20 hurdles of IVF

2 06 2010

When I look back at my IVF involvement nothing prepared me for that horrific 14 day wait-and-see period during which pregnancy is determined. It is the point at which no all omnipotent surgeon can influence any further Nature’s plan for us. It’s cruel but it’s where we as humans face the limits of our ability to manipulate the creation of life.

I thought I would look back on what hurdles I encountered along the way. On reflection, it seems like there was a pretty long list of things to tick before going anywhere not all of which I was ready for:

Hurdle 1. Are you within the necessary age bracket to get funding, for all, part or just drugs?

Hurdle 2. If you can’t get funding, for whatever reason, can you fund it yourself?

Hurdle 3. Are you mentally prepared for this? Do you really understand what’s involved for you both? Have you set a limit on how many cycles you will try? Have you discussed what happens if it all fails? This is vital, not to be ignored or presupposed that just because you know what you want is a baby, that everything will be fine – because that leaves too many hostages to fortune. You need a clear plan and one in which you have spent serious time, talking, discussing and being counselled – yes, guys, counselled, seeing someone who is a professional counsellor and specialises in the whole area of infertility.

At this point, I don’t have any time for men (and neither should their partners tolerate this) who are not prepared to talk about their feelings, openly, seriously and honestly. If the discussions are not open and mature, or if the male cannot commit serious time to this stage, then you will have problems. Having said that, no amount of being in tune with yourself will help you to deal with your partner’s feelings as you go through each stage of the cycle.

What we’re talking about here is preparation, mental preparation, which is no different to physical preparation or training in advance of a game or sporting event.

Hurdle 4. Dealing with family. Give them as much info as possible, be open, graphic and inclusive at these initial stages. Tell them it will get very personal. Personal in a way that only you two will ever know, and that the best thing they can all do is not to keep calling, asking if you’re okay. Apologise in advance if you shut them out. It’s not about them, it’s about you. All comments, advice and help needs to be contained and if wanted by you will be sought after. It comes to something when if things don’t work out you have to assuage someone else’s grief when dealing with your own.

Hurdle 5. Be prepared to be a spare part. If infertility is on your partner’s side, as it was for me, however much they dress it up, the clinics direct all their conversations to your partner. I found myself feeling like a pork shop at a Bar Mitzvah. I was occasionally spoken to but on the whole I felt pretty invisible. Be prepared for this, but make sure you ask questions as many as possible – be informed, one or other of you won’t be listening to it all, so it’s important you both glean what you can and questions help.

Hurdle 6. Be prepared to ignore the fact that you are spending thousands of dollars and that you are just another patient. What private medicine still does very badly is make you feel like you’re valued, rather than a number. Think of the most luxurious hotel you have stayed at and that is what the experience should feel like, but it won’t. If going private is new to you, it means access to specialists in usually pleasant surrounds. Their manner can still be the same, and the staff that support them are clinical rather than service oriented. However, if something is damned well not right, you say so – it’s costing thousands so bring them to book.

Hurdle 7. Be prepared for days when you bump into friends who mysteriously have gone quiet on you and then you find out they’re pregnant naturally. Be prepared, man to man or woman to woman to be adult about this, don’t lose good friends, be supportive if you can, keep a distance if you must, but try to share their good news – the world is unfair, but these are your friends, as much as you can’t have naturally what they can, it’s really not their fault or yours. Be kind, open and transparent with each other about how you’re all feeling. Please keep in touch, you will need them and perhaps, they you.

Hurdle 8. Be prepared for crass remarks and stupid comments, for they will be plentiful and will occur for a variety of reasons, hence calm yourself. Some people are ignorant, some are stupid, some are just plain nasty and insensitive. I have already described some of the pathetic remarks I put up with, and I chose to laugh them off and rant about them later, at first. Later on, I decided to attack my verbal assailants with wit and sarcasm in response. Talk about these issues with your partner, discuss them openly, stating how it made you feel. You need to share as much of what you’re feeling as possible don’t bottle it up.

Hurdle 9. Be prepared for a lot of technical jargon and acronyms. Stop the medics, ask them to explain, re-explain. Remember, you’re paying for a service and treatment, you need to know what it’s about, in full, clearly and precisely.

