Although IVF success rates are improving all the time IVF failure can occur and it can often take a number of IVF cycles before a patient will see a successful outcome, if at all.
As someone who has experienced a failed IVF treatment cycle, as well as a cycle that ended in an early miscarriage, I know how devastating both outcomes can be.
In contrast to the minefield of information that exists on how to prepare for IVF treatment there is very little to advise patients how to deal with a cycle that is not successful, and as a result, it can be a frightening and hopeless time for many people.
After potentially agonizing over the decision to pursue treatment in the first place, months of preparation, not to mention the physical and emotional side effects, it can be very difficult to accept that there will not be a baby at the end of it all.
Unless high-quality embryos have been frozen, which can be used for a Frozen Embryo Transfer (FET), many people find themselves at a complete dead end. They are frightened to pursue further treatment, yet unable to accept that this could be the end of the road.
While many people who write about IVF failure tend to describe their initial devastation and their eventual triumph over it, very few actually write about the practical things they might have done to help them through that period of their lives. Even though it is true that grief is a process that takes its own time, there are things that may help you to cope better with everyday life.
Some of the coping strategies I’ve outlined here are more relevant to those who do wish to pursue further IVF treatment, but others are applicable to everyone, regardless of the next steps.
The IVF Failure Blame Game
While some degree of anger is expected in the aftermath of a failed IVF cycle try not to let it take over or it can be destructive.
When we found out that our first cycle had failed we were completely and utterly blindsided. We had put all our faith and hope in IVF treatment and were convinced that it would work for us first time because we were young. To find out that it had failed, and knowing that we had no frozen embryos with which to attempt a follow-up cycle, was unbelievably heartbreaking.
My immediate reaction was to find someone to blame. At first, I blamed the clinic, convinced it was their negligence somewhere along the line that had caused harm to our embryos. I reflected back on every conversation I had had with them, trying to find holes in their processes and signs of their incompetence.
Then, inevitably, I turned the blame on myself, analyzing every single move I made during the cycle and wondering what it was that I did to stop my embryos from implanting. Being unable to conceive naturally had already been a harsh prospect to come to terms with, but being unable to get pregnant through IVF made me feel more inadequate and more of an IVF failure than ever before.
However, I soon realized that the anger that I was feeling was not helping the situation. In fact, it was dragging me down further and preventing me from moving on in any capacity. In the end, I had to accept that it came down to choice. I could choose to let the failure of our cycles consume me or I could choose to try and move on.
Focus on the follow-up appointment
In the first few days, and possibly weeks, following a failed cycle it can be difficult to contemplate another IVF cycle, especially a fresh one. The grief can be so overwhelming that it’s impossible to fathom putting yourself in such a situation again.
About six weeks after a failed cycle, when emotions have settled down a little, clinics will typically schedule a follow-up appointment to review the cycle and try to understand where it might have gone wrong. Try to hold out for this appointment and avoid making any definite decisions until you have talked to your doctor. You may find that there are changes that can be made to the protocols that might help your odds on a subsequent cycle. There may also be further fertility investigations that can be done or new techniques that can be tried. However, if egg quality is the suspected cause of IVF failure, it is worth preparing for the possibility that treatment options that you had previously rejected, such as using donor eggs, may now be the best chance of success.
Understand why the IVF failure occurred
Try not to leave your follow up appointment without ensuring you fully understand why your treatment may have failed. Many of the IVF patients I spoke to who experienced failed IVF cycles didn’t realise that there were signs throughout the cycle that their odds of success were low. For example, if the fertilization rates were very low, or the quality of the embryos on transfer day was poor.
On our first cycle, my husband and I had a very low fertilization rate and didn’t make it to a day-five transfer. However, we were so happy that we had an embryo to transfer that we didn’t really listen to or question what we were being told. Had we asked more questions along the way, and had realistic expectations, we may not have been so shocked by the outcome. Moreover, we didn’t really question why the treatment may have failed during our follow-up consultation, and so entered into the second cycle with exactly the same protocols.
