5 things that surprised me most about in vitro fertilization

The thought of having in vitro fertilization (IVF) terrified me. My husband and I had been trying to conceive for about a year, and we’d already tried one round of intrauterine insemination (IUI), which resulted in a miscarriage. I was reaching a point where I wasn’t sure if I’d ever be able to get pregnant—it felt like my body was failing me.

I’d done my research, so I knew it was going to be a make-or-break treatment. What I didn’t expect was how surprising a few facets of the therapy would be. Here are five things I thought I knew but didn’t fully understand until I went through them.

1. You should move  There are so many old wives’ tales about what you’re supposed to do and not do before, during and after IVF that it’s easy to feel like you’re walking on eggshells throughout the process. I had a pros-and-cons list for just about everything I ate, drank or did over the course of treatment. I analyzed, calibrated and monitored everything, but I was most militant about exercise. For some reason (I blame online message boards), I thought that working out would somehow harm my embryo or maybe even jiggle it loose after it had implanted. But Ari Baratz, a fertility specialist at CReATe Fertility Centre in Toronto, says movement is actually good at all points throughout the IVF process, especially after an embryo transfer.

“[Being mobile] improves blood flow to the reproductive organs, so we encourage patients to get up and move after,” he says. Exercise also helps keep energy levels and feel-good endorphins high. Going for walks and going about my usual activities helped keep my spirits up during this stressful time. Now he isn’t encouraging you to go out and try a new intense workout while doing IVF—that could actually put stress on your system. But when it comes to activities that you regularly do, such as running and spinning, go for it!

2. Outcomes are still quite low For how much you’re paying, it feels like IVF should result in a guaranteed pregnancy, but that’s definitely not the case. “Even under the best circumstances, IVF pregnancy rates hover around 50 to 60 percent per embryo transfer,” says Baratz. “It’s difficult to understand why, if the egg and sperm are being put together, a pregnancy won’t take.”

A lot of that has to do with negative outcomes that can have an impact on all pregnancies, such as chromosomal abnormalities in the embryo, uterine lining or placental issues or even fetal growth problems. All of these concerns can lead to miscarriage or stillbirth. “It’s a fertility treatment, but it doesn’t cure you of the things that can happen with any pregnancy,” he adds.

The only way to increase your odds is to have expensive prenatal testing for chromosomal or genetic abnormalities done on your embryos, but even then, negative outcomes are still possible (and pregnancy rates may only increase to about 70 to 80 percent, depending on the clinic).

3. It’s more intense than you can imagine Nothing could have prepared me for how stressful and emotionally draining IVF was, and that’s not just because I was a hormonal, drug-fuelled mess. “It’s not just one visit,” says Baratz. “It’s multiple visits on a tight schedule. A commitment is required.” He’s not kidding: I’m a loyal, dedicated person who tends to see obstacles as challenges and, even on my best days, I found it difficult to adhere to my injection schedule and get out of bed for my daily 7 a.m. blood work and ultrasound. The only thing that kept me going during this time was having my husband’s support, getting acupuncture treatments and always reminding myself of the end goal: to expand our family.

4. It’s confusing because it’s so high-tech “People are impressed with the technology now available,” says Baratz. “We can select embryos that are stronger rather than weaker ones and implant those. We can not only tell you about the chromosomes and DNA of an embryo but also track development in the first five days using time-lapse video capture.”

While that’s fascinating (and developments like these are positive for those who struggle with infertility), it also makes it difficult to fully understand what’s happening and being done to your body. The dance that doctors do to time the egg retrieval and embryo transfer and the fine line they walk with the doses of drugs they prescribe is truly mind-boggling. I tried to comprehend all of the nuances and facets of the treatment but found myself getting lost in the weeds of information instead of trusting my clinical team and focusing on my own health. Once I let go and became more comfortable with trusting the experts, the more relaxed about the procedure I became.

5. The cost is exorbitant “Cost is always a shock to people,” says Baratz. “Most people go through the healthcare process assuming that it will be taken care of by their provincial plan. You don’t think of [IVF] as an elective procedure, like plastic surgery; you think of fertility as a right.”

IVF can cost upwards of $10,000 for one cycle. Depending on what a patient is required to do, costs can escalate to anywhere from $20,000 to $25,000, and that pricing doesn’t include vitamins and wellness treatments (such as massage and acupuncture) that many people invest in throughout the process. It amounts to a hefty price tag that many can’t afford, especially if you believe some research that says IVF is most successful after three or even six attempts.

Luckily, some provinces have begun to fund IVF cycles, along with parts of other infertility treatments. Some insurance companies have also started to offer more robust drug plans so that the exorbitant cost of fertility medicine is partially covered.

Looking back on the process, I know my husband and I were lucky. We were one of the first couples chosen to receive IVF funding at our clinic, which allowed us to try the procedure. It also brought us closer together. We’ve always been an incredibly strong team, but surviving the ups and downs of infertility is something that could have broken us.

The key was realizing that we needed to give ourselves a break. It’s easy to think that infertility is someone's fault or that they’re to blame, but they’re not. Carrying that guilt around is stressful, and the last thing you need during such a harried time is more stress.

Go easy on yourself and indulge in some of the finer things in life together. Eat takeout, cook elaborate meals, see friends, go out for a beer (or two for your partner) and lounge around watching movies or reading. Trust me, you’ll thank yourself later.

Read more: What egg retrieval is really like 4 things that surprised me most about intrauterine insemination