Hurdle 10. Be prepared for the fact that there will be vast mood swings, lots of tears, rants, abuse and you will both feel extremes of closeness and vulnerability. Sex could become technical and mechanical or non-existent. You need to be sure to re-establish intimacy, if it disappears, talk the issues through, raise it with a counsellor, but do not allow close physical contact to evaporate, as I did.

Hurdle 11. Be prepared to get over the embarrassment of sample collection. Masturbation is normal enough, here you’re given an excuse (don’t abuse it or debase it, be sensible and mature about it). The room is usually small, not far from reception and very clinical. There will be porn in there for those who need it. However, there’s no reason why you both shouldn’t go in to that room together and have some fun with the process or do it at home and bring in the sample asap. What will astound you is the jar they wish you to collect in…be very careful with those sharp edges. Remember one other thing too – volume means nothing, and in reality you will collect a very small amount of fluid, so don’t think for one moment your donation is any less than any other man, it’s probably very similar (unless and unfortunately, it is your sperm count that is at issue, in which case the clinic will help you anyway with sperm collection). However, to get the best results, abstain for a couple of days before hand. Don’t be afraid, we all know why we’re there, come out, ring the bell and hand it over. If you’re interested, ask to see it under a microscope, indeed ask to see the technical side of the lab. The more you see, the more you’ll appreciate what’s happening.

Hurdle 12. Be prepared for the fact that when you see the follicles under a scan, like sperm, quality of eggs is what’s important. If you can get quality and volume, then all very good, but do not become despondent when you don’t collect as many eggs as you thought you were going to get.

Hurdle 13. Be prepared for the fact that egg quality and sperm motility may reduce the numbers of embryos that can be successfully transplanted back, from the initial quantity of eggs harvested. Nothing is guaranteed here, so even if all 8 eggs fertilise, for example, cells may not divide properly and as with nature, embryos may fail to develop. At the end of the day, for all of the clinic’s best efforts, there will be as many eggs and embryos fertilised as nature will allow. If you are fortunate, you will have spare eggs and/or embryos for freezing and either future cycles or for research, donation or destruction.

Hurdle 14. Be prepared to not feel anything for days afterwards. Be prepared for your partner to feel gripes and to be conscious and on the look out for the slightest signal of ‘something’. Unfortunately at this stage ‘fingers crossed’ is the only expression you can use because the matter is between your body, nature and God. Be understanding and accommodating, it might drive you mad, where every minute is dissected between now and the last ‘feeling’, and you start wondering what if? Best thing to do is carry on with life as normal. I think we went on holiday a couple of times, but really no special treatment is needed physically because naturally, you’d be doing what you do without knowing anyway.

Hurdle 15. Be prepared for the worst. If those HCG levels don’t make it up there, you’re going to be sad. Make sure that when you go in or speak to the clinic to get the result that you are both there. Nothing can be more lonely or desolate, I should imagine, to get good news or bad news on your own. You need someone to hold you, kiss you, be supportive, to cry in sadness or joy with you – to just be there. If your partner can’t make that effort, then I’m sorry, he’s a selfish arse, business trip or no business trip! It doesn’t take much planning to organise your life around these critical times.

Hurdle 16. Be prepared to say ‘enough is enough, let’s move on from this’. We didn’t, I blame myself for wanting to be a dad at all costs with a partner who also wanted to be a mum at all costs. We rushed into decisions about what came next when we should have stopped and evaluated our psychological, physical and relationship needs. We neglected ourselves, but you really do owe it to each other to slow down and not to make decisions without proper counselling and advice. These decisions will affect your relationship, long-term for ill or good. Make sure you are open, honest and true to yourself before committing to whatever those next steps might be. The last conversation I had with Richard Fisher at Fertility Associates concerned probability. “If I was to take $50,000 to Las Vegas right now, would I stand a better chance of winning there, than securing a child if I gave you the money?” He told me to go to Las Vegas. This was at the very end. He’d done everything he could, discussed our case with colleagues internationally, and we just had to face facts.

