When Abby Fischer and her husband decided to start trying for a baby one year after getting married, they got a positive test on her first cycle. “I remember joking with my husband saying, ‘And people make it sound like this is hard!’” she says. “But then it was hard.”
A few weeks later, Fischer experienced an early pregnancy loss. They tried again, but soon after came a chemical pregnancy. Still hopeful, Fischer started tracking her cycle using ovulation tests and realized she wasn’t producing an egg every cycle. With that information, and the fact that she would soon turn 35, she decided it was time to see a reproductive endocrinologist.
After five rounds of ovulation-inducing medication didn’t work, their doctor told them he thought in vitro fertilization (IVF) was going to be their best bet for pregnancy success. It was the beginning of a physical and emotional roller coaster that for Fischer started with fear, sadness, and disappointment.
“I didn't know anyone who had done IVF,” says Fischer. “All I knew about it was that there were just going to be a lot of needles, and I’ve always been deathly afraid of needles. I really didn’t want to have to do it. It felt like a last resort.”
The American Society for Reproductive Medicine estimates that almost 100,000 babies born in the U.S. each year — about 2.6% of all births — are the result of IVF. It’s a miraculous feat of science that helps people achieve pregnancy. It also takes an incredible toll on the body, minds, and spirit of those who go through it.
“It’s truly all-consuming,” says Fischer. “You’re constantly thinking of medication timing, or waiting for a result, or coordinating logistics for an appointment, and on top of that you’re on artificial hormones. You don’t ever really feel like yourself.”
If you’re starting an IVF journey, these facts may be daunting, but knowledge is power. When you know what to expect and learn tools to support yourself through the process, you can better prepare yourself for the road ahead.
IVF Medications and Mood
The medications you take during IVF help your body grow more than one follicle at a time so that your doctors can retrieve multiple eggs in a cycle. These medications are artificial versions of hormones your brain already makes, but in much higher doses than you normally release. Your body’s not used to this overload, so as a result your mood can swing drastically.
“I tell my patients that it's PMS magnified,” says Tendai M. Chiware, MD, director of the third party reproduction program at Genesis Fertility and Reproductive Medicine. “If you typically suffered from PMS signs and symptoms before IVF, it’s like that multiplied by 100.”
Along with hormonal shifts can also come anxiety about whether you’re taking your medications the way you should be, and frustration and discomfort from physical symptoms like bloating, hot flashes, and headaches.
Each person’s experience will differ, but one helpful predictor of how you may feel on these medications is how you typically feel during your period, says Rachael Jones, a family nurse practitioner and vice president of clinical client strategy at WIN, a provider of fertility and family benefits and services.
“If you're somebody that has heightened emotions, PMDD, or more severe depression during your menstrual cycle, then you are more likely to have the mood reaction on neurohormones,” she says.
But you may find that having a predisposition to heightened emotions pre-IVF may be beneficial as you approach the process, says Chiware.
“If you have coping mechanisms you’re already using for depression and anxiety, like medication or therapy, that can really help,” she says.
Waiting, Waiting, and More Waiting
IVF is a waiting game. What’s more, it’s a waiting game where the end of each wait presents another checkpoint to clear before you can move on to the next period of waiting.
“At each stage, there's a hurdle,” says Chiware. “Sometimes you've gotten past every single hurdle, and then at the end, unfortunately, you don't have a normal embryo. And then, of course, if you get a transfer, you may get a negative result — or even when they have a positive result, sometimes they can have a miscarriage. So it's really up and down, up and down.”
The No. 1 piece of advice Fischer says she tells people starting IVF is not to get married to a particular timeline. Instead, try to stay more in the moment and think about what’s immediately ahead of you.
“It’s tempting to say things like, ‘Oh, at Christmas this year, I’ll be pregnant and take pictures of myself with a bump in front of the Christmas tree,’” says Fischer. “But I would encourage you to temper your expectations.”
Sharing Savvy
You know yourself best, so think about how much you want to tell others about your IVF journey. For some people being an open book is a stress reliever, but for others it creates more anxiety and frustration.
