Written by Jenny Wordsworth, Founder of OVUM 

Understanding the IVF procedure from someone who has been there before can be invaluable. While we might all be on different treatment protocols and have different experiences, some universal truths help us all when preparing for IVF. 

In this guide, IVF patient and OVUM Founder Jenny Wordsworth walks through her IVF experience and the process from that first injection right through to testing for a pregnancy.

Pre-IVF

First, you and your partner will have plenty of paperwork to complete. Hopefully, this is all online, and your clinic has left the dark ages of written forms. Think about your full medical history, anything and everything that gives the doctors the whole picture of your fertility journey to date. Your first discussion with your doctor could be over the phone or in person. Either before or after (if you decide to proceed), you’ll need some blood tests (from both partners and a sperm sample. If you’re not in a heterosexual relationship/doing IVF solo then this part may vary slightly for you depending on the route you’ve taken.

Your fertility consultant should then review if IVF is right for you and whether this is the safest and quickest way for you to become pregnant. Ultimately, I chose my clinic based on its success rates and their questioning of my future family planning goals. No other clinic I spoke with had asked me how many children I might like (it seems so fanciful to be discussing the very idea of having more than one), and their approach to my IVF was curated with that in mind. I am now incredibly grateful for that approach as, years later, I have more options available to me.

Questions to ask your clinic pre IVF:

How will you factor in my family planning goals?

How will you keep in touch with me? How are nurse/patient comms handled? If you say you’ll get back to me later that day, please actually do so. I wish clinics would understand just how frustrating this is for the patient. It must be the easiest thing for a clinic to ensure they get right, yet it remains the case that most clinics fail to keep in touch. Keeping us updated with news during what is a physically, emotionally and financially draining time is the very least we deserve.

Are early appointments an option? This will help you fit in the many appointments you’ll need to attend around work.

What does the timeline look like? Is there a waiting list? 

Will you accept tests I’ve had elsewhere? I used an at-home fertility testing kit, and this was not accepted by my clinic, which wanted a venous blood test performed (ie blood taken from the vein versus an at-home test which uses finger prick blood). It is also worth checking the expiry of those test results that they’ll accept. My GP arranged my AMH blood test, and the clinic accepted these as they were less than 3 months old. Likewise, my husband’s semen analysis was done via our GP, and our IVF clinic accepted the results. 

I’d recommend writing down everything from the discussion with your clinic at this stage or asking them to. There is so much information given to you, and it really helped me to have it written down to refer to and lessen the feeling of being overwhelmed.

Your clinic’s goal should be for you to bring a baby home in the least invasive and shortest amount of time possible, and the answer to that isn’t always IVF. 

Hurry Up and Wait

If the decision is made that IVF is right for you, then the next step is probably the easiest physically, but mentally less so if you’ve reached the point that you just want to get this started. I myself felt incredibly impatient at this point and wanted to start yesterday/get it over with. The first step is to wait for your period to start so your medical team have a baseline. You’ll be asked to call your clinic to let them know as soon as this happens.

Further baseline tests are likely to be needed, too. Not everyone needs the same tests, so these will be based on your medical history. Usually, this involves more blood tests (FSH, Oestradiol levels, AMH) and an antral follicle count scan (which is done by a transvaginal ultrasound scan). This allows the clinic to create a personalised protocol and determine which fertility drugs are best suited to you, and, ideally, give you more information on your personal chances of IVF success.

From there, you may need further procedures such as a Hycosy or a Hysteroscopy, all to check the uterine environment and fallopian tubes for pregnancy. 

Armed with all of the above information, you’ll receive your patient protocol (a calendar with a start date and what you need to inject/take each day during this wild ride) and a prescription for all the fertility drugs you’ll need to take during the cycle. Some clinics might put you on birth control so they can manage start dates. 

This part could take weeks or months; it very much depends on whether any procedures are necessary in your case and the clinic’s availability to start.

