exercise are both useful for decreasing the buildup of cortisol in your system, which will help you avoid blood sugar complications. 

Studies have shown that adopting practices like mindfulness, meditation, gratitude, and journaling can help you manage your stress levels. Mindfulness and meditation apps like Circle+Bloom, MindfulIVF, and Headspace all have content geared toward the fertility journey. You can also find products like The IVF Positivity Planner to help you journal your way through this time in your life. 

Alternatively, you might take this time to revisit activities and hobbies that brought you joy as a kid. Creative expression can be a powerful tool for processing your emotions, improving your mood, and relieving stress. If you’re not an artistic person, creating opportunities to spend time with friends, or get a massage can be great forms of self-care. 

Emotional impacts of IVF  

By the time you begin in vitro fertilization, you will have probably experienced many ups and downs related to your fertility journey. IVF treatment is a personal experience unique to everyone who pursues it. However, many consider their time undergoing IVF to be one of the more stressful times of their life. Everyone will be impacted by this stress differently.   

Learn as much as you can  

One way to cope with stress and anxiety is to become more knowledgeable about treatment so you know what to expect. Organizations like RESOLVE and the American Society for Reproductive Medicine are great sources of information. As you learn about what to expect from IVF, you may want to consult with friends or family members who may have had in vitro fertilization before. Search for articles about IVF related topics learn more about the process, and take advantage of any resources your treatment center offers you.  

As you learn to manage your emotional health and deal with the increased stress of IVF treatment, focus on these steps: 

Prepare for decision-making 

One thing that increases our stress is the feeling of being out of control. Preparing ourselves for what’s to come can help us feel more in control. You will have several decisions to make as you begin in vitro fertilization. Think about questions like these to help you prepare ahead of time: 

• How will I handle a multiple pregnancy if it occurs?  
• How comfortable am I using donor eggs, sperm, or a surrogate, if necessary?  
• Will I freeze additional embryos? If not, what are the alternatives?  
• How do I emotionally prepare in case the procedure isn’t successful?  

• Am I willing to go into debt? If so, how far? 
• How do I maintain balance with my other obligations during treatment?  
   

Mental and emotional health 

As discussed above, your mental and emotional health may take a toll as you begin in vitro fertilization. If you are considering IVF, you probably have already experienced struggles along your fertility journey. It’s important to remember that a range of emotions, from jealousy to joy to sadness, is normal. Seek out support from meditation apps like Headspace or Calm and look for a mental health professional to meet with on a regular basis to help you along in the process.  

Personal relationships and support network  

If you are pursuing in vitro fertilization with a partner, you may want to talk with them about your relational expectations leading into treatment. Consider these questions:  

• How and when do I want to share my IVF journey with others, including friends and family members? 
• Do I want my partner or a family member to attend every appointment? 
• Do I want to limit how often I talk about treatment with my partner? 
• Should my partner and I both join an IVF support group? 

Identify your stresses and your coping mechanisms  

Everyone handles stress differently. At this point, you probably already have some coping mechanisms in place, but as you learn more about the IVF process, identify areas that you know may give you the most anxiety or bring on the most stress, such as making financial decisions or facing discomfort during procedures. During those times, be prepared with additional support. Find a therapist, a yoga practice, or a meditation app to help you. 

Anticipate problems  

It’s impossible to anticipate everything but identifying what you do and don’t have control over now will help prepare you when problems arise. Here are some questions to ask yourself:  

• Who is on my support team? 

• How will I support myself mentally and emotionally when no one else is there?   
• Can I avoid other major life transitions, such as a move or job change during this time?  
• How will I handle unexpected costs that may come with new procedures that may be needed? 
• Do I know what decision to make if I encounter multiple births, premature birth, or other complications that may arise from IVF? 

How does IVF impact your finances and career?  

Healthcare costs in the United States can be unpredictable. The cost of your IVF care will depend on several factors, including the state you live in, the fertility clinic you choose, and whether or not your insurance will cover certain expenses. Before you begin IVF treatment, consider the financial impact of in vitro fertilization on you and your household, and prepare yourself for the unexpected.  

Financial preparations and considerations  

One cycle of IVF can cost anywhere from $10,000 to $25,000, and this may or may not include the cost of medication or additional surgeries or procedures that often come up during IVF. Even if your doctor can give you an estimate, the final costs may end up being more than the quote. Plan to shop around, if you can. Depending on your situation, consider looking into options like discounted treatments and IVF refund programs.  

If you get a quote, ensure it lists all possible procedures including the following:   

• Pre-IVF fertility testing and consultations   

• Fertility drugs  
• Mock embryo transfer  
• Pregnancy testing, ultrasound monitoring, and blood work  
• Cryopreservation of extra embryos and storage fees  
• Other assisted reproductive technologies (ART) 

Understanding your budget 

Creating a fertility and family planning budget can help empower you in making decisions based on the resources available to you. Use the different quotes you receive as the basis of your budget. Don’t forget to include any additional travel expenses if you go out of state for treatment. This will give you a good picture of what you will need to add, but review all your pre-IVF expenses as well to see if they will be impacted. Crunching the numbers as best you can will help reduce stressful surprises, and let you focus on your fertility journey. 

What insurance options are available?  

One of the biggest questions you may ask as you begin looking at financing IVF is, does my insurance cover fertility treatment? Maternity and newborn care is considered essential under most healthcare plans in the U.S., but infertility treatment doesn’t fall under this umbrella. Some plans will cover IVF but not the hormone treatment, while other plans may not cover IVF at all. Check with your provider for more information on the specifics of your insurance plan. 

Financing 

Choosing to go into debt to pursue IVF is a major commitment that brings its own set of anxieties. Having a clear plan in place will help you make a sound decision if you decide to pursue it.  You’ll want to be sure you can pay down your debt once you’re in a position to do so. Making a financial plan that takes into account unexpected costs and procedures will help you get an accurate view of your overall financial picture. Put a limit on the amount of debt you’re willing to take on and stick with your plan. 

Preparing for IVF in the workplace  

In addition to the physical and emotional challenges of undergoing in vitro fertilization, the time commitment required during IVF can be difficult for people to navigate. During IVF treatment, you may have to schedule last-minute visits to the clinic. You may need early morning bloodwork, ultrasounds, or a consultation with a nurse. Sometimes, you’ll need to return the next day for a follow-up appointment. The side effects of IVF medications may also impact your performance at work, requiring you to take a sick day or two.  

Consider these steps to help you as you navigate this unpredictability while working:  

• If you can, block off early mornings in your schedule.  

• Choose a clinic that can be flexible with you and your work needs. Look for a facility close to your home or place of work.   
• Ask your employer if you can work remotely.   
• Find a supportive manager in your workplace who can help you manage conflicts if things get tough. 

There are a lot of things to consider as you approach IVF treatment, and infertility treatment as a whole. There is also an abundance of fertility support options available to help you feel equipped to handle any challenges thrown your way. Consult with your fertility team, listen to stories of how others have gotten through this, and most of all, remember that you never have to go through this alone.