IVF & Beyond For Dummies Cheat Sheet

Diagnosing an infertility problem: is IVF for you?

If you’ve been trying for a baby for a year or more without luck, it’s time to tackle the problem and find out what you can do about it. Here are some facts about infertility and IVF to get you started:

• You’re not alone: About 15 per cent of couples — nearly one in six — have difficulties conceiving. Over time, some of these couples will conceive spontaneously after trying for a long time, some will have a baby after undergoing infertility treatment or by adopting, and some will remain childless.

• What’s the problem: Your doctor will order tests and investigations of you and your partner to pinpoint why you can’t conceive, because knowing the cause of infertility guides your treatment.

• Causes of infertility: About one-third of infertility cases in couples are due to a male fertility problem, another third are due to a female fertility problem, and the final third are either due to both male and female fertility problems or of an unknown cause.

• Why us: It’s normal to feel shocked, angry and sad when you discover that you’re infertile.

• Low-tech options: Depending on the cause of your infertility, your doctor may suggest you try a low-tech fertility treatment alternative. If this treatment doesn’t work, your next option is usually IVF.

• Time for IVF: For certain causes of infertility, IVF is the only way to help you have a family. If that’s the case for you, read up as much as you can about treatment, because being well-prepared is the best way to handle the highs and lows that inevitably accompany treatment.

Improving your chances of IVF success

Research indicates that by getting into shape before you start IVF you can improve your odds of the treatment being successful. To boost your chances of overcoming infertility and falling pregnant, follow these rules:

• Avoid smoking: Smokers have lower fertility than non-smokers and smoking reduces your chances of IVF success.

• Don’t carry a lot of excess weight: Try to keep your body mass index (BMI) in the normal range of 18.5 to 25. A BMI higher than this can cause hormonal imbalances that disrupt ovulation and reduce sperm quality, which of course decrease the likelihood of conception, both spontaneous and with IVF. Don’t despair if you have a lot of weight to lose: Losing even just five to ten kilograms can greatly improve your chances of IVF success.

• Follow a balanced diet: A well-balanced diet is essential not only for your health but also for the wellbeing of a growing foetus. The bulk of your daily diet should consist of cereals, pasta and rice. You should also have three to five servings of vegetables and two to four servings of fruit, and two to three servings each of low-fat dairy products and meat/poultry/fish/beans for protein. Finally, go easy on sweet goodies and fats.

• Don’t consume too much caffeine: Women who consume a lot of caffeine — more than three cups of coffee per day — may take longer to conceive.

• Restrict your alcohol intake: Alcohol is known to decrease fertility and increase the risk of miscarriage.

• Take folic acid supplements: Getting enough folic acid before conception and during the early stages of pregnancy greatly reduces the risk of the baby having neural tube defects such as spina bifida.

• Start IVF treatment ASAP: Age is IVF’s worst enemy. In a nutshell, your odds of having a successful pregnancy decrease dramatically as you approach age 40.

Understanding some common infertility and IVF abbreviations

When you enter the world of IVF, you need a crash course in deciphering the many abbreviations used in clinics. Here’s a list of the most commonly used short forms of infertility-related terms.

Understanding the steps in an IVF treatment cycle

If you need IVF to treat your infertility, your doctor will provide you with tonnes of information about what treatment entails. Here’s the short version of the steps involved in an IVF treatment cycle.

1. Ovarian stimulation.

   Your doctor prescribes a course of drugs for you to take to stimulate your ovaries into hopefully producing 12 to 15 mature eggs.

2. Monitoring of your drug response.

   To monitor the progress of your ovarian stimulation you undergo an ultrasound examination and blood tests.

3. Egg maturation.

   Two days before your eggs are due to be collected you have a hormone injection, which triggers maturation of the eggs.

4. Egg collection.

   You receive a light general anaesthetic for this simple, short procedure, and your doctor retrieves your eggs using an ultrasound-guided technique.

5. Sperm production.

   On the day of egg collection, your partner provides a sperm sample.

6. Fertilisation.

   The embryologist puts sperm and eggs together in the lab and, if all goes well, the eggs fertilise and early embryo development begins.

7. Embryo transfer.

   Two to five days after egg collection, your doctor places one or two embryos in your uterus.

8. Embryo freezing.

   If you have additional embryos suitable for use, they can be frozen and kept for future transfers.

9. Pregnancy test.

   About two weeks after embryo transfer you have a blood test to find out whether the treatment worked.

   • If the test is positive, you have your first pregnancy scan two weeks later.

   • If the test is negative, you and your partner need to talk to your doctor and decide whether to try the treatment again.

Keeping your spirits up on your IVF journey

Infertility and IVF can be pretty stressful and at times you may feel sad and worried; you and your partner may even struggle in your relationship together. Follow these tips to help you keep sane during your IVF journey:

• Become as well informed as you can about the ins and outs of IVF treatment.

• Set realistic expectations for your treatment.

• Have a plan B in case treatment doesn’t work for you.

• Be actively involved in decisions about your treatment.

• Make use of the IVF counsellors at your clinic.

• Don’t bottle things up: Talk to your partner about how you feel.

• Don’t blame yourself if IVF doesn’t work.

• Keep doing the things you enjoy during treatment to give yourself a break from IVF. For example, continue with your hobbies or go for weekends away.

• Try not to let treatment take over your life.

• If talking about your feelings makes you feel better, confide in someone you trust.

• Use the internet to get in touch with people with similar problems who understand how you feel.

• Join a support group: By talking to others with similar problems you’ll realize that you’re not alone.

Caring for your baby post-IVF

When you’ve waited long and tried hard to have a baby, you feel ecstatic when IVF works for you. But even after IVF, you find that caring for a new baby is hard work. Here’s some advice to help you survive the first few crazy months of parenthood:

• Babies don’t come with a manual, so don’t feel bad if you feel a bit out of your depth at first. You need time to get to know your baby’s likes and dislikes.

• Knowing how to care for your baby isn’t instinctive — you have to learn as you go.

• The fact that you really wanted your baby doesn’t make caring for your newborn any easier than for other parents with newborns. Don’t expect too much of yourself and ask for help when you need it.

• New parents worry about the wellbeing of their babies, but after IVF you may worry even more and wonder about your ability to care for your baby. Rest assured: Your baby will be fine and no-one can do a better job than you.

• Some new mothers find that breastfeeding doesn’t always come easily: Get professional advice and support if you experience difficulties.

• All new parents need a break now and then, so share the workload and enlist as many stand-ins as you can find.

• If your baby cries a lot and is difficult to soothe, feed and settle, you may benefit from attending a day-stay or residential mother–baby program. Ask your maternal and child health nurse for a referral.