Questions to ask your clinic when waiting for your patient protocol:

How do you ensure my protocol is personalised to me?

What can I/my partner do to improve our chances? This felt like the only area of IVF I had control over, and while I’m knowledgeable about lifestyle factors that can improve fertility outcomes, I can’t tell you how odd it was having the consultant recommend our own OVUM product back to me in the consultation. 

Do you bring in any other practitioners? E.g nutritionists. You’re looking for a clinic that is doing everything it can to limit the amount of IVF you’ll need, to me, that means reviewing the patient as a whole and exploring all holistic therapies where there’s credible evidence supporting its use in improving fertility outcomes.

Ovarian Stimulation

Finally, we begin. Day 1 of the IVF process begins with injecting yourself (or finding a kind soul to do it for you) with hormones for around two weeks. The name of the game is to stimulate the ovaries to produce as many eggs as possible. From here on, you’ll probably attend clinic appointments every 2-3 days. 

The first scan (your ‘baseline’ scan) should take place on day 2 of your period and will continue throughout so the clinic can assess how your body is reacting to the medication. Often, each scan is accompanied by more blood tests, so they can monitor your hormone levels throughout. 

All this monitoring means the clinic is taking great care of you and your follicles as they evaluate how they’re growing over this time. This helps them calculate when exactly those eggs will be ready for retrieval. When it’s time, you’ll receive instructions on when to take your final injection - known as the ‘trigger shot’ - which gives the eggs a final boost, so to speak, and help with their maturation, ready for the next step in the process. 

Questions to ask your clinic about Ovarian Stimulation:

What resources do you have to help me understand how to self-inject, how to take my medications and when? I found this to be a great source of anxiety (and that’s with a doctor for a husband!), and I was always worried I hadn’t drawn up the meds correctly or gotten the timings wrong. Videos weren’t fully personalised to my protocol which meant having to watch videos that weren’t all relevant to me, which didn’t help with the worrying. 

What stimulation protocol will I be put on, long, or short? and why?

What do you do to ensure I won’t suffer from ovarian hyperstimulation syndrome (OHSS)? 

Egg Collection

The eggs are now ready to be removed, this is done by a surgical procedure, and you are usually heavily sedated throughout. For many, this is the stage of IVF where the most discomfort is experienced as your ovaries are so enlarged with the fluid that accumulates outside the ovaries and within each follicle. Later that day or perhaps the next morning, your clinic should call you to let you know the number of eggs retrieved. 

Questions to ask your clinic about egg collection:

When will you call to let me know how many eggs were retrieved? Ask for concrete information on exactly when they’ll call (or email). It is not fun waiting around for this call, and knowing exactly when they’d call me and having them stick to it helped me enormously. It also helped me build trust with the team, as they always stuck to their word. 

Should I take the day off work? I did, as I wasn’t sure how I’d feel. Physically, I felt fine after the procedure, but nonetheless, I had a relaxed day watching Love Is Blind.

Fertilisation

After your egg collection, if you’re having IVF, your eggs will be mixed with the sperm, and if you’re having ICSI, a single sperm will be injected into each mature egg.

You’ll then receive a phone call the day after your egg collection to confirm how many of your eggs were fertilised. They’ll then call you again after your embryo transfer, normally 5 days after your egg collection. If you’re having what is known as a ‘freeze all cycle’ (so freezing all embryos, no embryo transfer just yet) or PGS (freezing embryos and having a few cells from each sent off for genetic screening), you’ll probably next hear from the clinic on day 5 of the embryo’s development to talk through how they’re doing. 

Questions for your clinic about the fertilisation stage:

Does the embryology lab use a time-lapse incubator? This means a special camera is integrated into the incubator, and the scientists can observe the development of the embryos 24 hours a day without disturbing them. 

