Since the relaunch of The Fertility Podcast, we have been taking you through each step of your fertility journey. This blog, inspired by the podcast, is based on the next phase – what happens at the fertility clinic. Knowing what to expect in IVF is a huge topic in itself, but this guide covers the key points you won’t want to miss.
Your initial visit to the fertility clinic
Once you have an initial referral, it is likely that in both the NHS and private sector, you will have any tests needed done as ‘one-stop shop’ to try and identify the cause of your fertility struggles and decide on the appropriate treatment. This reduces the need of having to have multiple visits and waits for different results because you can get 2-3 diagnostic tests completed at once and have a follow up appointment with the consultant to discuss further plans.
What information should people bring with them?
Although clinics will have some form of questionnaire, it is good to have as much information prepared as possible to aid your initial visit. Details such as how long have you been trying to conceive, any previous pregnancies and their outcomes, your menstrual history, and any other factors, be it surgical, gynaecological, or medical which could potentially affect your fertility.
It is also important to identify any other risk factors which could complicate treatment or potential pregnancies.
If you have had tests done elsewhere, it is worth bringing in the results as some tests may not need repeating.
What about delays due to COVID?
If you have had previous tests done, it is important to consider the timeframe, especially with Covid causing delays or if you have had to delay your treatment for any reason.
In terms of key investigations, markers of egg reserve should be carried out, such as a transvaginal scan and AMH blood tests. If these have been done within the last 6 months, the results are unlikely to have changed much, so will still be valid.
Semen analysis likewise has a timeframe of 6 months unless there were signs of any significant abnormalities where it might need to be repeated.
These are the main 3 tests which will be carried out initially. Tests needed for IVF include HIV, Hep B, Hep C. These will be done within the first 3 months of treatment and every 2 years thereafter.
Home testing can be done by people wanting to be well-informed, and with the addition of Covid, there has been increase in home blood tests. Resident expert Dr. James Nicopollus describes how home testing should be fine as long as the lab is using the correct forms of testing. As long as your doctor can see the results and who you did your test through, there shouldn’t be an issue.
Remember all clinics are different so check with your clinic on the expiry date of tests and if they will accept home testing.
How often should you expect to see the same Dr?
It is understandable that you want to keep continuity throughout your treatment. Fertility clinics often work as a team. You will be under the care of the same doctor and probably have access to them. However, due to the nature of the treatment and timing of your embryos being ready, it might mean that your collection or transfer might not be at a time that your doctor is available. Fertility clinics will have team meetings and clinicians will speak to each other regularly, so it shouldn’t be something to worry about.
Starting your treatment
Following your diagnostic tests, you prepare for treatment itself.
One of the reasons why IVF can improve chances of getting pregnant and overcome fertility struggles is that you are stimulating the ovaries to produce more of the follicles than you would normally grow. Normally, only one egg will develop, but through IVF, you are given the FSH hormone in higher doses. This is with a daily injection – an average of 12-14 days of injections. Due to the increased hormones, the aim is to have more than one egg grow.
In almost every cycle, the stimulation phase starts just after your period. For 2 weeks, you take an injection to make your eggs grow with 3 – 6 scans to see when you are ready for egg collection. Some clinics may also do blood tests and use hormone levels as a further measure to decide on your dose and egg collection.
There is also a second medication involved in IVF. If the only thing being done was stimulating more egg growth, you would ovulate normally, and the eggs wouldn’t be able to be collected. The second medication is to stop your body from releasing the eggs. This will either be a nasal spray a week before or an injection halfway through the process.
Overall, you will likely have 2 weeks of intensive monitoring. Your oestrogen level will go up which will make you feel good. Post embryo transfer is the time when the hormones can make you feel more under the weather.
Stress and your wellbeing
Going through IVF or any other fertility treatment is stressful. With the logistics of IVF and varying hormone levels, it’s important to not worry about the little things and worry about getting stressed itself, especially as life is still going on at the same time. Current research suggests that stress does not affect fertility, so you don’t need to feel bad about the way you are feeling. All your feelings are valid.
I hope you have found this helpful and feel more informed about what to expect during IVF.