If you are contemplating IVF or about to embark on your first cycle, you’ve undoubtedly started reading and researching with the sort of enthusiasm that’d put an academic to shame.
Who can blame you? This massive undertaking isn’t for the faint-hearted, and you’ll be keen to know everything you can about what’s ahead.
However, there are a few things that don’t always make headline news in IVF literature, but they are still handy to know about.
Let’s look at six things you might not be expecting during IVF treatment.
What we’ll be looking into:
- IVF sometimes starts with birth control pills
- The surprising impact of IVF on your sex drive
- Why some fertility doctors insist on abstinence during parts of the IVF cycle
- Stomach bloating and the perceived ‘baby bump’
- Embryo transfer and the risk of surprise urination
Psychological impacts of IVF treatment
#1: You might be prescribed oral contraceptives
It might seem like the weirdest thing in the world, but some IVF treatment begins with a prescription for oral contraceptive pills.
It’s all to do with timing, as when taking the pill, your cycle should regulate and give fertility doctors a chance to schedule treatment precisely.
We usually associate the pill with preventing pregnancy, but taking it ahead of IVF is thought to help ensure the cycle works better. This is typically done 3-4 weeks before the beginning of your IVF cycle, but a minimum of 18 days will likely be advised.
What the experts say:
In the publication Medical News Today, the science behind oral contraceptives to help IVF is explained.
They write: “Each ovary contains ovarian follicles – small sacs that comprise fluid and one immature egg. In a typical menstrual cycle, one follicle becomes mature and can release an egg.
“Taking birth control pills (BCPs) prevents this follicle from reaching maturity. After an individual stops taking BCPs, they will begin taking IVF medications that promote follicle growth. Evidence suggests that pre-treatment with BCPs may help with the timing and egg yield during ovarian stimulation.”
#2: You might want to have more sex
A lot of IVF chatter talks about it being an ending to all bedroom antics, but that’s not necessarily the case.
The introduction of a lorry load of hormones into your body can have all sorts of effects on you, including turning the frisky dial up to full blast.
While we’re not suggesting you’ll want to swing off the chandeliers with your other half every night, there is a chance that your libido could increase.
Whilst this is the case for some, for many people, IVF has the exact opposite effect. If you aren’t feeling sexy, or driven to have sex, don’t feel bad.
IVF takes a massive physical and psychological toll on the body, and it’s completely normal to feel this way considering what you’re undertaking.
What the experts say:
What’s causing this spike in sexual desire? Experts believe it’s likely to be down to increased oestrogen levels in the body during IVF.
In IVF, oestrogen therapies are used to help stimulate follicles, help eggs to grow, and thicken the uterine lining ahead of implantation.
In the paper Increasing Women’s Sexual Desire, the authors reviewed multiple studies on female libido.
They found that in many studies, self-reported sexual desire peaked just before ovulation when oestrogen levels were at their highest.
They concluded: “These studies demonstrated that women’s sexual desire consistently exhibited a well-defined midcycle peak.”
It’s important to note that this study looks at the effect of increased oestrogen on all women, not just those undertaking IVF. Taking IVF brings a host of other factors along, which may undo the effects of the increased oestrogen. In fact, a lot of research points towards women undergoing IVF scoring lower on measures of sexual interest, desire, orgasms, satisfaction, sexual activity, and overall sexual function. This has the term Inferto-Sex Syndrome (ISS). Most importantly, everyone’s experience will differ, and it will likely change throughout your IVF journey.
Symptom #3: There will be times you’re asked to abstain from sex
When you were trying to conceive without medical help, you might have been participating in some kind of sex Olympics to increase your chances.
So, it might seem weird when you get told that during certain stages of IVF, you should abstain from sex or use barrier protection.
These times might include the lead-up to egg retrieval to limit any damage to ovaries, post-egg retrieval to prevent infection and the days before embryo implantation to prevent multiple conceptions.
Some doctors still recommend you don’t have sex in the days following embryo transfer, although recent research suggests this doesn’t affect IVF success.
What the experts say:
Different clinics have different approaches, but you may be asked to abstain to protect the ovaries from getting twisted.
On the parenting website Romper, gynaecologist Dr Kimberley Keefe Smith explains why this is recommended.
She said: “Having intercourse, especially penetrative intercourse in particular, is not a great idea because you could be at risk of twisting the ovary.