What time will you call me? If I miss the call, will you leave a voicemail with this information, or will you call me back instead? We’re back to communications again. It’s just such an important one, and I think it's vital to understand how your clinic approaches comms and whether they appreciate just what a crucial part of the process this is for you.

Do you grade your embryos, and will you tell me this information? You might not want to know. My clinic didn’t shout about this but were happy to tell me when I asked. I’m glad I didn’t ask initially, as I’d likely have spent time googling and comparing grades to pregnancy success rates. Not great for my mental health. 

It is worth asking your clinic what happens if there are no embryos to transfer. I personally would ask for an in-person appointment to discuss what happened and what might come next. I think it would help process the outcome.

The Big Defrosting 

If you’re having a frozen embryo transfer (FET), you’ll start taking progesterone to prepare your lining for the transfer. 

On the day of the transfer, you’ll be asked to arrive on time as they’ll start defrosting the embryo before your arrival. Again you’ll be sedated for the transfer and it should take around 30 minutes. 

I found the transfer day a wild experience. I’ll never forget seeing images on the big screen of our frozen embryo. I remember worrying about how full my bladder was and wanting to drink just the right amount of fluid so as to make the doctor’s job as easy as possible. I was handed a pair of anti-slip socks with “IVF got this!’ written on them.

I was out for the count and don’t remember any of it, really. I went straight home and spent the rest of the day watching Selling Sunset (just to mix things up). I didn’t particularly feel sore, bloated, or that I needed to lie down - but everyone around me assumed I’d need to rest, so I latched onto that and enjoyed an afternoon of doing nothing! You need a village to get through IVF, and it can be a lonely experience, so finding others you can be open with throughout can be helpful.

The Dreaded Two Week Wait

Symptom spotting becomes an Olympic sport during the Two Week Wait. There’s no great way of getting through this time other than knowing yourself and knowing what will help keep your mind from obsessing over every little symptom you’re experiencing and whether you dare allow yourself to believe you might be pregnant. 

I kept myself busy and we planned a few days away in the mountains. I was 100% convinced it had not worked, and when my Doctor texted me on the day I was due to come in for an hCG blood test, I replied to let him know I was happy to come in, but there was no point as it hadn’t worked. I had no intention of using a pregnancy test, but the Doctor persuaded me to, as if I really didn’t want to come in, then testing at home made sense as a next step. The entire OVUM team were also keen for me to film myself testing, so I did. The result was positive.

IVF isn’t easy, and I found people who had no experience with IVF were mostly excited on our behalf that we’d soon have a new baby. It doesn’t quite work like that, not for everyone, and not always. It takes its toll on relationships; it can be expensive if you can’t access treatment for this disease (and it is a disease) on the NHS, and physically there’s an impact too. My advice is to put yourself first during this time; self-care is everything during IVF, and you must prioritise yourself and your happiness throughout. 

Questions for your clinic about the two week wait:

How much should I rest over the next two weeks and what forms of exercise can I take up? 

What mental health support do you have in place once I have the test results? 

If I’m not pregnant, what are our next steps? 

How to Manage Expectations

I’m not sure this is really possible. You become scared to think out loud that this might work and flip between thinking positively. The games your mind plays on you are unparalleled. You want this to work more than you have ever wanted anything. 

Last Thoughts

I stopped all CrossFit and HIIT exercises throughout my IVF and was even more strict whilst waiting to find out if the FET had worked. Instead, I took up lots of walking and found a beautiful forest right by my clinic. Before or after each appointment, I’d pick up a giant Starbucks and then go for a power walk in the forest. Being amongst those tall trees with the sun always shining was immensely helpful. I found I needed time after each appointment to process before going home or back to work. I would record a selfie video on each walk for something to look back on.

Whilst this was my own way of managing the experience, everyone is different and you may find that different things work for you. It can be tough but speak to friends/family/even a stranger on a bus if that will help. 

I wish you all the best for your IVF treatment, and myself and the team at OVUM are always here if you have any questions we can help with.