Look, you can read about the step-by-step process of IVF in a number of places (like here: An Intro to the IVF Process) and hopefully, you've been well-equipped by your clinic. But it's likely that you are getting the high-level, glossy version; the tidy technical steps that—while daunting, seem straight forward(ish).
But if you ask anyone who has undergone the process they'll tell you that the advertised steps are really only part of the story. There is a lot more grit and emotional upheaval involved in the process than any handout could ever possibly highlight.
Here, in plain language, are the real 12 steps in an IVF procedure.
1. Referral for IVF
Eek! IVF feels like your best chance for a baby. Perhaps only chance? Feel elated and relieved that it is finally here, whilst simultaneously panicking. What if your ‘safety net’ option also fails? Feel all the feels.
Tell only a handful of people and then feel lonely. Be told ‘how exciting!’ by kind family and friends who are trying to be supportive but are unaware of the stats. They assume IVF always works and don’t know that:
a) You are about to walk a tightrope wire of your hopes and dreams.
b) You have poor balance, especially when pumped full of hormones.
And then, as is so familiar with infertility, you wait. And wait. And wait.....
2. Initial Appointment
Anticipate a life-changing appointment (it isn’t) because IVF begins today (it doesn’t) and the waiting is over (it isn’t). DO celebrate the fact that you are one step further along.
Enter the clinic and pass the gauntlet of smiling baby photos. Deliberate with your partner about whether this provides hope or is in poor taste. Decide its poor taste whilst also making a mental note to send in your own baby photo should the treatment be successful.
Meet with the nurses. Have your identity checked more thoroughly than at passport control and sign forms. Lots of forms. For everything.
Meet with the consultant. Decide that taking notes is too geeky and that you will definitely remember what was said at the appointment. Definitely. Instantly forget every word on exiting the room and curse yourself for not taking notes.
Clutch at an unintelligible drawing from the consultant about how your womb works (or doesn’t in your case) and ponder its meaning which was once clear but now escapes you. Consider, then dismiss, having it framed and put up at home as IVF ‘interpretative’ art.
3. Implications of Appointment/Drugs Appointment
Meet again with the nurses. Have a needle waved in your face that would be appropriate for tranquilizing an elephant and almost faint. Find out that it is not the one used for the injection. Pretend that you knew that by giving a little ‘in-joke’ giggle whilst internally heaving a huge sigh of relief.
Be shown how to mix the drugs, grab the fat and inject. Be asked by the nurse to do a dry run on yourself. An observed and critiqued recce. What now? Yes, now. Take the needle. Tell yourself ‘you can do this.’ Give big, reassuring smiles, like you are finding it the most natural thing in the world. Receive encouraging nods from your partner and the nurse. You are not reassured. One doesn’t have to do it ever and the other does it daily. Make a joke about not having any spare fat on your stomach only to have multiple areas pointed out by your partner (thanks love).
4. Drug Collection
Empty the fridge of all perishable goods to make way for its new calling in life as a drug storage facility. Collect drugs from the clinic. Drive home with extreme caution, like you work for a nuclear authority transporting an atomic bomb.
Spread all the drugs out on the kitchen table. Take a photo and send it to your partner with some amusing remark about ‘being a drug lord.’ Read the descriptions of each box. Be informed that your drugs are to be stored at room temperature. Turn it over in your hands. Realize you have no idea what it does and replace it carefully on the table. Sit back and look at the next month or two and thousands of dollars spread out in front of you. Have a little panic, potentially a quick weep, then crack on with the rest of your day (which includes going food shopping to restock the fridge).
5. Progress Scans
Pose in front of the mirror to see if your belly looks bloated. Try a different angle and another. Stick out your belly. Decide that is cheating. Panic that the lack of bloating means that it isn’t working. Throw a hissy fit. No fertility treatments work for you ever. Why expect IVF to be different, hey? Slump into the scan room like a deflated balloon expecting the worst.
