infertility blog

The misconceptions about IVF conception

Photo by    Nine Köpfer    on    Unsplash

National Infertility Awareness Week may have finished but the need to understand and support (in)fertility is a year-round topic. It prompted me to reflect on my own expectations going into my journey and what we can do to support individuals or couples undergoing (in)fertility treatments. Here are some common misconceptions:

Misconception #1: Getting pregnant by IVF is a sure thing

I wish it was, but sadly it is not. I went into two rounds with high hopes because everything “looked more than fine.” I came out on the other side with multiple fails and a non-diagnosis of “unexplained”. Doctors can have great success rates, high hopes, and by doing so, may raise your expectations. Know that they have the best intentions but they are only human after all, and science has only hit the low hanging fruit at this point. This (in)fertility process can reveal many things but not always a baby. After a glowing prophecy of a beautiful embryo that doesn’t take or worse miscarries, it can feel like someone just punched you in the face (multiple times).

Please be sensitive if someone tells you that they are undergoing IVF. To give some perspective, imagine sticking yourself with medicine/hormone filled syringes that make your emotions a roller coaster, your bloat world-class, and the bottom half of your body weighed down by giant egg follicles growing in your ovaries.

Be supportive, even if that just means listening, and/or sending good thoughts and positive vibes. Please do not heighten the expectation and pressure by talking about the future. The patient and doctor don’t know the outcome yet, please don’t pretend to either. 

Misconception #2: The patient is just along for the ride

IVF is a team sport. It always takes two, right? Biologically, you need an egg and a sperm but in the IVF case, the outcome is also assisted by a doctor. While it is on the doctor to choose the right protocol based on a patient’s medical history and needs, the patients still need to take care of themselves. Think about planting anything. The foundation and the conditions need to be right for anything to grow and healthfully. Same applies here. And the partner isn’t off of the hook, the patient’s well-being and the long term success of the relationship depends on it. 

Misconception #3: There is only one path to a child.

How an individual or couple gets there may not be the way that they envisioned but the end result can still be the same. Options exist and ultimately one day this will be readily available to everyone who wants and has the capacity to be a parent.

After my second IVF failed, my doctor shared that she thought it was a good idea to try again. In the same breath, she shared that if I failed a third time, she wasn’t sure that she could help me. Initially I was stunned, and that feeling turned to despair. I thought that I was a failure, blamed myself for not doing enough (acupuncture, eating enough greens), and that I might never be a mother. Yes, there were a lot of waterworks. So ugly. And yes, I found a new doctor.

What I wish that I would have known then was the comfort of knowing that there are options including egg donors, surrogates and adoption. Although it’s a lot to think about when you are determined to go about one path, it can be a relief to at the very least be aware that there are possibilities to achieve the end goal of having a baby if the general IVF route doesn’t work.

Misconception #4: If I share my (in)fertility story, people will think that there is something wrong with me.

There are 7.3 million (documented) cases of (in)fertility* and this is will continue to grow and impact future generations as we continue to live in a polluted, endocrine disrupting world. (Sorry for the Debbie Downer moment.) The (in)fertility topic is about to become so much greater than just our personal egos.

(In)fertility isn’t punishment for something, it just is the reality for many individuals and couples. In fact, (in)fertility affects 1 in 8 couples*. Many people that you know are grappling with (in)fertility, they may just be in the closet because of the many emotions borne out of the shame created by the silence around it.

The sooner that we stop hiding behind a perfection that doesn’t exist, accept that (in)fertility is a topic that we need to embrace, the sooner that we will be able to rally support from our workplaces to make the conversation safe and resources available for (in)fertility. After all, happy, healthy employees and families make happy companies, which in turn creates a happy economy.

*Source: 2006-2010 National Survey of Family Growth, CDC

The Nurse we all Need

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I am so excited to share the discussion that I had with Fertility Nurse and Consultant, Leyla Bilali of Fertility Together.  Leyla bridges the gap between doctor visits, the waiting, the results and so much more.

It is no secret that (in)fertility is a lot to navigate both mentally and physically. Leyla’s services combine emotional support with the medicine that's within her scope of practice. It’s also a huge bonus that Leyla helps her patients with the administration of their medicine in the comfort of their own home and is also a constant sounding board. The result is that Leyla’s patients are much more than just that, they are individuals who receive support tailored to their needs during their fertility journey. 

Read on to find out more about the discussion that I had with Leyla, the Fertility Nurse that we all need.  I have come to think of Leyla is a fertility fairy godmother. Everyone going through fertility treatments needs a Leyla!

What is a fertility consultant and what inspired you to become one?

 A fertility consultant holds your hand during your fertility journey. This doesn’t necessarily have to just be for IVF but for all fertility related treatments including egg freezing. I work with some women that aren’t in a secured relationship or ready to have a child yet, but would like the option to potentially have a child in the future. From egg freezing to IVF, I help women navigate the whole process from who to see and what tests to take for baseline testing.

Sometimes an OB will suggest that a patient should see a reproductive endocrinologist, especially if a couple has been trying without success for over a year. I can guide that person on who to see based on their personalized medical history rather than just send them to a clinic where there is a relationship (between the OB and the clinic). A lot of this (fertility) world is not personalized. There is such a high volume at the large clinics which has its pros, but it makes it difficult to personalize care for people. My role is to help guide through all of the results and keep my patients sane.