Don’t rush into anything
When IVF fails it can feel as though you are back at square one. The backup plan has failed and it can feel like you’ve run out of options and there is no hope left. Having probably spent many years trying to get pregnant naturally prior to attempting IVF treatment, many people feel as though they need to move on without wasting more time. In order to feel as though they are doing something to get over the IVF failure many rushes into a decision about what to do next. Some will decide to close the door on IVF completely, and others leap straight into another cycle. In my experience, the immediate aftermath of a failed cycle is not the best time to make big decisions.
We started our second IVF cycle barely three months after finding out that our first had failed. On reflection, this was far too soon. I hadn’t allowed nearly enough time for my head, my heart, or my body to heal properly. I wanted to stop the pain, the anger, and the feelings of despair, and the only solution I could see was to get pregnant as soon as possible. In hindsight, there is no question in my mind that we should have taken a long break to ensure that we were both in optimum condition, both physically and mentally, to withstand another cycle, but we were desperate to do something to alleviate the anguish and get out of that dreadful limbo. The second cycle was easier in some respects since we were no longer dealing with the unknown. However, we both found it more physically demanding, possibly because we were still so exhausted from the first cycle. Sadly, this cycle was also unsuccessful and ended in an early miscarriage.
Try to focus on what did go well
Even if the ultimate outcome is negative, there will probably be plenty of aspects of the cycle that did go well. Try to focus on these as much as possible, especially if considering another IVF cycle in future.
Following our second cycle, I was continuously told by family and friends that I should focus on the fact that at least I could get pregnant. Initially, these comments infuriated me, as it felt as though no one really understood just how much we had invested to make it as far as a positive pregnancy test.
Acknowledging the short-lived pregnancy as a positive thing seemed futile. I couldn’t even contemplate the thought of trying IVF ever again – the pain was just too unbearable.
However, over time I started to realize that those people were right – there were positives to focus on, and I tried to gain strength from them. My body had overreacted to the stimulation medication, which may have compromised the egg quality, but this could be adjusted in a subsequent cycle, and although we had suffered a miscarriage one in four pregnancies ends this way, regardless of whether IVF was used or not. As bleak as things were, we had to acknowledge that there was still hope.
Take time out
In the aftermath of a failed cycle, it is important to try and take as much time out to grieve and heal as you possibly can. If you haven’t taken time off work during treatment then you should try and take some time out afterwards. Many people I have spoken to found that, although they had felt unable to talk to their employer about treatment while they were going through it when a cycle failed they found that they had no choice; going to work and putting on a brave face was impossible. They were grieving and needed time to mourn and come to terms with their loss before attempting to resume a normal life.
Find a new distraction
After months of researching treatment options and preparing body and mind, not to mention constant appointments and tests at a fertility clinic, IVF may have started to feel like a full-time job. When it is over many people find themselves at a loose end. Without the joy of a pregnancy on which to focus, life can seem very empty all of a sudden, thus exacerbating the pain. If you feel up to it, try to find something entirely unrelated with which to distract yourself, such as a new activity or hobby.
What really helped me was to make a list of all the things I wanted to achieve in my life, whether I had children or not. It was essentially a bucket list that included all manner of activities, both big and small. I started by ticking off the small things: eating in a restaurant I had always wanted to try and go to a museum I wanted to visit. The act of achieving a goal, no matter how small, and being able to tick something off my list made me feel stronger and more empowered.
Consider all your options
Before plunging ahead with a similar treatment plan, convincing yourself it was just bad luck that the first one failed, or before rejecting a new treatment plan that may seem extreme, spend time researching as much as you can. Many people make uninformed decisions about treatment only to regret it afterwards. Talking openly to your doctors and to other patients who have been in your shoes can provide a new perspective. I have talked to many people who eventually became parents through a treatment option that they had initially rejected, so try not to close any doors before you have fully considered the options.
Just as counselling can offer invaluable help to ART patients before and during treatment, it can also offer support when it fails. A number of people who have experienced IVF failure told me that they gained huge strength from attending counselling sessions. Counselling will be particularly helpful for those who are unsure of whether to pursue further treatment or not.
