So first is the big disclaimer, as we are certainly not anywhere near the edge of the woods on this our very first pregnancy of any variety or even remotely experts on IVF (though I joke about adding an M.S. in Infertility to my resume, oh what I could/would have rather done with the last two years and all that money...), but I thought for those who may be venturing down this path for the first (or 2nd or 3rd... time) that I'd share what we did and what worked for us, FWIW...
Unfortunately, as we all know too well, much of what contributes to the success or failure of any cycle is out of one's control, but if you're anything like me (and I know some of you are ;) ), you want to try to help where ever you can, so you have your very best shot. Sadly, many of these things also cost real money (one of the biggest problems with IF, IMHO), but we realized that when we weren't going to get pg on our own (at home, on vacation, anywhere), that there would be some expense involved. That's just the reality.
So in no particular order... (sorry for the canned commentary, but you already know I'm opinionated)
1) Find the Best: Around the time we finally decided that we were ready for/needed to do IVF (last summer after seeing RE #3, who I loved, but is ironically pretty anti-IVF), I started looking at the
SART scores of clinics in our area. I'm a confessed number cruncher (it's what I used to do for a living, and it's in my blood), but it also made SO much sense to me not to waste our time (and more importantly our precious and paltry insurance coverage/one shot at IVF) on a clinic with lousy success rates, regardless of how convenient it would be (which regrettably had been a key driving factor in choosing my first two sub-par REs). It was common sense to me and DH, but for some reason a lot of people fall in love with their clinic or their RE (or don't have many choices), and are somehow blind to these. I obviously have no way to know for sure, but I honestly think it made a difference for us.
2) Be open to complementary therapies: I had some experience with yoga, but absolutely no personal experience with acupuncture before I came across
Pulling Down the Moon late last year when I was still doing IUIs w/RE #1. I took their Yoga for Fertility class right away, and then started acupuncture early this year. I did give it up after our failed IUI in May, but started up again before our IVF cycle and religiously went for the many visits my trusted acupuncturist recommended all through our cycle. Studies show that especially pre- and post-ET sessions contribute significantly to IVF success rates. I will continue to go during our pregnancy, as I've already got lots of fun symptoms. I'm also starting prenatal yoga this weekend. :)
3) Get healthy:
Sleep: Historically speaking, I've always been an excellent sleeper (and part time narcoleptic, but that's a story for a different post), though not surprisingly times of great stress (like the extended hell that is IF) have a way of killing my streak. I knew it would be important for me to be getting good sleep during my cycle. This was actually one of the reasons that I decided to take off of work, as our clinic is about an hour a way from home/work. They, of course, offer very early morning appts., but I knew then that this time would come right out of my sleep bank and that was not going to do me any favors in the short or long run. I took their latest appts. (I used my drive as leverage) and slept in...
Food: DH and I fortunately eat really well anyway (mostly a Mediterranean diet, which he cooks very well), but I made an extra effort to eat good organic and whole foods before and during my cycle. Lots of whole grains/complex carbs, plenty of good fats and proteins, and veggies. Having a new Whole Foods minutes from home and office certainly made this much easier to manage. Remember you not only need to get yourself pg, but need to support an ever growing parasite/s for nine months. :)
Supplements:Much to everyone's surprise (apparently) I've also been taking a PNV for almost three years (on
Rainbow Light now/again) and am also on Omega 3 and Vitamin D. DH took Conception XR, though he likely started it too late to make much of a difference.
Weight:I am lucky to be genetically blessed in this dept., (though my figure can best be described as overgrown teenage boy) I know it is a tough one for most women. I am 5'11" and weigh about 150 lbs. now, so I have a bit of reserves (as DH affectionately calls them), which is exactly where I want to be. It is almost my top weight ever, except for my freshman year of college when I rowed crew when I maxed out at 155, but I could also bench press my weight (so there ;) ) I've been as low as 125, when I had mono my Sr. year, and it was not pretty. I used to do some modeling, which I can assure you is much more lame than glamorous, but now my job is to be as healthy as possible. I have not and will not worry about my weight until after baby is here.
4) Have a support network: I've heard of and seen many people doing IVF in secret, but I honestly have no idea how or why they do and knew that was not for me (even though I'm a very private person). My family (parents, sisters), close friends, my boss, and of course all the lovely ladies on the Bump IF board all knew what we were doing. I think this is very important to help maintain your sanity.
5) De-stress: I realized at some point that I was not going to even attempt to undertake IVF while working in my ridiculous job. This, of course, required me to tell my boss what we were doing (which I hadn't planned on doing). But as I've said here before, I honestly think it's the best idea I've EVER had. By taking unpaid leave, which cost me a pretty penny, I was able to really disconnect from the office (I actually did put my Blackberry and laptop aside) and focus on what we were doing and just be in the moment and healthy.
6) Deal with your mental baggage: We've all got it, it's just in different sizes and colors. I spent a lot of time writing, thinking, and talking w/DH before and during our cycle in order to clear my head (and therefore my body) of the crap that comes with lugging that stuff around.
7) Don't be shy about making sure you've done everything else you can: (this is where I do my "lap dance" ;) )
We could have done IVF a year ago, glad we weren't in that big a hurry, with our very 1st RE, who recommended it after our first two failed IUI's w/Clomid, when she didn't see the need to remove my septum. RE #2 removed part of it (as we'd later learn), but didn't think we needed IVF. I just knew we weren't done when we got either of their advice.
One of great things our consult with Dr. David confirmed for me is that IVF isn't the best/most efficient way to find out what's causing your problems, though if you are lucky on one of many tries it may get you around them. He recommended tons of new tests and a lap before considering IVF. We took this to heart (partly because it jived with our philosophy/ins. limitations), though some of those tests (namely a new SA for DH) pushed us even farther in the direction of IVF.
When I found out that my septum was not completely removed (see: wasted surgery #2 in Jan.) and RE #4 would need to go in yet again, we insisted on having a lap done as well. He was amenable (and fortunately it was covered under our regular insurance) and it was useful in giving him a valuable perspective on the surgery, so we did it and found that we probably didn't have anything else going on that was causing issues. That may make you think, what a waste! (though our 1st two actually were a complete waste) But with one shot, we needed to do this first and if nothing else it gave us HUGE piece of mind that we had done absolutely everything we could, aside from endless inject cycles, to avoid IVF. I just don't understand people who do many rounds of IVF before/without doing a lap. Maybe it shouldn't be part of the dx process (as it used to be) but it is certainly easier/cheaper than multiple rounds of IVF (as are many other cheap and easy dx tests).
8) Prepare for Failure:This may sound defeatist, but it's actually a very effective coping mechanism to deal the realities of infertility and ART. We literally had all our eggs in one basket, but I had elaborate scenarios charted out, which made my type A mind feel somewhat assured that if we failed miserably, we would be okay. We were lucky and got a BFP (with two in me and two in the freezer), but if the first round didn't pan out, we would have done an FET OOP. Or if not, I already have a maxed out 2011 FSA (with DH having to next wk to set up his) to do a new fresh cycle next year. Now I will use this for acu and L&D. I started looking at how we would pay for future cycles (new insurance/job for me, asking DH's employer for more $, income/bonus, savings, assets, shared risk, etc.) but we've already talked about adoption and if everything failed I actually was able to wrap my head around offering DH a "get out of jail card" and start a new life for myself. I think there is something to going through all of this. It makes you realize that you will, in fact, survive.
If you've made it this far (congrats!), I'd be interested to hear if anyone has any other words of wisdom? Tips for success?
Mother Nurture
Mayo Clinic Guide to a Healthy Pregnancy
