I started my first IVF cycle in November 2013. I had no clue what I was getting myself into. I did very little research. I trusted my doctor 100%. I just remember wanting a baby…like yesterday…..and was going to do whatever I could in the shortest possible time to make that happen. But, as most of you know, it did not go as planned. But through all of those years, I did so much research and learned a LOT. If I can help even one person by writing this, it’s worth it!

So here are some suggestions on what to do BEFORE you start IVF. Some doctors are pro-active and will have you do these things before ANY talk of IVF. But others will suggest IVF before taking these, I believe, necessary steps. A few of you might not even need IVF after taking these steps but even if you do, you will be more prepared and have checked off any possible issues that could hinder you from bringing a healthy baby home! So here we go!

#1: Test your levels of Vitamin D, MTHFR, TSH

If you are having trouble getting/staying pregnant, please have these levels tested first! I know there are many more tests but these 3 are major.

Vitamin D: low levels of Vitamin D might be hindering your ability to get pregnant. If you have low Vitamin D levels and take a supplement, in some cases, that may be all you need!

MTHFR: is something I wish all Reproductive Endocrinologist’s(RE) would test at the beginning. Too many wonderful women (in this blog world, online and who I personally know) have lost healthy babies to MTHFR. Heartbreaking. With a simple blood test, you will know if you have MTHFR and if you need to take necessary actions. Most likely, you would take a folate supplement(not folic acid) and sometimes injections throughout your pregnancy. I’ve seen many women go on to carry healthy babies to term once they have been diagnosed and treated accordingly.

TSH levels: Your thyroid is important, especially when you are talking about pregnancy. Your ideal TSH level should be between 1-2. If it is not within that range, you should speak with your doctor about what steps you might need to take to increase your chances of a healthy pregnancy.

#2: ObGyns are NOT Reproductive Endocrinologists(RE)

I did this myself. I would ask my ObGyn questions about infertility and trying to get pregnant and I got no where. I didn’t even know what to ask at the beginning stages. But the three major things I would ask if you are questioning your fertility is for : AMH and FSH tests, an HSG test to see if your fallopian tubes are clear and a semen analysis for your husband. Those are three things your ObGyn should be able to do for you(and recommend a place for your husband’s semen analysis) and if any results are off, then go to a Reproductive Endocrinologist asap. Don’t waste any more time. ObGyns are great for delivering babies but most do not have the time or knowledge to help you get pregnant…especially if you might have a major issue.

#3: Once you have an RE, ask for copies of your results

Your RE has many patients. But you are your only patient. You should either receive copies of all of your results or take photos of them. I am a big promoter of this. Sometimes doctors get confused or something is forgotten….accidents happen. But, if you write down all of your results, you can compare, you can keep track, you can research for yourself. You never know, you might end up solving your own issue!

#4 Before IVF, ask for a diagnostic hysteroscopy

It blows my mind how many RE’s do not perform a routine hysteroscopy before an IVF cycle (or before that!) So if you have been trying to have a baby for a while, and are about to spend thousands of dollars on IVF, why not make sure that you have a healthy uterus?? That is a large piece of the puzzle! I know many doctors say that the HSG will show if there is a problem with the uterus but that’s not always correct. My HSG showed my uterus looked fine. Then I had my hysteroscopy….and scar tissue was everywhere and I needed surgery. Many times HSGs cannot see scar tissue or a lot of other problems inside the uterus. So, even if I would have transferred a healthy embryo, it would not have worked.

Having a diagnostic hysteroscopy should be a part of every IVF protocol. I can’t tell you how many times I have seen women go through 1, 2, 3 IVF cycles, all fail, to finally have a hysteroscopy and find problems. Problems that should have been corrected before they even went through one IVF cycle. It’s so sad that a procedure that cost maybe $700(or less if it’s covered by insurance) could have helped solve the problem.

#5 Ask for a personalized IVF protocol

If you are with an RE that does the SAME protocol for every patient….beware. You cannot tell me that the same protocol on a 25 year old with a normal AMH/FSH will work the same on a 42 year old with Diminished Ovarian Reserve. Just doesn’t make sense. We are all different, our bodies are different. Different doses of medicine, different medications, different timing are necessary to encourage egg growth or, on the other hand, to prevent OHSS(Ovarian Hyperstimulation Syndrome) which can be extremely dangerous if not monitored closely.

