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When my husband, Rahul, and I first learned we would need to do in vitro fertilization (IVF) to have a biological child, we were nervous but excited. At that point, I was 36 years old and we’d been trying (and failing) to conceive naturally for many months—so we initially saw IVF as a beacon of hope. A way out of the darkness. Sure, we knew people who’d struggled with the IVF process for years, and sure, our reproductive endocrinologist told us from the get-go that it could be a long and difficult road. But for some reason—naïveté, I suppose, or maybe a dash of relentless optimism—we thought that wouldn’t happen to us. We thought it would just work for us.
And then…it didn’t. And then it didn’t again. And again.
Fast forward to now, and we’ve been in the infertility trenches for nearly three years. We have officially become those people you hear about, the ones we never thought we’d be, the ones who’ve tried everything and still can’t seem to catch a break. IVF is a complex, needle-filled process in which eggs are surgically retrieved and then fertilized with sperm outside the body to create embryos, and then one of those embryos (or multiples) is transferred into your uterus, or a surrogate’s, in the hopes of achieving pregnancy. My husband and I are currently going through our fourth round, after three failed rounds, two canceled rounds, and one failed IUI (a less invasive fertility treatment). I even had a painful laparoscopic surgery after our second failed round of IVF to diagnose—and then remove—endometriosis, which I didn’t even know I had.
Believe it or not, I’m still one of the lucky ones. I have a loving and supportive partner to go through IVF with—one who has also mastered the delicate art of preparing and giving injections—which is certainly not the case for everyone. As a freelance writer who works from home, I also have a flexible job that makes it relatively easy to schedule my days around doctor’s appointments and emotional breakdowns. And Rahul and I have good insurance that covers three rounds of IVF in full; the process can be prohibitively expensive otherwise (one round costs about $16,000 out of pocket at our clinic). Yet despite all these fortunate circumstances—circumstances I’m truly grateful for—IVF is still the hardest thing I’ve ever gone through, both physically and emotionally. For the first time in my life, I know what it’s like to feel truly unwell, to ache in all of the places one can ache.
According to the World Health Organization, one in six people suffer from infertility. While I’m genuinely proud of the way Rahul and I have handled our experience overall, there are still some key things I would have done differently to set us up for a smoother journey from the beginning—and now I want to share those things with you.
Keep in mind, I still haven’t had success yet, so my advice is not prescriptive. I can’t pass along any “do this to get pregnant” tips when I have never gotten a positive test myself. Rather, I’m talking to you as a woman who is still very much in it, but has learned how to preserve her sanity along the way. With that in mind, here’s all the advice I wish I had when I started.
First things first: Choose your fertility clinic (and your doctor) wisely.
If you can, try to choose a fertility clinic that’s not only well-rated, but also close to your home. The “morning monitoring” appointments are frequent and early, and if you’re able to walk to your clinic, as we are, it makes things so much easier and less stressful. Our clinic, Kofinas, is a 20-minute walk from our apartment, which has been very convenient.
Next, be sure you have a good rapport with your doctor. I didn’t realize just how important this would be, but now that I’m two and a half years into the process, I cannot emphasize this point enough. When we met our reproductive endocrinologist, Charalampos Chatzicharalampous, MD, PhD, FACOG, FACMG (Dr. Harry for short), we loved his warm vibe and got along with him well, but we had no idea just how big of a role he would play in our everyday lives—not to mention the nurses and the rest of the team at the clinic. Understand: These are people you will see at very early hours in the morning every other day for weeks, months, years on end, and ones who will guide you through one of the most stressful periods of your life—so you better like them! Dr. Harry keeps it real, stays positive, and truly knows his stuff. If you don’t get a good vibe from your doctor or clinic, shop around—it really, really matters. FertilityIQ is a great place to search.
Accept that this season of your life will be dominated by the uncertainty of IVF.
