Top 10 Takeaways from our IVF Class
Cory and I attended a required, 4-hour IVF introductory class this week at our clinic. In this post, I share the top 10 takeaways from this class, including information about the IVF process, IVF success rate, and IVF cost. Let me know what you think! What else would you add?
I’m not a fertility specialist, but I’ve been trained to detect good clinical practices. I know good medicine when I see it, which is why I feel somewhat credible enough to share my insights and takeaways from our IVF introductory class this past week.
A little bit about my professional background: I attended the top graduate program in the country for my specialty – a program that prides itself on being a “premier institution for training, research, clinical service, and outreach.” The program focuses on forming clinicians that are critical-thinkers and who can seamlessly transfer knowledge between research and clinical care. I am trained with a sharp eye to detect clinical expertise…as well as clinical BS.
For the past six years, I’ve worked at an adult rehabilitation hospital in the Denver Metro area – a rehab hospital that is one of the best in the country. During my first five years there, I worked for a doctor who is the Brain Injury Program’s medical director. All of this is to say that I know good medicine when I see it. And I demand good medicine to be practiced on my body.
It is with this background that I entered the infertility arena just three months ago. Cory and I took a lot of time deciding on a fertility clinic. We ended up choosing Conceptions Reproductive Associates of Colorado in Littleton, Colorado (PS: I’m not getting any kick-back from them by mentioning them here – that would be cool though! I just wholly believe in their mission and practices). This clinic is the #7 most successful clinic in the United States and the #1 most successful clinic in Colorado. And my reproductive endocrinologist (RE) is Conceptions' medical director. I'm in great hands.
(Side note: I just realized that the rehab hospital I work for is #7 in the country for adult rehabilitation. And my fertility clinic is #7 in the country for IVF! Seven days in the creation story! Seven days in a week! Seven colors in the rainbow! Seven notes on the musical scale! Seven dwarfs! Seven seas! Seven continents! John Elway’s #7! James Bond and 007! The universe’s mysterious magic continues to be on our side!)
Okay, back to success rates. How is IVF success determined? By the percentage of total live births per frozen embryo transfer (FET). Per this website, data collected by the CDC in 2016 showed that the top clinic in the United States is the Western Fertility Institute in Encino, California with 73.7% live births per FET. My clinic, Conceptions, averages 68.2% live births per FET.
All of this talk about my graduate training and stellar workplace and Conceptions’ awesomeness is to lead up to this fact: I trust Conceptions. I trust Conceptions so much so that I feel compelled to share the top 10 things I took away from their 4-hour IVF introductory class.
1. Stress is one of the most influential factors on fertility
Mental health is my clinic’s number one priority. They’d prefer that their patients take care of their mental health and stress levels rather than obsessing over the nitty gritty fertility do’s and don’ts the Internet throws at you. “Go ahead and have a couple glasses of wine,” the lead IVF nurse recommended. “This process is stressful, and you need to take care of yourself.”
And my clinic practices what they preach! In the room where we had our class, they had a Keurig coffee maker and delicious caramel corn for snack time. They weren’t pushing Kombucha and celery sticks (even though I can totally get down with a good Kombucha any day of the week…and celery sticks too, as long as they’re slathered in peanut butter. Let’s be real). Our clinic wanted us to feel relaxed and comfortable. And comfort through food is a real and useful strategy (despite what the Internet says…darn Internet!). Coffee and caramel corn and wine are okay! Take care of your mental health rather than scouring the Internet for all of the things you should and shouldn’t be doing (which is what probably led you to this exact list).
"Okay, great," you think. "You say I shouldn't stress? Well then how do I not stress? What strategies can I use to decrease my stress?" This is the harder part. The first step is to be aware - aware of the fact that mental health is priority in this process. The second step is to identify strategies to decrease stress levels. Read some of my ideas in my post "How I Stay Here, Now." What other ideas do you have? Comment below!
2. There isn’t lot that you could do to screw this whole IVF thing up
This takeaway goes along with #1. The lead IVF nurse wanted us to know that while our participation in the process is crucial (read: you gotta inject yo-self, duh), there’s not a lot we could do that isn’t fixable. The nurse shared a story about a woman who accidentally injected herself with a triple dose of one of her medications. She frantically called the emergency line of the clinic, desperate for help and fearing that she had ruined the whole cycle. The nurse responded with a laugh and, “Wow! Okay, that’s just a really big dose of that med. No biggie.” While I’m sure there are some things you have to do perfectly (e.g., timing of your trigger shot), I took away the fact that most errors are fixable. Everyone take a big breath, give yourself a hug, and repeat, “I’m doing the best I can. I’m not a robot. I’m doing the best I can.” (See #1)
3. Make sure you’re actually injecting the medications
Remember how I said there’s not much we can do to screw up the process? Well, there is one major thing we need to do: actually make sure we’re injecting the meds. The nurse told our class about a past patient who happened to be a doctor. She was so confident in med administration that she didn’t pay much attention to the details. It just so happened that this patient hadn’t been properly depressing the syringe of one of those pre-filled meds. Every day, the patient was poking herself with a needle and not really injecting anything. “This…this was a problem,” the nurse said. Note to self: make sure med goo goes into body. Check.