#6 If you have multiple failed IVF’s…look into an ERA test.

Once again the uterus plays an extremely important role in the development of a healthy pregnancy and unfortunately, it is often overlooked. I wrote about the ERA testย a couple years ago before many had heard of it. Just like I mentioned above regarding personalized IVF protocols…there should be personalized transfer days as well! You cannot tell me that every…single…woman’s uterus is receptive on day 5 after progesterone supplementation. But many RE’s just continue transferring on Day 5 because…well, that’s what they’ve always done. Well, the ERA test will help detect when you are actually receptive. For some women it is Day 6, for some Day 7….and others it’s Day 4! How about that?! The ERA test costs between $800-$900, plus the cost of medication. You are ultimately doing a “trial transfer”. Instead of transferring an embryo, they biopsy your uterine lining and send that tissue to be analyzed for receptivity. If it is not receptive, you would perform the test over again until it comes back receptive(I know, time consuming and expensive but it is a lot less expensive than another full IVF cycle) Also, when it comes back receptive, you’ll know your uterus is not the issue, or if it doesn’t, then you’ve saved yourself from heartache of failed transfers and can move on to a gestational carrier like I did (stayed tuned for a detailed post regarding Gestational Surrogacy in the next few weeks!)

#7 PGD/PGS Testing…is it necessary? And safe?

I know many RE’s that push PGD(Preimplantation Genetic Defect-specific gene defect) PGS(Preimplantation Genetic Screening-overall chromosome normality) testing of embryos on almost everyone. I won’t get into too much detail as I am currently writing a longer post on this topic (so stay tuned!) But PGD testing was originally created to help determine severe genetic disorders in embryos. I know that before my husband and I went through our first IVF cycle, my RE had each of us do genetic testing on ourselves to see if we matched for any severe genetic disorders that would affect our embryos. If we matched he would suggest PGD/PGS testing, as even if embryos made it to blastocyst stage a significant amount would be affected by the severe genetic disorder. We were fortunate and did not have any severe genetic disorder matches. So I personally chose not to do PGD/PGS testing on our embryos. I’ve done a lot of research and, again, will post here soon but it is a very personal decision and don’t let anyone, including your RE, push you to have this testing if you are not 100% comfortable, have done the research and understand the risks associated with biopsying your embryos. There are positives and negatives associated with PGD/PGS testing so just educate yourself before deciding!

#8 After a failed IVF(or 3), look for a second opinion

There is no harm in getting another opinion. I know that you may feel comfortable with your RE. That maybe you’ve been with them for years. But if they haven’t figured out your case, a new set of eyes is sometimes the best next step. There is no “right” way about infertility. And some RE’s are just set in their ways. If they are not willing to listen to your questions or concerns…simply move on.

#9 Focus on your end goal….having a healthy baby

I know, easier said than done. I get it. I’ve been in your shoes. Being a part of this “infertility club” is tough. It is so overwhelming at times that you will want to say…”I’m done!” “That’s it!” “It’s all I can take!” It’s confusing, it’s expensive, it’s frustrating, sad…I could go on and on. But, if you keep putting one foot in front of the other…it can happen. Now, I’m not saying that you will 100% get pregnant and deliver a healthy child, I mean, that did not happen for me…BUT I am saying, if you want a child, one way or another…it is possible(IVF, donor egg/sperm, gestational surrogacy, adoption, fostering to adopt). I was denied, failed, disappointed, frustrated…all of the above. But I had to keep going, whether it was me being pregnant, having a gestational carrier, using an egg donor, using a sperm donor, adopting, fostering…I was going to have a child one way or another. And that was just the way I thought. Not the way I envisioned or dreamed of…but the way it was meant to be…and I am thankful for the way it all happened. Just thankful.

And if you think you are not strong enough….you are wrong.

If you believe you are not brave enough…you are wrong.

You will soon find out that when you have no choice but to be strong and brave…you will surprise yourself. You’ll be proud of yourself and you will come out of this as an inspiration for others.

