In a previous post, we provided an overview of the IVF treatment process to help ensure patients are more prepared for their journey. However, at Grain Fertility, we not only believe in preparing patients, but also giving patients tips and the tools they need to make IVF easier and empower patients. To help with this, Grain Fertility founder Joe Cody asked IVF fertility coach, fertility nurse, and patient advocate Lauren Haring, RN for some tips, advice, and expert opinion to help IVF patients through different parts of their journey.
The IVF process can be overwhelming for anyone, so to help make it a little easier to process, it is best to think about it in phases. At Grain Fertility, we think of it in four distinct phases: Trying to Conceive; The Stimulation Phase; The Retrieval/ Fertilization Phase; and the Transfer Phase. Below, fertility coach and IVF expert Lauren Haring, RN provides some insights and tips to help you during each of these phases.
Trying to Conceive: Before the IVF Journey Begins
Infertility is defined clinically as not being able to achieve pregnancy after 1 year of having regular, unprotected intercourse, or after 6 months if the woman is older than 35 years of age and traditionally doctors and insurers require patients meet this definition before moving to an RE for fertility work. Unfortunately, this often means by the time someone is referred to a reproductive endocrinologist (RE), odds are they have been struggling for months or years before this, many times without anyone knowing.
Joe: Often patients are told to wait before seeing a reproductive endocrinologist for a fertility consultation. What are some circumstances when a patient should seek a fertility consultation before they meet the traditional definition of infertility?
Lauren: If there is an underlying condition already present that affects fertility, such as PCOS, endometriosis, pelvic inflammatory disease, or a known sperm issue it is not recommended to wait the suggested 6 months if over 35 or 12 months if under 35.
Joe: When finding and deciding on a fertility clinic, what advice do you have for patients to help them choose the one that is best for them?
Lauren: The most important thing is to find a clinic that you feel truly supports you and is on your team. It is crucial to trust your fertility team and the care you are receiving. I have a blog post where I provide patients nine areas I would consider when evaluating a fertility clinic.
Joe: How do you recommend patients best prepare for an IVF cycle?
Lauren: It is important to get educated. You are paying for this and deserve to be an active member in your treatment. Learn about your diagnosis and treatment so you can ask questions and ensure your fertility concerns and goals are being addressed. I have written a blog post where I give patients 10 ways to help you mentally and physically prepare for IVF like a pro.
Stimulation Phase
During the stimulation phase, a person takes injectable hormone medications to encourage the entire group of that cycle’s eggs to mature simultaneously and fully. The goal is to retrieve as many eggs as possible for fertilization. The type, dosage and frequency of medications prescribed will be tailored to the individual based on their medical history, age, AMH (anti-mullerian hormone) level and response to ovarian stimulation during previous IVF cycles (if applicable).
Joe: The stimulation phase can be intense for patients. What are tips or tricks that you give to your patients to help make the experience a little easier emotionally and physically?
Lauren: It’s important to celebrate all of the milestones throughout IVF, big and small. Getting the go ahead to start stimulation medications is a big deal and accomplishing each injection is a true badge of IVF courage. Recognizing each time you pass a milestone is empowering.
It is vital not to run out of medications. Keeping track of your supply and ordering refills before you might run out is crucial.
As an IVF coach, my clients have direct access to me anytime throughout their cycle and I strongly encourage them to reach out with any questions, concerns, or simply to vent. I support IVF confidence through extensive information and expert guidance. I review all the personalized details relevant to the IVF cycle prior to starting their first injection. We discuss the medication protocol, cycle plans, what to expect, tips for a better experience, and ways to be a better advocate during treatment. It’s crucial to advocate for yourself by asking questions to ensure you understand what your results show and better manage your expectations for the cycle.
Joe: As an IVF coach, how do you help patients keep track of changes and updates that clinical staff provide to the patient during monitoring?
Lauren: I give my clients a resource to record all of their monitoring results and medication dosages throughout their complete IVF cycle.They can also track the retrieval outcome, embryo progression, and more. At the end they can see the full picture of how the cycle went.