Everyone talks about the hormone injection needles and the infamous butt shots, and yes, those are brutal. They sting and cause all sorts of bruising and soreness. But Tom Petty was right: The waiting really is the hardest part. For me, the biggest misery of IVF is having to live in limbo, in the in-between. Because every step of the process is based on the success of the last step—i.e. you can’t move forward with an embryo transfer until you have a good embryo to use—it’s impossible to make any plans in advance, let alone any big life decisions, since you don’t know where you’ll be in the process at any given point. As a result, it can start to feel like you are living in a flow chart, where life becomes centered around contingency planning and you are forced to make a series of “if this, then that” decisions.
This is exhausting. And my only advice is to surrender to the flow. In the beginning of IVF, Rahul and I made the mistake of thinking we could bypass this crucial truth and make plans based on how we thought things would go, which was a terrible idea. We ended up bailing on all sorts of big events at the last minute—including a wedding and two family reunions—because we had to be home for IVF procedures. Now, I’ve finally accepted my fate: I simply cannot plan anything in advance during this time. When people invite me places, I tell them I can’t commit in advance, but if they are open to having me at the last minute—if a window of time happens to open up between procedures—then I’m all in. It took me a while to get to a place of peace with this idea of last-minute everything, especially because it seems like everyone around me is making big, sweeping plans for the future, but I’ve learned it’s the only way to go. So when the urge to plan creeps in, just remind yourself: Not now. Not yet. Someday, but not today. And then focus on doing your best to enjoy the present moment.
Time may seem like it’s running out. Know that you have more of it than you think.
I know that fertility declines with age. There is no denying that. But once you enter the IVF community, you’ll also meet all sorts of women who seem to defy the odds and show that time often expands and stretches for those who need it most. Ages that once seemed old will begin to feel young, and months that seemed long will begin to feel short. After all, time is real, but it’s also relative. The way I see it now, Rahul and I already missed the boat on being “young parents.” We also missed the boat on becoming parents at the same time as most of our college friends. Whatever happens next is going to be on our own timeline and will be a miracle no matter what. So now, what’s a few more months?
Remember that some aspects of IVF are in your control. But most aren’t.
Instagram definitely knows I’m going through IVF, because I’m constantly targeted with fertility products that promise to help me “call in” my baby. (The worst is the “Baby Dust in a Bag,” a “fertility blend” that’s basically just powdered herbal tea with extra magnesium.) These products are psychologically damaging beyond belief, because they all support the pervasive idea that becoming pregnant is in your control. A Very Important Reminder: It is not! Infertility is an actual disease. While Big Fertility wants you to believe you can buy your way to a baby, the truth is it’s largely out of your hands.
There are certainly lifestyle changes you can make to help the IVF process along, of course, and I’ve made them all. It’s best to reduce your caffeine intake to 200 mg a day, for example, so I’ve cut down to one cup of coffee or two matcha lattes. Alcohol’s out, too, so I’ve been taking advantage of the golden age of mocktails (my vote: Seedlip and Athletic Brewing Co. are the best non-alc options around). Exercising is tricky, so I’ve mostly been sticking to walking at least 10,000 steps a day and gentle yoga. The general consensus around food is that the Mediterranean diet is best, and supplements are a must (ask your doctor for a list; they vary depending on your protocol). I’ve also added weekly fertility acupuncture sessions at Yinova Center to the mix (research has shown that acupuncture helps with IVF outcomes), and I’ve started doing ten minute IVF meditations most mornings.
But remember: I’m still not pregnant! I bring this up not for sympathy, but to remind you that infertility is still a medical issue, and these extras are just that: extras. They are not going to make or break your odds of success. It’s all too easy to drive yourself crazy doing all of the things and then blame yourself for not “doing even more to relax” if you get a negative test. (The irony is rich.) In the end, the lesson is do what you can, but don’t worry if you slip up. The majority of this process is out of your control anyway.
Try to stay in your own lane.
About a year into IVF treatments, I had a session with Jennifer Racioppi, a professional astrologer and transformational coach. Jennifer immediately got on my level, and had one huge takeaway for me: Put your blinders on and stay in your own lane. She reminded me it’s all too easy to “compare and despair” while experiencing infertility, especially when it seems like everyone you know is getting pregnant—so it’s key to do everything in your power to eliminate this possibility from the equation.