Hurdle 17. Be prepared, if things aren’t successful, for a lot of pain, hurt, frustration, anger, feelings of isolation, mental self-torture, blame and bewilderment. If you can’t face both families write one letter to them all and send that, rather than having to explain everything in detail in long, arduous telephone calls – in my case, 18,000 kms away. Allow each other to grieve. It’s okay to be silent about it and not discuss it for months. However, it may sound clinical, but if you know each other well enough, plan in advance what you will do in the immediate aftermath, how you will behave and so forth. It can help to avoid a lot of misunderstanding and unnecessary tension if you can.

Hurdle 18. Be prepared to see lots of babies, parents and families, going about their lives having a good time. It will upset you. How you deal with this at large is down to your own sensitivities, but you may need help and guidance to get through it, because it will be a constant reminder of what you aspire to.

Hurdle 19. Be prepared to deny the urge to create a nursery, buy baby things or to accept any donations from well-intentioned folk who think you might be needing them. The last thing you need, if things fail is to sit in a room with all this stuff and be reminded of what might have been. We did that, it’s not pleasant and it’s something you should avoid.

Hurdle 20. Be prepared to not let infertility define you as a couple. Do not become a prisoner to it, it is not a sickness or an illness, it is something that unless contained and qualified will destroy you both. It has tremendous destructive powers and if unleashed without constraint, you will end up totally consumed.

Hurdle 21. Be prepared to receive the clinic’s final invoice, not long after. It comes at a vulnerable time and in my case got kicked about the kitchen floor and was then attached to the cat scratching post. It’s a hard one, but it’s a practical reminder and one you need to accept and get on with.

Hurdle 22. Be prepared for the fact that this journey is life changing – nothing will be the same again because it’s pretty invasive and affects aspects of our lives in which the stakes are high and the emotions raw. This is where the counselling comes in at the very beginning. I repeat, do not scrimp or treat with disdain this part of the journey, but definitely find someone you’re comfortable with – it’s critical – and if you need the name of someone in Auckland, please contact me.

These were my hurdles. You may read this and think that some, all or none of it applies, that’s fine. I wanted at the very least to convey an experience, an emotional journey, a tragic path that we embarked on to achieve our end goal, and to help others plan and prepare for the challenges or hurdles they will inevitably face along the way.

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12 responses

3 06 2010
AP

Dear David,

Such sad and moving articles, do hope that by writing about these painful experiences, you can now move on and enjoy your exciting new life.

Hopefully, others may read these wonderfully written pieces, and take some solace from them, then perhaps all your suffering will not be in vain.

Well done !

AP

7 06 2010
djpnz

Thanks mum, I think I spoke to you about this, but I do value your comments and appreciate you taking the time to write. Love me x

19 07 2014
Leroy

Love the advice I’m trynig right now to get pregnant and hopefully it will happen! I’m staying happy about it thinking good thoughts I’ve been trynig for about 6 months now and one of these days its going to happen your article has given me a few more things to try.Thank you!

4 06 2010
Sister 3

I had no idea of the depth of your pain. How courageous of you to share all of this in the attempt to help others and I hope, to come to terms in a small way with all that you both endured.
I love you lots and admire your openess, for a man, I would guess that this has been most difficult to open up about and I hope that there are other couples out there who may take some comfort and shared wisdom from your agony over the last years.
G xx

7 06 2010
djpnz

Thank you sis! Appreciate you taking the time here. It hasn’t been easy carrying all that around, but it’s been very helpful writing about it. There’s more to come! Love you too! x

7 06 2010
Neezy!

David,
Even though, as you know I have worked with some patients in this area (very many years ago when IVF was indeed in it’s pioneering stages) when it involves a family member then this becomes an even larger emotional roller coster. Every “Hurdle” you have itemised is so very true and honest. No one can truely imagine what you have both gone through over the years because none of us have actually experienced the process of IVF for ourselves. It must have taken a lot of courage, examination of suppressed and hidden emotions to be able to write of this incredibily moving and life shattering experience as you have? I admire and respect you both enormously. I hope this carthartic piece of writing has helped you to be able to “heal, move on” and finally enjoy the exciting and life changing experiences waiting to happen in this new chapter of your life?
Luv n’ hugs in abundance, Neezy xxxx

1 07 2010
egghunt

Hi David
Thanks for your comment on my blog… I meant to comment on yours before linking to mine so sorry bout that.