I believe that a nurturing, knowledgeable partner like me can make all the difference as someone discovers their unique path to fertility. In my 11 years as a registered nurse, six of them in pediatrics, and five of the most recent in fertility, I have learned how to make healthcare more comfortable and human by inserting my compassion, humor and reliability.

 The medical world can feel very stiff and scary and we often need a shoulder to lean on to get through it. This is especially true for fertility patients as they are usually in a vulnerable state to begin with. Whether you are simply curious about your reproductive health, ready to take action via egg freezing or struggling with infertility, it doesn't get much more emotional, raw or intimate than this. And because of this intimacy, it's often hard for people to talk about it. As a society, we are beginning to lift the taboo of fertility but we still have a ways to go!

I have been fortunate enough to recognize my calling as a fertility consultant at the suggestion of some of my most dear patients. I thought I was supporting them medically and emotionally, and instead I was the one that was rewarded ten-fold with a great business idea. It actually occurred to me while I was at the home of one of my patients assisting her with injections. Sometimes the patient or the partner has a hard time administering or doesn’t feel comfortable.

I realized what was missing in fertility care when my patient said “I don’t know how people do this without a Leyla. You should start your own business.” No one else was doing this in the Tri-State area so I officially launched Fertility Together in August of 2017.

You mentioned personalization for each patient. Can you please elaborate?

 After looking at a patient’s medical history and understanding their personality, I make recommendations on who that patient would work well with and provide A – Z assistance from injections to on-call support. Even if it isn’t the full IVF, egg freezing is still the first full part of IVF by way of egg retrieval. I can assist the patient on what to expect from the medications and help administer it, if needed. 

What is your view on the correlation between stress and conceiving?

 Stress wreaks havoc on your body so there is no reason that it wouldn’t wreak havoc on your reproductive system and egg quality. 

 Cortisol (stress) hormones compete with progesterone hormones. Progesterone is crucial to pregnancy, specifically to conceiving and holding a pregnancy. There are a lot of indications that stress plays a role in infertility.

 One method that I like to combat stress is acupuncture. There may not be any direct studies that acupuncture increases egg quality but it does affect your nervous system, which can suppress your stress levels. JAMA recently released a report on an acupuncture study where some patients received traditional acupuncture and others received a placebo of randomly placing needles. The result showed no difference between the traditional and the placebo. However, because the participants felt that they were proactively doing something to alleviate their stress, the positive IVF outcomes were increased. 

What do you most regularly hear your patients “stress” about leading up to and during IVF treatment?

The anxiety from the medication and injections. The partner relationship also plays a huge role (of importance) because that is your support system and any potential lack of it, can also be a source of stress.

What are your top tips for patients to optimize positive outcomes and reduce stress?

  1. Taking care of your body is huge. If you have an eating disorder, are under or overweight, you are damaging your reproductive system. You can improve egg quality and support it with good whole foods, decreasing alcohol consumption, and not smoking.

  2. It is important to work with a doctor that you vibe and feel comfortable with. The doctor and the facility should be available to answer questions. You should not ever feel like a bother for asking.

  3. Communication between you and your partner is crucial. We often forget that our partner is going through this too and that they have (support) needs as well. Maybe you need a third party like me or an IVF therapist to help.

  4. Do what makes you feel sane; that could be acupuncture, exercise, or another healthy activity.

Are there any myths about stress that you would like to debunk?

 Prior to transferring an embryo, I have a lot of a patients who ask if the timing is right and if stressful life events will alter their results. For example they have a stressful work week coming up or life just happened. The answer is no. If the embryo is going to take and it’s going to be a viable pregnancy, it’s going to sustain despite your everyday level of stress and anxiety. 

There is nothing wrong with being stressed and anxious about this process. That is why it is annoying when people say “don’t stress or just relax”. I think that it would be abnormal if someone didn’t stress or have anxiety during the process. Letting yourself feel these emotions is where my services come in. I am a sounding board. You get to tell me that you are stressed out and just talking about it will make you feel better. 

Are there any resources that you think are a must for anyone going through or considering IVF?

  • Acupuncture, Liz Carlson at Common Point. I go to her myself!

  • IVF therapists

  • Resolve.org offers a resource list for consultants, therapists, support groups

I would love to get to the point where people don’t feel ashamed that they had to undergo any fertility treatment to have their baby. Ideally it would be normalized and not a taboo topic.

What moment in your career has inspired you more than you could have imagined?

I was chatting with my husband’s colleague at a holiday party who knew that I am a fertility nurse, and upon meeting me shared that he was an IVF baby. He told me that he was so appreciative of what his mom went through to have him. It brought tears to my eyes.

 

Leyla Bilali, BS, BSN, RN is an experienced fertility nurse and fertility consultant. Leyla received her Bachelor of Science in Biology at Emory University, and her BSN at the Columbia University School of Nursing. 

To learn more about Leyla and Fertility Together, please visit: fertilitytogether.com or @fertilitytogether on IG.