Look after your relationship
A failed IVF cycle can take a huge toll on those who are in relationships. Like all forms of grief the way each individual deals with the loss may be very different; this can lead to tension and even feelings of resentment between a couple. Having gone through three IVF treatment cycles I can understand why so many relationships do not survive IVF failure. Day-to-day living whilst going through the process becomes extremely strained and the relationship itself can become less important than the goal of having a baby. Difficult as it may be, try to spend time talking and understanding each other’s grief, and continue to make time for yourselves as a couple.
The above extract is taken from Five Million Born – An IVF Companion Guide by Anne-Marie Scully. It is available to buy now for Amazon Kindle for a special promotional price of just $1.99.
Here Are Some Tips To Break The Invisible Wall
“Most relationships fail because we spend too much time pointing out each other’s mistakes and not enough time enjoy each other’s company.” – Unknown
Struggles through infertility can tend to take over your life. The constant stress of the treatments and the repeated disappointments can definitely strain the relationship between partners. Women may feel more irritable & emotional and her partner may feel helpless and worried. This makes for a difficult combination for any conversation to occur! Slowly there is an invisible wall starting to appear between the couple, emotions take over and make it even more difficult to talk.
With infertility, making a baby isn’t sexy. It isn’t fun. It’s stressful. It’s hard. It’s hormonal. It’s just miserable. The process truly is a make or break on relationships. Women can especially feel volatile just like a volcano about to blast at anytime with no warning. One minute you are positive, the next negative, becoming miserable, seemingly out of the blue. It can become exhausting for the partner quickly. The invisible wall gets thicker and taller… Sound and feel familiar?
Infertility can be an awful journey if the partners are not truly supporting and caring for each other. I have heard so many stories where partners are separating temporarily or permanently due to the stress and struggles with infertility. It doesn’t have to be that way!
Here are some tips to break the invisible wall…
1. To the woman who is in the thick of infertility, pay some attention to your partner. Ask them how they are doing. One of my clients asked her husband that very question on Father’s Day, and he broke down. Men also feel it, they just feel it differently.
2. To the woman struggling through this process, allow your man to be vulnerable. As a man, vulnerability with your partner doesn’t make you weak, it makes you even stronger. I have seen many relationships become very successful amidst the pain and struggles, when there is vulnerability between the couple. It strengthens your bond and makes you closer.
3. To both partners, when emotions are running high, remove yourself from the situation, take some time to collect yourself. Don’t talk or act when emotions are running high. The invisible wall gets higher when emotions are high.
4. Remind yourself and your partner frequently that “Together, we will make it thru this too”. Saying it out loud makes a world of difference and gives a great comfort to the other partner.
5. Get professional help, specifically someone who truly been there and understands the infertility struggle. They can help with tools and techniques to slowly eliminate relationship struggles, help identify the relationship goals and help you move forward positively in your life with or without successful fertility treatments.
Don’t let the invisible wall keep growing stronger and taller. Find ways to break the wall down slowly. Infertility shouldn’t be the reason for a relationship to break! Take small steps forward.
20 Things You Should Never Say To Someone Struggling With Infertility!
“You may never know what someone is going through, but if you notice any signs of pain—hostility, negativity, or over-sensitivity—then odds are, you know how they feel. Respond to the pain instead of judging the signs.” Lori Deschene
I have unexplained infertility and my fertility journey was very long and painful with almost 8 years of failed treatments. I had 3 miscarriages, 3 IUI failures and 8 back to back IVF failures. It was an emotional roller coaster. I struggled in silence for the major part of my journey. I avoided talking to people with the fear that they will ask me about having kids. I avoided going to India (where all my family is) for 4 years in a row giving all sorts of bullshit (pardon my language here) reasons on why I can’t go. I wore a mask at work and never talked about anything personal. Talking to friends and family members was a nightmare especially who recently became pregnant or had a child!