For me, hurdle #4 was the most significant… My family, as loving as they are, are such a handful for me to deal with while going through IVF. The constant checking in and needing to know every little detail has been an ongoing frustration for me personally. I finally snapped dufing our last IVF cycle and told them how insensitive it was for them to be continually asking all these questions and that they wouldnt ask any ‘normal’ couple how often they had sex or what sexual position they used to get pregnant so why should they bombard us with equally personal questions.

Its hard enough to convince yourself you are not a science experiment whilst going through this without having well meaning family/friends adding to the mix as well… so setting ground rules from the very beginning (yes, even at that first IVF when you are sure it will work) is so important. 🙂

1 07 2010
djpnz

Family is both a blessing and a curse. From their perspective, they are damned if they do call and damned if they don’t! It’s either over sensitive or insensitive?! I remember thinking don’t they know how to behave? And, the answer was ‘no, of course not…’ but then who does? I think it’s appropriate to write an email to all – they all get the same words, at the same time with the same information on it, almost the ‘Do’s and Don’ts’ of your IVF.

I am going to write a post about how to spell it out in formal, but simple terms, rule of engagement for family and friends, something like this:

1. We thank you for your love and concern, but this is difficult for us, so please respect our wishes
2. Seriously, please don’t call us to discuss IVF, parenthood or anything remotely connected – we’ll call you. Rest assured, if we need you, we know where you are, but we need space for ‘us’ as we go through this together. When we have results, we’ll let you know. If you want to talk about anything else, that’s fine, just not parenthood right now.
3. Please don’t ask any questions, we’ll tell you what we can, when we can. If you want some background info, or to try to understand how we feel, then try these blogs or websites [selected list]
4. Don’t be offended if we’re a bit odd… drugs, emotions and fear does this, but we’ll be back to normal soon
5. This is about us trying to be parents, it’s not selfish, or indulgent, it something which everyone else takes for granted, so for us it’s huge. You will never understand this, we don’t expect you to, but we do ask for your patience and your prayers.
6. Please, don’t be offended, but advice is something we don’t need – we have specialists for that. Old wives tales, or stories of amazing things that happened to people who ‘stopped trying’ or ‘decided to move on’ or ‘relaxed’ or ‘went on holiday’ and became pregnant are really quite unhelpful and sometimes hurtful.
7. We know you don’t mean to cause offence and sometimes appear lost for words, but really, a hug, a smile, a warm embrace, without words – or even a box of chocolates please, speaks volumes.
8. Sometimes we’ll just be shitty, sorry, it’s nothing personal, but it’s how we’re feeling in the moment, …allow us to be
9. Nobody can fix this for us, just let us know you’re there.
10. We reserve the right to change all the rules above, depending on how we’re feeling from one day to the next, so if we invite your opinion one day, it doesn’t mean that licence has been granted…sorry, we will be unpredictable and fickle.

I need to work on this some more.

I take it you’ve been on several cycles now? How are you both doing?

16 07 2010
Morph Muscle

Well I do not typically comment on blogs but I ran into yours while I was doing some work researching in Bing today so i decided I would leave a simple comment. Needless to say I have gotten a tad sidetracked after sticking around to browse a number of your articles. Keep up the excellent writing and i’m already looking forward to exploring upcoming posts. Take care!

5 08 2010
djpnz

Thank you so much Morph Muscle. Pleased you got sidetracked, as I have in recent weeks. Take care too!

18 07 2014
Zai

It is very important, in my oiopinn to be a healthy weight in order to get pregnant. I noticed that when I had a few extra pounds that it was harder to conceive. When I lost a little weight I became pregnant. You also need to relax. My husband and I tried for 3 years to conceive and when I finally did, it was because I had the attitude that if it was gonna happen, it would and it did

28 01 2015
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