Be told to your surprise that follicles are developing and have lots of numbers thrown about (size of each follicle). Rub your tummy proudly. You knew it was all going to plan. Float out of the scan room on cloud nine. Promise yourself never to panic again about bloating. Forget this at the next progress scan and repeat the above steps.
6. Trigger Shot
Do NOT mess it up. Don’t be a plonker. Don’t pull the back off the syringe. Don’t spill it on the floor. Don’t bodge up the timing. It needs to be exact. EXACT. How exact? Like to the minute? Mix it early. Sit staring at it and worry that it is curdling. Get your partner to watch you like a hawk and check that you don’t do anything stupid. Partner stares at you, while you stare at the needle. And you both wait, for your exact time slot.
Trigger done! Phew. The final injection. 36-hour count down commences.
7. Egg Collection
Feel sorry for your partner, as having a compulsory orgasm under clinical conditions must be tricky. Then remember that you are having an operation after weeks of injections and feel a little less sorry.
Wake up post-op with a throat like sandpaper. Be asked by the nurse if you need a wee. Negative, but thanks for asking. Nervously await a visit from the embryologist about how many eggs were collected. Convince yourself it is none, for no logical reason. Be asked again if you need a wee. No, thanks.
Have lunch—eggs are on the menu, how appropriate. Be asked again about needing a wee (does the nurse have a fetish?). Be informed by your partner that you need to urinate successfully before being released. Feel like an idiot. Go for a wee.
8. Progesterone Goes Where?
Face head-on (or more appropriately... bottom first) your fear of pessaries/suppositories. Enter into the classic ‘up the front or back’ debate. Decide to mix it up, because you’re that kinda gal. Marvel at the unstoppable waxy mess created in the gusset of your undies. Decide that ‘gusset’ is a horrible word that should never be used. Buy pantyliners. And new underwear. Start getting into the swing of it. Wonder what other small household objects you could, in theory, shove up there. Wonder why you ever panicked about this stage, it’s a breeze.
9. Embryologist Calls
Stay indoors all day nervously awaiting the call. Pop to the shops for two minutes. Receive a call in public. Typical. Respond to embryologist’s comments with something knee-jerk and nonsensical:
- “The majority have fertilized” - “Oh, I do actually produce eggs then?”
- “I’m sorry to say that only one has fertilized” - “Well I didn’t want twins anyway”
- “They are a mixed bag in terms of quality” - “That’s OK, can’t be helped.”
Ponder whether the embryologist can block your treatment if they consider you too stupid to reproduce. Hope not.
10. Embryo Transfer
Off come the pants, AGAIN. Up pops an image on the screen of your beautiful bundle of cells. Feel emotional. Get teary. Have a civilized mini domestic with your partner about whether to take a photo (does it jinx it?). Watch a plastic straw containing all your hopes and dreams being passed through a 1970s style service hatch in the wall. Wonder if a cup of tea and scone will follow it. Watch everyone in the room as they all watch your muff.
And just RELAX. Yeah, right.
11. Two Week Wait
Leave no stone unturned in your attempts to ‘complete Google’. Read every article, research paper, blog post, on IVF success rates. Consider responding to the crazy woman on that forum about spell casting. Then remember you are just a normal person in a tough spot and regain your composure.
Read into every twinge, gurgle or pull. Decide that it definitely means EITHER you are pregnant OR about to start your period. Remember that those are the only two options. Think that, actually, the sensation is more likely to be the tight elastic on your brand new knickers. Try to distract yourself with a cup of tea. Whilst drinking your cuppa have one last check of Google.
12. Pregnancy Test
D-Day has arrived. The tortious two-week wait is over (yippee!), but you don’t want to take the test. Because one way or the other, IVF is over. Can your heart cope? Remember that you are strong. Of course, you can cope, no matter what.
Marvel at how professional the clinic pee test is in comparison to your Amazon cheapies. Have the most important wee of your life. Go to the kitchen and make a cup of tea (tea makes everything better).
Deep breath. Return to discover your fate.