The reasons you’re worried about IVF, and what to do about them

WHEN READERS SIGN UP FOR ANY OF MY FREE DOWNLOADS, they have the option to complete a survey and tell me what they’re most worried about when it comes to IVF. Below are the most common ones I receive, along with some (hopefully) helpful guidance.

Is there anything you’re worried about that’s not mentioned below? Email me! mish@theduff.co.uk

I’m scared of needles

You know who else is scared of needles? Katie Price (aka Jordan). She managed to conquer her fears because she wanted a different face and bigger/smaller/bigger/smaller/bigger again (I think?) breasts, so unless you have an all-out phobia, I’m confident you can conquer yours too.

Most IVF injections don’t hurt – or if they do hurt, it’ll only be for a second or two. There are just three types of injection that might noticeably sting:

• The hCG trigger is usually a subcutaneous injection but can sometimes be prescribed as an intramuscular one.
• You might be prescribed blood-thinning injections after egg retrieval. These burn for a couple of seconds when the medication is going in, and can also cause a fair few bumps and bruises (which disappear in time).
• After embryo transfer, you’ll be put on “progesterone support” to encourage the lining of your uterus to remain thick and cushiony. Progesterone can be prescribed as subcutaneous injections (which go just under the skin), suppositories, vaginal gel or intramuscular injections (which go into the muscle and are absorbed more quickly). It’s the intramuscular injections that can ache.

Here are a few tips on how to reduce any pain:

• Try not to tense up. Tensing the muscles can make injections hurt more than they would otherwise.
• For intramuscular injections, apply a heating pad to the injection site for about ten minutes beforehand: it can help to relax the muscle.
• Dab a gum/ulcer gel (such as Anbesol) onto the injection site a few minutes beforehand (but be sure to wipe it away before you actually inject). It should numb the area slightly so you won’t feel the needle going in too much. This method won’t work so well with the blood-thinners, because those sting from the medication itself going in – not the needle.

But remember: most injections don’t hurt at all. Dive right in and get the first one over and done with – and then you can return to worrying about getting your vag out in front of the doctors.

I’m embarrassed about getting my vag out in front of the doctors

Hard as it might be for you to believe, your doctors won’t judge you or even think about what your vagina looks like or smells like. To them, it’s simply an entry point to what they’re really interested in: examining your uterus and ovaries.

Not convinced? Here’s a whole other way to think about it: whatever embarrassment you have over hairiness, smell, shape, moistness, remnants of period, vaginal fart sounds or anything else, there’ll be someone in the waiting room with a vagina that’s in a worse state than yours. Guaranteed.

I’m worried about the pain of a transvaginal ultrasound scan

I never experienced pain from it at all. Then one day, a fellow IVF patient emerged from the scan room in a terrible mood and said to her partner grumpily, “He was f**king brutal down there. That hurt like a motherf**ker.” I walked in after her feeling pretty smug because I’d done it a million times before and never suffered, but – sure enough – the doctor was f**king brutal.

Now, an ultrasound scan shouldn’t hurt (unless you have a condition like vaginismus or vulvodynia). I won’t pretend it’s akin to a spa day or a superb slice of chocolate cake, but it’s fine. If it’s not fine, you need to tell your doctor to stop treating your insides like a fencing strip. I did, and he apologised profusely and started acting more gently.

There’s a risk things will hurt if you tense up – and I have two tips to help with this. Firstly, you need to breathe deep, in and out – especially when the probe is going in. Secondly, imagine pushing something OUT of your vagina as they’re getting the probe IN: it’ll actually help everything to “open up” and let the probe glide in more easily.

I’m unsure of my rights as an employee when it comes to time off

The Equality and Human Rights Commission (EHRC) – which has a mandate from parliament to “challenge discrimination” – says that, while you’re not entitled to it, you can still ask your employer for time off for IVF treatment. If your employer refuses, “you may want to ask for annual leave instead to attend appointments”.

While that’s probably not the answer you were hoping for, note that “The Equality and Human Rights Commission Code recommends that employers treat requests for time off for IVF treatment sympathetically and that employers may want to establish procedures for allowing staff to take time off for IVF and fertility treatment. These procedures may enable women to tell named members of staff, in confidence, that they are having treatment.” If your employer tells you a straight-out “no”, you might want to make them aware of this paragraph. (You can find it on the EHRC website here.)

Your employer will also need to be consistent in their approach to paid time off. (E.g. if women can’t take paid leave for IVF treatment, men shouldn’t be allowed to take time off for male medical procedures.) If they’re not being consistent, they could face claims of sex discrimination.

I’m worried my partner doesn’t want a baby as much as I do

After our very first appointment with the fertility department, I burst into tears and my husband didn’t. Before the first injection session, I read and re-read the instructions while he tapped his foot and pointed out that dinner was getting cold. When I talked his ear off about all my fears and stresses, he clearly thought I was bonkers.

