I see many patients who are in the process of undertaking IVF but who aren't really mentally or emotionally ready for it. Panicked by their age, or the staff at the clinic they are using who have told them they must start IMMEDIATELY (let us not forget, are also running a business) or the crushing monthly feeling that takes over when a period makes its unwelcome appearance. The momentum carries them through from the panic at being told their AMH levels are low, or polycystic ovaries, or they are just a bit past their sell by date and if they don’t do it NOW they will have left it too late, to the point where they are booking in for treatment without taking stock.
Yes, time is a factor. Egg reserves are a factor. But not the only factor. Panic, fear, stress can all contribute to creating the wrong conditions for a positive result and you only have to look at the statistics to know that they are also against you.
To quote the quite wonderful Zita West, fertility is a whole body event. It is not something that takes place independent of your brain, your emotions, or your physical state.
So please, please, please, make sure you are feeling kind of ok. That you have come to terms with the IVF option. That you aren't railing against your fate, crying in toilets a lot, and feeling angry / resentful / depressed that you are going to have to try and conceive in an expensive, intrusive way. Some questions you can ask yourself (and be honest about the answers, you are only lying to yourself, after all.)
How healthy are you? You should be exercising regularly. This doesn’t mean embarking on some crazy regime but you need to be getting your heart pumping a few times a week whether you swim, run, walk, practice yoga or love Zumba.
If you don’t exercise habitually then start walking every day. This is important for bringing oxygen into your body, promoting healthy blood flow and circulation, which will help your mental state as well as your physical state. Exercise reduces stress, lowers blood pressure, improves sleep and increased your overall wellbeing – all of which are beneficial for anyone on the IVF train, which can be a huge strain. So not only will you improve your odds but you will also feel better.
BMI: If your BMI (body mass index) is over 30 then you are categorized as obese and studies show this can affect your response to IVF and a successful outcome. If you are an NHS patient they may not fund a round of IVF until your BMI is lower, and if you are paying for a round then unless you have money to burn and an emotional equilibrium like Teflon you need to address this.
If your BMI is under 20 then a risk of miscarriage is higher.
To calculate your BMI divide your weight in Kg by your height in Metres, then divide the answer by your height again. Or go online and find an easy online calculator to do it for you.
Have you been eating right? You know that too much coffee, skipping meals and drinking too much are not going to help. So make sure you are getting omega 3s, leafy green veg, lots of protein and just a little bit of whatever you really love so you don't feel like you are being punished twice. You honestly can have the odd cream cake or glass (glass, I said) of wine.
Are you (both) prepared for a bit of a rollercoaster? IVF can be bruising, no doubt about it, so you need to be going into it holding hands, a team. From the initial tests, to the drug stimulation, egg collection, fertilisation and embryo transfer you can go from hope to disappointment, so brace and try to rise above it all. These are all things you can't really control.
Could you deal with a multiple pregnancy? The chances of a multiple pregnancy are 1 in 5 with IVF, vs. a national average of 1 in 80, according to the HFEA. If you are undergoing IVF then on the one hand a multiple pregnancy would seem the answer to a ready made family. Two for the price of one, so to speak. That's true, but carrying twins (or triplets) carries far greater risks for you and your babies. If you are doing this alone, can you truly afford / cope with two? Or even three? If you don’t think you can then perhaps you should talk to your clinic about the number of embyros they transfer per round.
Are you strong enough to cope with any disappointments? If you think failing a round of IVF will pull you under then please just wait. It's unlikely to work if you are that fragile anyway. Have some counselling. Try acupuncture, CBT, or hypnotherapy, or anything else that can improve your state of mind and help you feel a bit more robust. The statistics don't lie and IVF can be a bit of a long game.
So if you need a month or two to get your head in the game, take it. It's important for you, your partner and for the months to come. And I absolutely promise it will help.