4. It ain’t that easy to get preggers naturally
We probably all know this by now. Getting pregnant naturally is hard. It’s the exception to the rule. The lead embryologist reported that natural means to conception (SEX, hee hee) results in a pregnancy only 8% of the time. This number felt really low to me, so I did a little research. The National Women’s Health Resource Center reports, “A couple ages 29-33 with a normal functioning reproductive system has only a 20-25% chance of conceiving in any given month.” Let’s say pregnancy occurs between 8-20% of the time. Those are not great odds. We also learned that an IUI results in pregnancy only 12-15% (Internet says 10-20%). And traditional, old-school IVF, where the sperm is plopped into the Petri dish with the egg, results in pregnancy only 40% of the time. Conceptions does not do this type of IVF. They use Intracytoplasmic Sperm Injection (ICSI), where one single sperm (the most handsome sperm with the highest IQ!), is injected directly into the egg. IVF with ICSI results in pregnancy about 75% of the time. I like the way that sounds! Relax and let be (see #1).
5. You can freeze sperm. Don’t believe me? Ask a cow.
Freezing sperm was perfected on cows in the 1940s! Well that’s pretty cool. Enough said.
6. IVF is expensive, and I’m ticked that insurance doesn’t cover it.
I’ve known all along that IVF is expensive, but it didn’t fully register until we laid down our credit card for the $1,000 deposit at the start of class. According to a little research, nearly every person doing IVF needs to borrow money to pay for the expenses. I read that the average couple spends $19,000 out-of-pocket for IVF (and this is just for ONE cycle…some people need to do more than one cycle to get pregnant).
The only way we are making this first round of IVF possible is through a careful combination of savings, credit cards, and borrowing money. I can’t imagine what we will have to do if this cycle doesn’t work…or if we have to transition to adoption (average price for domestic infant adoption is $25,000). Most resources on how to pay for IVF I’ve found online (like this one) are not super helpful. It just leads me to believe that no one really has a good answer about how to pay for IVF. Insurance really should cover IVF...don't even get me started on this! For a really compelling read about this, take a look at "40 years later, why is IVF still not covered by insurance? Economics, ignorance and sexism."
Cory has been incredibly supportive with the financial aspect of IVF. He trusts and sees the macro. I worry and obsess about the micro. He has helped me realize that spending this money now, while incredibly daunting, is so worth it. Building our family is priceless (which is one of the reasons I get so mad…clinics know we’ll pay through the nose for this treatment…grrr! BTW: pay through the nose? What the heck does that even mean?). And then Cory reminds me to breathe and take a sip of wine (see #1).
What have you been doing to pay for IVF? What do you recommend? Comment below with ideas.
7. Air bubbles in your injectable medication will not kill you!
Somewhere in the back of your mind, there’s this fear that injecting air into your body will result in immediate implosion. Am I right? I don’t know where we learned this. Movies? TV shows? All I know is that when we started to learn how to mix and administer our meds, I feared the evil air bubbles! Our lead IVF nurse calmed our fears and told us that a few air bubbles are okay. Phew! Stress relief (see #1).
8. Don’t get caught up in the numbers game
Many couples obsess about how many eggs are retrieved. Essentially, our clinic told us that they prefer quality over quantity. They’re looking for mature follicles that are 16 mm or greater. It doesn’t matter if you have 40 follicles that are underdeveloped. They’d rather see a handful of fully matured eggs. This helped me chill out (see #1).
9. Humans are resilient and capable and hard-core
I looked around the classroom at Conceptions in awe at the other couples there with us. Thursday morning. 8:30 AM. 20 people attending an IVF class. 20 people who care so deeply about having a child that they’re willing to make endless sacrifices to make it happen. 20 future parents who are already on their way to the sacrificial love needed to raise a child. Throughout this IVF process, I’ve just been so impressed with people. The people who are dealing with infertility, doing whatever it takes (hopefully not Handmaid’s Tale-style whatever it takes! You should definitely watch this show though). The people who are supporting the people going through infertility. I’ve been impressed with Cory and me. With how our families and friends and coworkers have responded. With you, reading this post. Humans are resilient and capable and hard-core.
10. Don’t stress, drink wine, and enjoy your day.
I sat here at my dining room table trying to think of a tenth takeway for a few minutes. Nothing readily came to me. And you know what? I’m not going to force it. I’m going to practice #1 and honor my mental health by not stressing over it. Instead I’ll go pour a glass of wine (well, maybe in a couple hours…) and cheers to a beautiful Saturday!
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