So…if you’ve been diagnosed with infertility. I am here for you. If you need to go through IVF. I am here for you. If you need a gestational carrier…I get it and will support you through it all. I understand what you are going through. You are not alone and I know thousands of other women who are here for you too. So if you ever have any questions, send me an email or direct message on instagram. I will try to get back to you as soon as I can.

You will get through this…….believe it.



****Disclaimer: I am not a medical professional. The information provided on this website is designed to provide helpful information on the subjects discussed. This blog is not meant to be used, nor should be used, to diagnose or treat any medical condition. For diagnosis or treatment of any medical problem, consult your own physician*****

13 Comments on Infertility: Before Your First IVF Cycle…Read This!!!

  1. Hey there! Sarah Breece here. I always LOVEEE reading your blogs and absolutely love the platform you have taken now post-baby. ๐Ÿ™‚ Everything is so insightful and informational and you are doing so much good by continuing to blog and reach out to those going through IVF. I have a question for you – and feel free to say no… but your most recent post brought up some feelings (not bad) as I was reading it. See – Brett and I just recently decided to end our pursuit for a child. After 2 clinics, 3 rounds of IVF, genetic testing and at least 2 transfers (that we know of) of PGS normal embryos without any of them taking, we have decided to step back from it all and just be still. We are even going as far as saying we are choosing to live childless, not by choice. Your most recent post left me with a feeling of wanting to share that piece of infertility in addition to the beautiful words and insight you just posted. I can say that going through infertility is isolating, but choosing to stop treatments altogether comes with its own set of feelings, both good and bad. I know that your platform is to not give up and how worth it everything you went through was, and I 100% believe it!!! But for some, we end up having to face a reality for various reasons (financial, emotional, physical) that we have to someday move on from TTC… My question… would you ever be open to having a guest post from a perspective like mine? Talking about having to face that tough decision… the feels, both good and bad that come along with it… and what is next? Not to contradict anything you just wrote about, but to add to? Thoughts? Also – don’t feel like you need to publish this post. ๐Ÿ™‚ You can write me back personally if you want to at srb912@gmail.com. I hope you are doing well and LOVEEEEEE your blog/pictures/inspiration.

    • Thanks for the kind words Sarah…and I seriously want to reach out and give you a HUGE hug. Infertility is not fair at all…not one bit. I am sorry for what you and Brett have been forced to decide. It is all so consuming and exhausting beyond belief. I send my prayers and love to you all.
      I know you mentioned that you thought my blog platform was “never giving up”….but DID give up. I had to “give up” in a way and even wrote a whole post about it here: http://dreamingofdiapers.com/2016/01/15/giving-up-on-getting-pregnant/
      I do try to encourage as many readers as I can but I definitely understand that there are unfortunately so many men and woman, who have done everything like you and Brett and there comes a time for a decision.
      Also, I would be honored to have you write a guest post on that topic. I absolutely agree that sometimes there is no other choice but to give up to move on and actually have a couple of friends who did exactly that and are still very happy with their decision and life..though..I do understand it wasn’t really theirs/or your decision. Again, it is all so, so tough. My heart goes out to you my friend and I will support you through it all. If you need anything, you know I am here for you and please, send that guest post over and I’ll be happy to publish! dreamingofdiapers@hotmail.com
      Lots of love to you and Brett! xoxo

  2. @ Sarah breece I think I would love a post like that too I am 35 n I Ve been doing this TTC over 4 yrs with failed cycles and endless test and shots Not knowing when My body will heal And still can’t conceive . my husband and I are broke financially ,emotionally and physically. We are ending this journey to move forward .God has blessed me at least one child and we are grateful for that. But Iam tiered of being hopeful n positive cause I know there is no light to the end of my tunnel just a dead end so I am gonna pick myself up and go back and move on and not feel that I gave up but rather that I got a wrong tunnel ๐Ÿ™‚

  3. In addition to MTHFR, may I suggest asking to be tested for ANY blood clotting disorders. My son was stillborn in February and that was the first thing they tested me for. I couldn’t believe that a simple blood test that could’ve told me if I had issues with a clotting disorder, was not done prior to having a stillborn. Fortunately, I do not have one (we do know what caused my Asher’s heart to stop beating) but I j ow several women who have found out they do have one after losing a child. If it was found before they got pregnant, that loss could’ve been prevented. Thank you for all your information. โค๏ธ

  4. This is such a great primer! We actually needed most of these checks to help us get pregnant. I wholeheartedly believe checking MTHFR (I’m homozygous a1298c), TSH (I had elevated anti-thyroid antibodies) and doing the ERA (I was pre-receptive by a day) helped us have our beautiful twins. (I mean talk about really working!)
    Great job!

