In-vitro fertilization (IVF) can be an intimidating process, but it is definitely manageable with the correct information and preparation. During an IVF-stimulating cycle, a woman undergoes a series of hormone injections to stimulate the ovaries to produce more eggs. Not sure what to expect before IVF? You’ve come to the right place. I’m here to lay it all out!
You should know there are so many hoops and hurdles to jump through before beginning IVF. Prior to undergoing IVF treatment, you’ll need to qualify for assisted reproductive technology (ART). To qualify for ART, you have to get through several prerequisite steps.
Many couples turn to IVF in an attempt to conceive after being diagnosed with some sort of infertility. My situation is a bit different. I underwent IVF to preserve my fertility due to an endometrioma on my left ovary. (More about that here.)
In this blog post, I document my personal journey toward IVF. While the reasons I underwent IVF may be different than others, the process remains the same. I’m here to share a play-by-play of my experience.
Prior to Starting IVF…
You’ll have a consultation.
True story: my initial appointment was a surgery consult. After being diagnosed with stage IV/V endometriosis at 34 years old, I was ready to cut it out. Literally. My OB recommended OTC pain meds ad hormonal therapy (aka birth control), but I was so not about that life.
I knew from the start I wanted to freeze my eggs and attack this disease head-on. I asked for a specialist referral and found my way to our current medical team in November 2022. At our first meeting, we discussed my medical history and the best protocol for my body and unique circumstances. I also underwent the first of many blood tests.
You’ll get baseline ultrasounds.
Diagnostic tests TBD by your medical team
Before starting any IVF injections, I had a baseline ultrasound to determine the number and size of follicles in my ovaries. I also underwent more bloodwork. For the next 2 menstrual cycles or so, my luteinizing hormone (LH) and progesterone (P4) levels were monitored. The endometrioma was frequently viewed and measured by ultrasound to ensure it had not grown or burst.
I even had a hysterosalpingography (HSG) in early December 2022 to outline the internal shape of the uterus and show whether my fallopian tubes were blocked.
All testing came back as expected: bloodwork showed I still had decent ovarian reserve (surprising for my age), the HSG showed my reproductive tract was free from any blockage (surprising for advanced stages of endometriosis), and ultrasounds revealed my left ovary was still producing and releasing monthly follicles (eggs) despite the massive endometrioma (probably the most surprising revelation of them all).
You’ll develop a course of action.
With the help of my reproductive endocrinologist (RE) and fertility specialist team, we strategized the best course of action for my particular scenario. While my OB had suggested hormonal birth control to subdue my endometriosis symptoms, this new medical team wanted to preserve my fertility and surgically remove my endometrioma.
I hoped to (naturally) delay pregnancy for another 1-2 years, but if surgery was sooner than later, well, we’d do what we had to do as a family and adjust our plan. My endometrioma measured 4cm at the time of baseline assessments. Surgery is recommended at 5cm. As a result, we decided to harvest eggs and freeze them for a later date before considering surgical interventions.
Insurance also played a large part in our medical plan. Your policy may have you try intrauterine insemination (IUI) before IVF because it is cheaper. With IUI, sperm would be injected when it was known I would be ovulating in hopes of becoming pregnant. Again, since I wasn’t looking to be pregnant right now, this was a silly option. If and when I decided to use IUI, it might not work because of my advanced maternal age at that point. Because of our family plan and my underlying condition, however, insurance allowed me to bypass IUI and go right to IVF to harvest eggs. For what happens during IVF, be sure to check out the next blog post in this miniseries: What to Expect During IVF Stims
ACTIONABLE STEPS: Got questions? I may have answers. Don’t be shy; say hi! I’m happy to help ease your mind. If you’ve gone through the IVF process before, share your own experience in the comments below. What should other women expect before undergoing IVF treatment? Got tips and tricks? We’d love to hear them all!