I always avoid telling others about my infertility journey to avoid the comments that can really sting, let my blood pressure rise and bite my tongue, to put it mildly. There are sometimes where I wanted to react in a more animated fashion to those somewhat insensitive and ignorant comments.
This doesn’t just happen to me. It happens to many of us who are struggling with pregnancy loss, primary or secondary infertility. I recently put a question (What is that one thing that people say annoys you most about infertility?) to an online FB support group and its members had overwhelming response talking about their personal experience with these insensitive comments.
This list is based on my personal experiences and the collective experiences from many amazing souls going through fertility challenges including my wonderful fertility clients.
I am writing this to create awareness to those people who haven’t experienced infertility, who typically say things like this (many times with good intentions) to others going through infertility.
Here are 20 things NOT to ask/say people going through infertility:
- When are you going to have a baby? You are running out of time.
- Just relax, it will happen
- Drink a glass of Wine, it will happen
- Go on vacation, it will happen
- Stop trying, it will happen
- Lose weight
- You are young, you have plenty of time
- Do this, try this, it worked for, it will happen (Varies all the way from eating McDonald’s fries to using essential oils)
- For people with secondary infertility or have experienced losses before- You at least know you can get pregnant
- I know a bunch of ladies who’ve had babies in their 40’s! Don’t worry, it will happen
- To people with secondary infertility- At least you’ve got one, you’re so lucky, you might just have to be happy with one
- You are lucky you don’t have kids yet! (or) It’s so hard having so many kids
- You can have one of mine
- My husband looks at me and I get pregnant (or) I sneeze near my husband and I get pregnant
- Comments by a younger couple – We tried for a really long time( 2-3 months) to get pregnant, I understand your frustration
- Don’t worry, the technology is so good these days!
- Have you thought about adopting? it will kick-start your hormones and you’ll get pregnant. It happened to my (insert random relative)
- If God thought you were ready, you’d be pregnant.
- Maybe it’s just not meant to be (or) whatever is going to happen will happen.
- It’s not just the words, it’s the body language too- When people ask if I have children and I say, I do not, their reply almost always is, you never wanted kids?! With a surprised look on their face.
Even today at my nail salon, my manicurist asked me, how many kids, I said one(adopted). How old, 5 years. The next question immediately, you don’t want to have more???? You should have more..
This article is not intended to judge or blame those folks who say these comments. Many of you say these things out of good heart and well intentions. You all want to support and care for your loved one dearly.
Just keep in mind, these words can and will create a deeper wound to people going through fertility struggles. Because many of us are desperately seeking and doing whatever it takes to get and stay pregnant and yet it’s just not happening.
Unless you have experienced infertility, it’s hard to understand and relate to the pains and struggles all around. Infertility affects ones overall being- physically, mentally, emotionally and spiritually.
Here is one suggestion I will offer to people who are supporting a friend or a loved one.
Tell them, I may not truly understand what you are going through, but remember, I am here for you. And give them a big hug. Sometimes that’s all we need to feel better even a teeny tiny bit!
“Sometimes, what a person needs is not a brilliant mind that speaks, but a patient heart that listens.” Anonymous
Fertility Treatment Survival Skills
Practical and Emotional Top Tips from Iris Fertility Sherpa Natasha Canfer, Clients and Colleagues.
As the founder of Iris Fertility – an organisation offering bespoke practical and emotional support and companionship to individuals before, during and after fertility treatment – I am regularly asked what people can do to help manage the challenges that fertility treatment throws at them. Together with Iris Fertility clients and colleagues, I’ve put together our top tips, insights and nuggets of information.
- Put Yourself First Throughout the Process
Go gently, treat yourself kindly and say ‘no’ to people who are going to sap your emotional energy especially when treatment’s underway or you’re in the 2 Week Wait (2WW) – finding interest in or compassion for anyone else while you’re in the throes of fertility treatment can be challenging. Put activities on hold that you’re not interested in or can’t face. If you feel like you ‘should’ be doing something with someone then probably best to avoid! Be aware that how you feel day to day (and even within the day) is likely to change.