But when we learnt we had 18 viable embryos, he was the one to jump up and down with excitement. When one of those embryos turned into a foetus, he was the one with his eyes glued to the scan monitor. And when our 5lbs 4oz preemie emerged after an occasionally hair-raising labour, he was the one to get all teary – not me.

We all have different ways of dealing with things and handling our emotions – so bear that in mind before you worry that your partner doesn’t want a baby as much as you.

If he actually doesn’t want a baby, though, that’s a different issue – and one I’m not best placed to help with. All I know is that this is a different situation from accidentally becoming pregnant and getting your partner to come round to the idea eventually. With IVF, you have months of physical and emotional toil before you even get to the starting line of pregnancy. Consider getting counselling to figure things out before you start treatment.  

I don’t want life to go on hold while I do IVF

In next to no time, you’ll realise how brilliantly you manage to “do” normal life around your IVF commitments. You’ll inject yourself in restaurant loos, take medication abroad (be sure to get a letter from the nurse if you’re flying) and answer important work emails from the hospital waiting room.

What’s more, you may even find ways to enjoy some parts of your treatment. For example, my hospital was a 1.5-mile walk away – so I took the opportunity to fit in a load of podcast listening. Sitting in the waiting room, meanwhile, gave me a chance to read Kindle books or articles I’d saved on my phone to read later. And “injection time” became a nice little way for my husband and me to kick off each evening together.

I’m worried I’ll mess up the timing of my medication

On episode 2:5 of the superb Big Fat Negative podcast, the hosts asked fertility specialist Professor Tim Child about how important it was to take medication on time – and what would happen if they ever forgot until hours later.

Here’s the gist of what he said:

• When you’re doing downregulation on the long protocol, it doesn’t really matter if you forget. Take the next one as soon as you remember, then continue as normal.
• During stimulation, most clinics will tell you to take your medication at roughly the same time each evening. That’s so you can have your blood tests and monitoring scans during the day, and then the clinic can call you later that afternoon to tell you whether to increase or decrease your dose for that evening.
  
  If you forget to take it one evening, it isn’t the end of the world: the half-life of these drugs is very long, so even if you missed out on a whole day of injections, it won’t make too much difference because there’ll still be medication in your system from the previous day. Take the missed medication as soon as you remember, then get back into the swing of your regular evening medication after that. (If you're at all interested in what's meant by a “half-life”, here's a good explanation from Quora.)
• The injection for triggering ovulation is the one you can’t mess up. You’re meant to have the injection roughly 36 hours before egg retrieval, which means you’ll arrive at the clinic with fully matured eggs that they can collect from your ovaries (before you’ve ovulated).
  
  If you have the injection more than two hours too early, you may have already ovulated by the time you reach the clinic for retrieval. And if you have the injection too late, the eggs might still be immature.
  
  If you were early/late in taking your injection, call the clinic ASAP so they can try to reschedule your egg retrieval time.
• Once you’ve had your embryo transfer, you’ll be on various hormones (like progesterone) to support a potential pregnancy. You might be asked to take these two to three times a day, and you should ideally space them out. The half-life of these hormones is quite long, so don’t worry if you occasionally take one a few hours too late.

You can hear exactly what Professor Child said on the Big Fat Negative podcast. (Start listening at 43:35.)

I’m terrified IVF won’t work

The latest statistics for a live birth per embryo transferred (using own eggs and sperm) are:

• Under 35: 29%
• 35–37: 23%
• 38–39: 15%
• 40–42: 9%
• 43–44: 3%
• Over 44: 2%

The key, I think, is to be optimistic but prepare for the possibility that each cycle won’t be successful. If you didn’t think you had any chance of success, you wouldn’t be doing IVF – and it’s important to remember that when everything feels hopeless. Plenty of people have had babies as a result of IVF, and you could be one of them.

Equally important is to make sure you don’t start blaming yourself or your actions if a cycle doesn’t work. There’s a lot of luck involved, and no amount of pineapple or post-transfer bed rest is going to affect your chances. Something to bear in mind: most (around 70%, depending on the study) young and perfectly fertile couples who aren't doing IVF don’t get pregnant during a single month either.

Finally, it makes sense to come up with a Plan B if you’re one of the unlucky ones. You could keep trying, of course, but there are lots of other possibilities – like egg/sperm donation, surrogacy, adoption, IVF abroad (where it might be cheaper), or deciding to be happily child-free.

I’m not sure how I can afford to do this

Read my article on 8 tips to help you afford private IVF treatment. (And perhaps you're eligible for IVF on the NHS?)

I’m confused because I want a baby so much, but I’m terrified of pregnancy. And what if I hate being a parent?

I promise you: you’re far from alone. Please don’t feel guilty, and please don’t start thinking you “don’t deserve” IVF treatment.