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 test 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*****