How To Prepare For Your Second IVF Cycle
By Elyse Ash
Let me tell you a little story about my first round of IVF.
Spoiler alert: it was a big fat failure.
When we started our IVF journey, I was so excited! Finally, after a year and a half of trying to conceive we were actually DOING something about it. And our odds were good! With a solid sperm count and above-average AMH, our Reproductive Endocrinologist gave us a 75% chance of InVitro Fertilization (IVF) and a Frozen Embryo Transfer (FET) resulting in a real-life baby. I remember my husband Brad and I left that appointment feeling so hopeful and excited; we were basically picking out baby names.
But our optimism quickly fizzled out after my egg retrieval resulted in only 7 eggs, which quickly dwindled down to just two day-5 embryos. After another two-week wait, we got the genetic screening results back and learned that our two little frozen embryos both had chromosomal abnormalities that were not compatible with life. We had no healthy embryos to transfer.
Cue ALL of the sads. I spent the entire month of July crying. I bought a lot of poetry books. I journaled every day. I was inconsolable. How could this NOT work? This thing that we spent so much money on and believed in? All those drugs? All those appointments and ultrasounds? That 75% number the RE gave us? How could modern medicine NOT have worked?
Call me naïve, but I hadn’t even considered this outcome. Sure, I knew IVF wasn’t a guarantee, but I always assumed it would fail later. Maybe a transfer wouldn’t work, or a frozen embryo wouldn’t thaw properly. But to not even make it to a transfer? Woof. That was brutal.
It took a couple of months for me to get my emotional shit together and prepare for a second round, which we underwent a few months later. When you get ready to go through a second round of IVF (or a second IUI), there’s an odd mix of feelings. It’s both easier and harder than the first round.
It’s easier because you know what to expect. You know how to administer the injections, how to plan your calendar, and how to predict your feelings. But some parts are also just plain excruciating. Sometimes, it’s harder to get as excited as you were during the first round. There’s also more at stake from a financial perspective, with more bills and more pharmacy runs and just more everything. But above all else, it’s hard to go into round two with the same blind faith and hope so many of us had with round one.
Here are some suggestions and tips for ways you can prepare yourself as you gear up for your second round of IVF (or IUI, or embryo transfer):
1. Understand that the first round not working wasn’t your fault.
As women, a default reaction is oftentimes to blame ourselves. Perhaps you experience an unhealthy internal dialogue that sounds something like: “If only you had cut out gluten…”, “Why didn’t you do more acupuncture?” or “You should have worked out less.”
The first step in getting ready to jump back into round two of IVF is to acknowledge that this is not your fault. Bodies react differently. There’s not always a scientific rhyme or reason why it didn't work. It sucks and it’s nebulous, but it’s not because you had too much cake, and it’s not because you got too into HIIT workouts.
Cut yourself a much-needed break. Sometimes these things work, and sometimes they don’t. It’s truly not your body’s fault. It’s doing the best it can.
2. Make sure you’re really ready to start again.
Having a failed cycle of IVF, a failed embryo transfer, or a failed IUI is heartbreaking even in the best possible situation. Now multiply that heartbreak if it resulted in OHSS, a chemical pregnancy, a miscarriage, ectopic pregnancy, or another complicated outcome. Not only are you going through emotional heartbreak, but sometimes your body is also physically traumatized.
It’s important not to rush right back into treatments if your soul and your body are not yet ready. You need time to process what happened and how you’re feeling. You need time to regroup with your partner and make sure you are still aligned and emotionally, financially, and physically prepared for the next step.
Every single day spent trying to conceive can feel like a year, but waiting can sometimes be a good thing if you’re not yet ready to move on.
3. Try to avoid back-to-back cycles.
Even if you feel emotionally and physically ready to jump right back into treatments, you may still want to consider avoiding back-to-back egg retrievals.
According to Carolinas Fertility Institute, the standard space between IVF cycles is one full menstrual cycle. A fresh IVF cycle should not be done two months in a row without a menstrual cycle in between them. That means waiting about 4 to 6 weeks after the embryo transfer and negative pregnancy test to start another full cycle for most women.
There are a few compelling reasons to avoid back-to-back IVF cycles:
Physical: The medications used for ovarian stimulation may cause some inflammation. Many doctors think it’s beneficial to wait for the inflammation to subside before going forward with another fresh cycle.
Emotional: It’s important to give yourself time to not focus on IVF. For your mental health, you may need to take a breather from the emotional rollercoaster of treatments.
Financial: Unfortunately, even insurance plans that cover fertility treatments often do not cover everything. So it may be necessary to pause treatments to assess things and make arrangements for the next cycle.
4. Let go of expectations.
It can be tempting to compare your second round of IVF with the experience of the first round.
It’s important to let go of these expectations because every cycle is unique. During your second round of IVF, you may be extra keen on reading up on all aspects of the process. But sometimes information overload can do more harm than good. Sometimes knowing too much can take a toll.
Consider what it would look like to detach yourself a bit more from the process. This could look like staying off Dr. Google, or decreasing your time sifting through the depths of online forums. It’s perfectly okay (and healthy) to shelter yourself from information overload and let yourself feel grateful for your body and for making it this far. That, in and of itself, deserves recognition.
5. Consider changing things up.
Sometimes, making some small changes between cycles can give you a greater sense of control. Whether that means taking more supplements to increase egg quality, working out more, going to therapy, or even working with your RE to change your medication protocol, making small changes to tweak your attitude and outlook can make a big emotional difference.
It’s just human nature to try something different a second time once a first attempt fails. And while it might not necessarily make a huge difference, it certainly doesn’t hurt. As always, be sure to consult with your doctor first.
6. Continue making mindful medical decisions.
After your first IVF cycle crashes and burns, you usually have a “WTF Appointment” with your RE. That’s when your doctor will tell you what they learned from your first cycle and how they plan to change things up the next go-round.
Maybe that means adding more meds or changing your pre-stimming protocol. It could also mean suggesting that you pursue egg donor, sperm donor, or surrogacy options. Just be sure that you and your partner are making mindful medical decisions on how you both wish to proceed.
Don’t let ANYONE pressure you into a decision you are not comfortable making. Take your time. Ask lots of questions. Do your research. Write a pro and con list. Take a vacation. Do whatever you need to do to get educated, aligned, and then prepared with your partner.
7. Take care of yourself.
You can’t pour from an empty cup, so make sure you’re filling yours during this process. It will help you stay as calm and grounded as possible as you get ready for round two. Whether that means surrounding yourself with good friends, buying new slippers, cutting out alcohol, or finding yourself a mentor who understands, do whatever you need to do to feel safe, supported, and mentally prepared to get back in the game.
Remember also that self-care looks different on different days. Some days self-care means drinking green juice and going for a run, other days it means drinking a milkshake and binge-watching The Office. Again.
Whatever self-love looks like for you, it’s going to be necessary as you embark on IVF round two, so think about what brings you joy, and do more of that.
Elyse Ash and her husband Brad went through three years of infertility, two rounds of IVF, and one frozen embryo transfer before seeing their first positive pregnancy test, which brought them their daughter, born in March 2018. Elyse lives in Minneapolis and loves poetry, hockey, social justice, Beyonce, and pretending she’s into yoga.