  5. Thank you for this!! My husband and I just had our first meeting with our fertility clinic and your information will be of great use as we move through this journey. I do feel rather lucky that so much of your “must do before IVF” list has been done (or being done) already. It helps me understand a bit more about the process. Thank you for all your information and hope ๐Ÿ™‚

  6. Wow! Thank you so much. I feel this came at the right time for me. I’ve done most of those tests and it feels great to know I’m doing it right. Especially as you’ve been there! I feel so overwhelmed with it all especially now the red witch is here. Thank you for helping me feel strong and positive again!

  7. Thank you so much for your post. I really enjoy reading other people’s experiences. and feel very lucky that almost all of that was tested on my first round in the fertility clinic without me having to ask. We are starting in October with androgel and then IVF in November and then I have to go on Lupron for 3 months and then we can hopefully do a transfer- obviously only if everything goes according to plan!

  8. This is such a great post! This summer I was about to start IVF for the first time after 3 years of TTC & 3 failed IUI’s. My doctor did a HSG a week before I was supposed to start the IVF injections & found that I have what is called a septum blocking my uterus. Because of this, I had no way of even getting pregnant the past 3 years & would have had no chance with IVF. We are now in the process of getting set up for a surgery & will see how that goes! Before having the HSG done, I was a little annoyed because I have had so many different tests done & they are all expensive, but it really was a huge blessing my doctor recommended me having the test done & that he was able to diagnose the problem (it is very rare). So I wholeheartedly agree with getting these tests done before starting IVF. I also agree that having a new doctor can sometimes have a different perspective & help you because if I had stayed with my first doctor, he would have continued to do IUI’s & IVF without even knowing the real problem.

  9. This such a great post…. specifically when my doc told me that it is IVF for me…

    .just 4 days back got done with Hysteroscopy and Lap..

    will know about other results by tomorrow I guess..I think.(I am not sure if they have sent)they would have sent my endo lining for biopsy can I tell to them to do the ERA test now only even before my first IVF cycle..

    Thank you again for this post… before I start my IVF journey…

  10. I love your posts! Every suggestion in your outline is exactly what I wish I had when I began my IF journey. You must know that your blog is extremely valuable. I hope all women who enter our community stumble upon it so that they can avoid some of the cruxes you mention. Me, myself and I had to run like heck from the first center/specialists who were very bottom-line oriented and committing all the sins you mention: HSG, but no hsyterescopy tests,Vit D, M…, and other essential tests. And they were soooooo pushy. Turns out when I switched centers and REs their treatment highlighted and exposed all the mistakes made at the onset, including my AMH. Originally the first center’s lab tests reported my AMH as .18 but it turned out my actual AMH was 1.45. If I needed proof it was in the numbers. At the first center I got up to 3 eggs the 1st cycle because my protocol was wrong and extremely aggressive…where they started me at the high doses–300 of each hormones. At the 2nd center with a more appropriate protocol I got 14 eggs and 8 blasts!!! Just sayin . One must be vigilant and in the right hands.

  11. Hi I’m 44 years old . 4 miscarriages last one was from iui after 3 years of trying. I was diagnosed 4 years ago witjMTHFR . I had an Anora test done on my last miscarriage and was told the baby 7 weeks old had triple copy of trisomy 20. We were told our only chance to conceive was thru ivf
    I had all the tests you suggested. I just started first ivf treatment 3 weeks ago during my follow up appt I was told I had developed mild hypothyroidism based on my TSH levels mine is 4.6 but they want less than 3. I’m so anxious bc I’ve never had thyroid issues. I’m concerned how this will affect my chances or if I get pregnant how it will affect my baby
    I’m scared. Not sure if this is dangerous or will it correct itself. Anyone’s feedback will help. By the way they started me on 50mcgram of thyroid medication

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