Don’t put off taking that first step – that might be going to your GP or going directly to a clinic for a Fertility MOT.
Don’t do too much of your own research – it can be mind boggling, confusing and cause anxiety.
Seeking the support of an individual or organisation (like Iris Fertility) who knows the process really helped us with having a sounding board away from the clinic environment. We could ask the questions we didn’t necessarily want to ask our clinic and raise concerns we weren’t able to share with friends and family. Don’t leave a niggle or a doubt unsaid.’ Loretta, Somerset
2. Trust Your Gut Feeling
Follow your instincts. Those instincts or your gut feeling might not appear to be logical but if something doesn’t feel right then it probably isn’t for you – even if you can’t pinpoint the reason.
3. Inform Yourself
Depending on your circumstances, appointments at fertility clinics can feel overwhelming. You might be presented with a lot of information and it can be difficult to take in exactly what’s being said and what that means for you – particularly if you’ve just received tests results that aren’t as you’d hoped. Also, a clinic may only give you information that’s specific to the services it offers rather than providing you with an overview of what might be available to you nationally and globally.
‘Don’t be afraid to ask questions – the doctors aren’t gods and they need to be challenged sometimes so that you know they’re doing the best for you as an individual.
Talk to people who have also been through this and don’t bottle things up especially through the 2 Week Wait.
Don’t be scared by the process. Embrace it but be careful as it can become addictive – trust your instincts when it comes to knowing whether you’re ready to say “enough is enough”.’ George, Ireland
Other sources to look into if you feel able are:
Progress Educational Trust (PET) – a UK-based charity which advances public understanding of science, law and ethics in the fields of human genetics, assisted reproduction, embryology and stem cell research: Progress Educational Trust
Human Fertilisation and Embryology Authority – the UK’s independent regulator of fertility treatment and research using human embryos. An expert organisation in the fertility sector and the first statutory body of its type in the world: www.hfea.gov.uk
‘Question, question, question your clinic about all the costs involved and its refund policy.
Ask your clinic about risks of failed fertilisation and unsuccessful thawing of frozen eggs and embryos.
If you opt to use a clinic abroad, check whether you can use a clinic of your choice in the UK alongside that overseas clinic or are you tied to one of their associated clinics?
If you go abroad, factor in how easy it is to arrange scans, blood tests, medication, intralipids, etc. Also work out whether you will easily be able to get flights and accommodation at short notice.
Is the clinic open at weekends and able to work around you?’ Sarah, West Yorkshire
4. Remind Yourself that it’s OK to be in a Different Emotional Place from Your Partner
Depending on your circumstances, it’s possible that you and your partner may want to choose different treatment options or you may find yourselves in a different emotional place from one another. That’s OK and totally understandable. Open and honest ongoing respectful communication with each other is important – and can also be exceptionally tricky especially when emotions and hormones are running high. If you feel that counselling would be beneficial then speak with your clinic about what they can offer you and when. Otherwise, you could locate a specialist infertility counsellor through BICA
Take the time you need.
Talk to your friends. If they are real friends they will want to lend an ear.
It’s OK to recalibrate your understanding of who you are if that’s necessary.’ James, Hertfordshire
5. It’s All About You: ‘Fertility Treatment’ is an Umbrella Term
Ensure that your clinic tailors all your treatment and medication to you and your needs.
6. Who’s Who? Clinic Staff
Make a friend among the clinic staff and ask them for their work contact details. It’s beneficial to have an ally or two on the ‘inside’.
If there’s a staff member who you have strong negative feelings towards for whatever reason and you would prefer them not to be involved in your care then let your clinic know. Most clinic staff work as part of a team and will try and accommodate patient requests of this nature.
I would’ve liked to have treated myself almost as if I was recovering from an illness – very gently. So do what makes you happy or at least calm. Go to places that make your heart sing and your fear retreat. See only those people who make you feel positive and with whom you can be completely yourself.’ Caitlin Allen Acupuncture, West Yorkshire
7. Statistics and Other Numbers are Only Part of the Picture
Perhaps easier said than done but try not to get too hung up on statistics and numbers. No one can say for definite how things are going to work out for you. Ultimately you need one egg, one sperm and one womb to get along with each other. If you’re comparing clinics then make sure you’re comparing like for like statistics. The figure you’ll probably be most interested in is the live birth rate for the female age group relevant to your situation.