The Retrieval/ Fertilization Phase
The Retrieval/ Fertilization Phase is a very stressful time for IVF patients, as only about 50% of the fertilized eggs should be expected to become viable blastocysts, but it is not uncommon for results lower than this, especially for people with undiagnosed issues with their eggs or sperm.
Joe: As an IVF coach, how do you help prepare patients to deal with the stress of waiting for blastocysts to develop?
Lauren: Knowledge combats preventable stress from uncertainty and not understanding what is expected and what is happening. While my clients are waiting for results, they are always encouraged to reach out and talk about their concerns. Each time my clients get an embryo update from their clinic, we review what the details indicate regarding the number of embryos and progression, along with the next steps.
Joe: Are there recommendations or tricks to help patients physically and emotionally prepare for an upcoming transfer?
Lauren: Physically there is much a woman can do to prepare her body for an embryo transfer, which should ideally begin at least three months in advance. Focusing on the lifestyle areas that can positively affect the fertility foundation, like nutrition, sleep, movement, and more is equally as important as stress management.
Acupuncture has become more commonplace as an additional modality for IVF. It is important to find an acupuncturist who specializes in fertility support as there are special protocols they may recommend.
It is also important to utilize your personal support network, which will look different for everyone but may include your partner, family, friends, religious affiliation, professional support and beyond. Whether support comes from family and friends or through a trusted reproductive mental health professional, the key is that no one should go through IVF alone.
Joe: How do you help patients cope with a failed retrieval that does not result in viable embryos or blastocysts?
Lauren: A failed cycle is devastating, regardless of the reason. When there are no viable embryos for transfer, it can be especially difficult after putting in all the effort IVF requires. I review their cycle in detail with them and suggest questions to ask their fertility team so they gain the best understanding of how the cycle went from their view and what recommendations they have to achieve a favorable outcome.
No one can decide for you when it’s right to start another IVF cycle, or if there is another step that’s more appropriate. Emotional healing is variable and while some are ready or even feel a strong need to jump back into another IVF cycle, it is also normal to take time to heal mentally before starting again.
The Transfer Phase
The mental and physical preparation for the Transfer Phase can be incredibly intense and stressful. To help cope with this process, it is important to understand what you should focus on and what can be less of a priority.
Joe: What is the most important information clinical staff are looking at to determine if a patient is ready for a transfer?
Lauren: Thickness of the uterine lining is the most important factor, but the lining pattern is also important. Ideally there should be three layers (trilaminar) to indicate a mature lining. Typically most doctors like to see the lining at least 8mm and above in thickness before proceeding with an embryo transfer. Studies show higher success rates with thicker linings, but women do get pregnant with thinner linings as well.
Joe: Are there any tips or tricks you can offer to patients to prepare for the two week wait?
Lauren: It is important to protect yourself. Searching the internet during the TWW can do more harm than good by supporting many of your worst fears. You will likely find conflicting information that can add further confusion. If you have a question or concern, it is fine to reach out to your fertility team for sound advice.
It is ok to schedule “worry time.” Set aside 15 minutes once or twice a day to worry, obsess, cry, question, and feel your feelings. Once time is up, change directions and move on with your day. It is also fine to find ways to indulge yourself, you have earned it!
I also recommend trying to avoid using home pregnancy tests. Nothing is more reliable than the blood test your fertility clinic will do at the appropriate time. The results won’t just come back positive or negative, but with an actual number for the HCG. You will get more information with supporting hormones (Estrogen and Progesterone) to provide a better picture of what’s going on. It is easy to obsess over the home urine test kits so remove the guesswork and try to avoid them if possible.
In our final post of our IVF treatment overview series, we will soon highlight specific ways the upcoming Grain Fertility application can help fertility patients with each step of the IVF journey.
If you are interested in continuing to receive amazing resources from experts like Lauren, sign up for our waitlist and join other fertility patients who want to be the first to gain access to your own fertility management platform at https://www.grainfertility.com/sign-up-today.