“Thankfully, it’s really rare, but penetrative intercourse is something that we would want to avoid during the actual IVF cycle, during the [phase of administering] injections where we’re growing the follicles.”
It’s important to stress that this is rare, having an incidence rate of 9.9 per 100,000 women of reproductive age.
Symptom #4: You might ‘look’ pregnant before you are
Congratulating somebody on their pregnancy when they aren’t expecting is one of life’s most cringeworthy mistakes.
But if someone says it to you when you are undergoing IVF treatment for a longed-for baby, cringe becomes cruel.
However, there is a chance you might develop bloating in your stomach due to IVF treatment that others might mistake for a baby bump.
This bloating is a very normal part of the IVF journey. This can be extremely uncomfortable and painful, and the bump can often be an equivalent size to much later in a natural pregnancy journey.
What the experts say:
During IVF, you may have treatment to stimulate the follicles in your ovaries ahead of egg retrieval.
Sometimes, the fact that multiple follicles have been stimulated makes the ovaries stretch, causing bloating.
Dr Jacqueline N. Gutmann explains that bloating is sometimes linked to Ovarian hyperstimulation syndrome (OHSS).
She says: “Women with OHSS have a large number of growing follicles in their ovaries in conjunction with high oestradiol levels. This leads to fluid leaking into the belly, which can cause bloating, nausea, and swelling of the abdomen.
“One out of three women has symptoms of mild OHSS during controlled ovarian stimulation for IVF.”
Symptom #5: You might wet yourself during embryo transfer
There will be parts of your IVF journey where dignity deserts you, and for some of us, that’s during the embryo transfer.
Your medical team are likely to ask you to arrive at the embryo transfer appointment with a full bladder, as an external ultrasound is used to guide the embryo transfer.
However, the combination of a full bladder and intense pressure applied by an ultrasound wand can result in accidental leakage on the table.
What the experts say:
The experts share the embryo transfer process to better explain why the bladder needs to be at least partially full.
They write: “Abdominal ultrasound is used to guide the transfer. To perform the transfer, your physician will place a speculum in the vagina, and the cervix will be rinsed with a sterile solution. The embryologist will load the embryos into a small catheter, and your physician will ease the tip of the catheter through the cervix into the uterus.
“A partially full bladder often will allow the transfer to be completed more easily and will allow a better picture on the abdominal ultrasound.”
If the pressure does trigger a leakage, it won’t be a new experience for your medical team, so don’t be embarrassed.
Symptom #6: Psychological Impacts of IVF Treatment
News of infertility can have a considerable impact on a person’s mental wellbeing, often experiencing the same agonising emotions as anyone sitting with grief or loss. Shock, frustration, anger, and shame are all common emotional states.
It’s no wonder that emotional distress is reported by 80% of people navigating infertility struggles, with 30-40% experiencing clinical levels of depression and anxiety.
Therefore, entering the IVF journey can be daunting.
The physical demands of medication, costs, and uncertainty surrounding outcomes all contribute to the higher levels of reported overwhelm. This coupled with balancing the demands of day-to-day responsibilities and prioritizing self-care may seem unreachable.
What can help?
In the early stages of the journey, sourcing education and transparency around the different steps may help to reduce lingering guilt or worry. Throughout the process seeking support when making decisions, discussing side effects (all of which can be different depending on the individual) and ways to manage expectations of self and others is vital.
Taking control of the psychological effects of the IVF journey is within reach. Practising simple strategies such as picturing a positive outcome at the end of your journey has been proven to act as a “protective factor” against self-blame and anxiety on the IVF journey. In addition, surrounding yourself with family members and friends that hold a similar outlook can support you with taking a self-compassionate stance.
Always ask for clarity and support
We hope this rundown of some less well-known IVF experiences is helpful.
You’ll discover that the IVF journey and how your body and mind respond to it is very personal.
There might be symptoms, incidents, or feelings that don’t chime with the accounts you’ve read.
Our advice is to always contact your medical team and support network for help and clarity when things don’t feel right, or you are unsure about what’s happening.
Remember that your mental and physical well-being is vitally important, so don’t be afraid to ask questions and seek help when you need it.
Keep an eye out for our upcoming site feature, “Aunt Kari”, where you’ll be able to send in your questions for our experts to answer. These questions will be fully anonymous, and answers will be published weekly on our website.
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