Tips to Prepare for IVF

I love helping people get ready for their IVF cycle. 

I’ve been a reproductive endocrinologist helping people build families for over 15 years, and I recognize that in vitro fertilization can feel like a lot if you’ve never done anything like it before. I want my patients to feel prepared and educated, particularly regarding logistics. 

Here are five things to think about when you’re considering IVF: 

1. Think about your goals. 

What do I mean by this? When I first started practicing IVF, the typical goal was to get pregnant as soon as possible, and we would do a lot of fresh embryo transfers. 

Today, things have changed so much. Nowadays, many think of IVF as a fertility preservation tool by freezing eggs or embryos. In fact, very few people in my practice are doing fresh embryo transfers anymore, which creates a natural break between getting the eggs and creating the embryos, recovering from the stimulation process, and actually getting pregnant. 

So, by goals, I mean, how many embryos do you want before you start to get pregnant? If you are starting your family in your late 30s or early 40s, you might want to consider embryo banking if you want more than one child. 

Other goals you’ll want to consider (or discuss with your doctor) include how you’ll fertilize the eggs. Your options may consist of conventional insemination or intracytoplasmic sperm injection (ICSI), where the andrologist looks through the sperm, and the embryologist puts the best sperm into each mature egg. Clinics don’t always offer these options, so discussing and knowing what you want and need for your success is essential. 

Another goal to think about: Are you going to do genetic screening on your embryos? This type of testing is called preimplantation genetic testing for aneuploidy (PGT-A). It's a way to biopsy embryos and finds the correct chromosome balance to increase the chances of success (and decrease the chances of miscarriage) with a single embryo transfer. 

2. Get your finances in order.

By this, I mean that you want to be crystal clear about all things finance. It is stressful enough to remember to take your shots, rejig your calendar, and show up for appointments. You don’t need the added stress of a call from the clinic billing team about getting pre-authorization for your insurance company to pay for the IVF cycle.

Before you start IVF, figure out everything related to payments. Determine how to work with your insurance. Talk with your HR department, call your insurance company, and even work with your clinic’s billing department to ensure you are thinking through everything. 

These simple administrative steps can immensely decrease the stress from last-minute questions leading up to (or in the middle of) your IVF cycle. This is a huge tip that I recommend to all of my patients.

3. Understand your compliance checklist.

What does that mean? Well, there are a lot of logistics that go into setting up the IVF cycle. 

Deciding to do IVF, how to fertilize the eggs, and whether or not to do genetic testing are just some of the decisions you will make. 

For example, there’s blood work that will need to happen. At my lab at Pacific Northwest Fertility in Seattle, we're an FDA-approved lab, and part of the FDA requires knowing the patient’s virology status (such as HIV, hepatitis, etc.) if you’re handling any tissue. It's not that we don't treat people that test positive; it's just that we have to know their status so we can implement the proper lab protocols accordingly. 

If you’re doing a fresh embryo transfer, you’ll want to have a uterine cavity evaluation before starting the stimulation. This ensures that the inside of the uterus is set for an embryo implant. 

Trust me when I say that you don't want to miss something on your compliance checklist. It’s the clinic's job to ensure you're aware of what needs to be done, but it’s also a team effort. You can do your part by confirming, double-checking, and ensuring you’ve got everything ready before your IVF cycle. 

4. Make time for self-care.

Usually, there's a little lead time into an IVF cycle. A typical protocol begins with a menstrual cycle, where you’ll then go on birth control pills for a couple of weeks to get everything lined up and ready. Then, there will be an intense two weeks with shots, ultrasounds, and the egg retrieval. 

Before those two weeks start, you can talk with your team to plan ahead. You will want to avoid traveling and decrease commitments during that time. I encourage you to make space. If you've never done this before, you don't know how you will feel. Many of my patients feel bloated and tired. IVF can feel like a second or third job because it involves many checklists, responsibilities, and appointments. 

You can gift your future self by making space in your calendar as far ahead as possible. Try to avoid having deadlines during your stimulation, egg retrieval, and embryo transfer. I know it’s a lot, but try to decrease stress and life commitments to make IVF your priority at that time, and part of that means taking care of yourself. 

5. Know how to get your questions answered.

Here’s what I mean by this: You can read information online and handouts from the clinic, but questions will naturally come up in your cycle. It’s essential to know how you can get these questions answered. 

If you know you have stimulation shots coming up, ask if there are videos you can watch to remind yourself of the proper way to medicate yourself. 

If you have questions on a day you aren’t coming to a clinic, find out how to get those questions answered, such as by email or phone. 

You might want to find out if there’s a provider available in the middle of the night if you have a question at that time. 

It’s nice to know all these details beforehand, so you feel supported. This experience is new, and questions will occur, so be prepared. 

Let’s recap.

• Review your goals. Make sure you are aligned with your provider and team on your family-building goals to make the key decisions about your IVF cycle. 

• Get your finances in line. Ask a lot of questions to make sure there are no surprises. 

• Go through the compliance checklist with your team. Make sure all your T’s are crossed and I’s are dotted to avoid stress during the cycle. 

• Plan ahead. Review your calendar, decrease deadlines, and make time for self-care.

• Find out how you will get your questions answered throughout the cycle. 

I hope you learned something from this blog post. If you have any questions, comment on my YouTube video. You also might like my other IVF resources.