8. Check Out Donor Conception Network
If you’re considering using donated eggs, sperm or embryos then check out Donor Conception Network (DCN) as soon as you can but preferably before you even start any treatment or become pregnant. Donor Conception Network is a charity and supportive network of more than 2,000 mainly UK-based families with children conceived with donated sperm, eggs or embryos; those considering or undergoing donor conception procedures; and donor conceived people. Staff, volunteers and network members have a wealth of knowledge, information and expertise about all things past and present in the world of donation including the possible impact of telling or not telling donor-conceived children about their genetic heritage: www.dcnetwork.org
‘If you wish to find the best possible fit with a surrogate mum, then Surrogacy UK is a great association to join. With their ‘friendship first’ ethos, get togethers are organised so that friendships can be formed before Teams are created.
Speaking as a two-time surrogate mother, I felt that finding the couple to team-up with was all about friendship chemistry. Being open, honest and approachable is a good way to connect with a potential surrogate. It may feel scary at first and you may feel exposed and vulnerable, but it works both ways. Imagine a year down the line when your surrogate/friend is about to birth your baby, she will be trusting you to hold that space for her, as the baby is delivered at long last in your arms.’ Jay Kelly, Surrogate, Baby Alchemy
9. Going Abroad – Is the Grass as Green as You Think?
If you’re thinking about going abroad for treatment, investigate what the implications of doing so could be for you and any future children. Here are just a handful of things to consider:
- If your UK clinic is encouraging you to go to a particular overseas clinic then is it affiliated in some way to that clinic? If so, how and what does that mean for you and those clinics?
- How is the overseas clinic regulated?
- What’s the legal situation regarding types of fertility treatment in the country (or state) of your choosing?
- Which screening tests are performed on patients and partners?
- How much is it going to cost you financially, physically and emotionally especially by the time you’ve factored in flights and accommodation?
- If you’re using a donor abroad then how are they screened and selected?
- What are the anonymity rules in relation to donors and how would this impact on any child(ren) born from treatment?
- How many families can a donor donate to and what could this mean in terms of the number of half siblings for your potential child?
10. DIY Donor Sperm – Future Proof Yourself
If you’re using donor sperm outside of a clinic environment then before you even start preparing for pregnancy ensure that your personal safety is paramount. Also, get legal advice regarding your specific situation and make sure you have legal agreements in place in relation to your particular circumstances.
11. Remember the Adult Child
While your focus may initially be on you becoming pregnant, your goal is to have a baby. That baby will hopefully grow to become an adult so when making decisions around the types of treatment you are willing to undertake, consider how your future (adult) child at different life stages could feel about any decisions you make and the impact of your choices on them.
12. Include Your Partner
It might feel that the spotlight is on the individual physically undergoing the fertility treatment so actively include (and encourage your clinic to include) your partner if you have one.
13. Changing Times
The nature of fertility treatment changes all the time so if it’s been taking you a while to get that baby into your arms you might begin to wonder if a particular treatment had been available to you earlier then whether life would have worked out differently. Be kind to yourself and remember that on your quest to become a parent you can only make your best decision with all the information you have available to you at the time the decision needs to be made.
Develop a new hobby or skill in which you can immerse yourself and that can be done at any time regardless of the stage of treatment you’re at. Current favourites to distract clients are escape rooms, singing and learning a new language.
If you’re eligible to receive NHS funding but you’re not sure you want to have treatment in your allocated NHS fertility clinic then you could investigate the possibility of transferring your funding for use in a private fertility clinic.
If you’re not eligible to receive NHS funding or it’s not available in your area then speak to your clinic about any payment plans it might offer. You could also look into specialist fertility funding organisations which provide IVF refund schemes and multi-cycle programmes.
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