For me, this has meant finely curating my social media (I’ve muted a lot of people who are pregnant or have young kids), leaning into all of the self-care (massages, manicures, long nature walks…anything that makes me feel good), and finding people I can talk to who are in my lane and understand what Rahul and I are going through. I’ve never been much of a joiner in terms of support groups, but I have leaned on friends and family members who’ve either spent time in the infertility trenches themselves, or taken the time to research each step so they know what I’m talking about when I’m freaking out. Ultimately, it’s really comforting to be able to talk about the nuances of the process at length with people who just get it. Not having to explain every complicated step is a big relief—so be sure to find people like that, whether they’re online or in your own circle IRL. It makes all the difference.
Your friends and family may not know how to tell you they’re pregnant. Be proactive about telling them how you want to receive the news.
When you’re struggling with infertility, it’s impossible not to hear pregnancy announcements and feel triggered and depressed about your own: Why not me? And in an ideal world, your loved ones would Google “how to tell your infertile friends that you’re pregnant” to help lessen the blow. But I have learned the hard way that they will probably not look up how to handle this delicate situation. The truth is, most people who have never gone through IVF simply don’t understand how hard the process is, and therefore don’t realize just how much their words and actions can impact you as a result. Or, some do understand how hard it is, but won’t know what to say to you—or will often avoid the subject entirely—because confrontation and tough conversations can feel scary to them. My advice: Don’t blame them for this (it’s not like we learn this stuff in school!), and advocate for yourself instead. If you know any of your friends or family members are trying (naturally or through fertility treatments), tell them in advance how you would like to receive the news. The general consensus in the infertility community is that finding out through text or email, not in person, is best for this. This leaves you time to process the news on your own, because yes, it is news that requires processing. However you choose to handle it, the key is to take control and be proactive.
Allow yourself time to grieve.
IVF can be a really traumatic process, particularly after a failed cycle when you realize you somehow lost something that was never even yours. My advice: Take time to properly grieve, both on the day you receive the bad news and in the weeks after. When everyone around you is reminding you the clock is ticking—and you yourself know the clock is ticking—it can be hard to find it within yourself to pause, but it’s imperative that you do. In my early days of IVF, I tried to keep working through the pain after getting “the call” from the clinic, and not only did I get nothing done, I ended up feeling even worse about not being productive. Now I know to clear my schedule ahead of time to the best of my ability, because I know I’ll need time to process. I’m getting a call tomorrow, for example, to tell me if our embryo from our last retrieval made it through genetic testing, so I’m trying to finish writing this article today. If I find out the embryo didn’t survive, I know I’ll just want to order takeout, cry, and stare at the ceiling. And that’s okay! Instead of beating myself up for not being “stronger,” as I did in the beginning of this whole ordeal, I’ve learned to be gentle with myself and give myself space to feel sad.
On a similar note, I’ve also found it helpful to travel between cycles. This can be difficult depending on your financial situation (I’m really lucky and grateful that I have good insurance and that my job often covers travel expenses), but if you can swing it, it’s a game changer. Getting out into the world is a great reminder that there’s so much more to life than needles and doctor’s appointments and hospital waiting rooms. That perspective shift has given me the energy to keep going. Which brings me to my final point…
Keep the hope alive.
I just turned 39, and I have never seen a positive pregnancy test in my life…but I still have hope. I have endometriosis and an autoimmune system that apparently attacks my embryos...but I still have hope. I have gone through three failed rounds of IVF…but I still have hope. I have every reason to believe this could not work out for me and Rahul, and yet…we both still have hope.
Hope is a dangerous thing during IVF. It doesn’t always translate to reality. But sometimes it does. And for me and Rahul, that small chance of success, that tiny little glimmer of possibility, is enough to pull us through the darkness. Maybe it’s enough for you, too. Everyone always says you’ll know when you’ve reached the end of the line, when it’s time to call it quits and look to a new future, but I know we’re not there yet. I truly believe the universe can still deliver some magic. And who knows? Maybe it’ll be better than we possibly could’ve imagined. As Joni Mitchell sings in “The Circle Game,” “There’ll be new dreams, maybe better dreams, and plenty…before the last revolving year is through.”