“One of the first things I always tell my patients is that they should create boundaries around who they share with and how much they tell people to reduce pressure and stress,” says Chiware. “You’re already dealing with a lot, and so you want to think about who you have texting you on top of that asking what’s happening.”
Jones says that on the other hand, she’s seen the act of sharing IVF experiences open unexpected doors to support for her clients.
“You will find that more people know people that have undergone fertility treatments — or have done it themselves — than you think,” she says. “Maybe a friend introduces you to a friend who has IVF experience, and suddenly you have a connection to someone who gets it.”
Emotional Triggers Everywhere
Amidst your all-consuming IVF process, life elsewhere just keeps on going. Social media, social gatherings, and even small talk can bring up emotions you’re not expecting.
“Any pregnancy announcement, even from college acquaintances I haven't talked to in years, was like a gut punch that ruined my day,” says Fischer. “It felt like further proof that other people have working bodies that can get pregnant and stay pregnant. There was a lot of jealousy and bitterness, and then I felt really guilty about feeling jealous and bitter.”
Those experiences have shaped how she’s moved forward in her journey. After two egg retrievals and three embryo transfers, Fischer is now in the second trimester of a pregnancy, and says she took great care with her own pregnancy announcement.
“I wrote a long caption on social media because I needed to call out IVF and talk about what we went through to get to where we are,” says Fischer. “I wanted anyone struggling with getting pregnant to hear me saying, 'I see you. I've been there. I get it.”
Building Resilience
You can’t control your feelings, but certain tools can help you ride your waves of emotion more smoothly.
Practice proactive stress relief. If you don’t already have tried-and-true (healthy) stress relief strategies, now’s the time to explore some. Meditation and breathing exercises are accessible and available to you wherever you are. You can also journal, exercise, or spend time on creative pursuits such as art, dance, or baking. Be intentional about carving out time each day for the things that ground you and bring you peace.
Search out support. Therapy with a licensed counselor or psychologist is an effective mental health option. Alongside that, you can also tap into the vast IVF community through support groups. Whether you prefer to stay anonymous or want to connect face-to-face, you can find others who have been or are where you are and can offer advice and a listening ear. A good place to start is with your clinic — often they offer support groups or can point you in the direction of one.
Fischer found her community through AllPaths Family Building, a nonprofit that provides an online community for people struggling with fertility and family building.
“It’s helpful to have a sounding board and all of these women on a screen nodding their heads in agreement with you as you're telling your story,” says Fischer. “You feel so validated and seen and understood.”
Check in with your partner. If you’re going through IVF with a partner, the experience can put a strain on your relationship, but it can also bring you closer together. It may feel like your intimacy has been hijacked by science, so it’s important to pay attention to what you both need.
“Partners want to be supportive in general, but they don't often know the best way to do that,” says Jones. “You may be physically going through it, but they are also emotionally going through that roller coaster, and so they will have some feelings about it, too. Be open to sharing that with each other so that you both feel heard.”
Give yourself grace — and credit. Think about your mental and emotional load elsewhere. What can you let go of in this season? You’re doing a hard thing, and that deserves space, time, and focus.
“IVF isn’t a sprint, it’s a marathon,” says Chiware. “People who go through IVF are some of the strongest people I know. But you have to be kind to yourself and give yourself compassion, too.”
Fischer says her experience with IVF has taught her a lot about herself and what she’s capable of. “Never in a million years would I have thought I could get through something like this,” she says. “But now I look back and I realize I’m a lot stronger than I ever thought I could be.”
Show Sources
Photo Credit: Moment/Getty Images
SOURCES:
Abby Fischer, Somerville, Massachusetts.
Tendai M. Chiware, MD, reproductive endocrinologist and infertility specialist, director, third party reproduction program, Genesis Fertility and Reproductive Medicine.
Rachael Jones, FNP, vice president of clinical client strategy, WIN, Greenwich, Connecticut.
American Society for Reproductive Medicine: “US IVF usage increases in 2023, leads to over 95,000 babies born.”
Society for Assisted Reproductive Technology: “Preparing for IVF: Emotional Considerations.”
Center of Perinatal Excellence (COPE): “Looking After Yourself During IVF.”
