Tips and Tricks--ART, IVF, IUI, DE

[Anonymous]

There is so much knowledge on this Board, so let's pass it along. What tips and tricks have you learned in your ART journey?

[Anonymous]

--IM shots really aren't that bad. They look like they should hurt like a MF, but hurts less than a pin prick on your finger

--PIO goes in better if it's warm. I use a microwavable heating pad. Place the filled syringe on it for a few minutes. Inject, massage, then sit on the heating pad until it cools.

--When you need a full bladder (for some tests and transfer), do not drink the water when they tell you to or more than 16 oz. (SG says 1 hour prior to arrival, but you have to be there 30 mins before the transfer) I drink it 1 hour from the procedure time and only 16oz. Anything more than that and I'm in so much pain. If you can, try it yourself before hand to see when you feel uncomfortable.

--Should have moved on to DE sooner. My numbers said I should have moved on, but I was holding out hope. Now that we are doing it, I'm so relieved.

--BCP are the worst. Nothing is as bad as BCP!

--PIO (or any Progesterone) will give you pregnancy symptoms. DO NOT symptom spot. Until you test positive, you aren't pregnant.

--Even if you aren't using progesterone, you will have pregnancy symptoms (or no symptoms) DO NOT symptom spot. For every person that had your symptoms (or no symptoms) and was pregnant, you will find someone who wasn't pregnant. Each person, each pregnancy is different. Until you test positive, you aren't pregnant.

--Don't put your life on hold. Do you best to plan vacations or weekends away.

[Anonymous]

PIO injections: it will get better after a while. My nurse told me not to ice, and gave me a prescription for Emla cream (contains lidocaine) to numb the site. A hot water bottle also helps.

I second the recommendation for the full bladder tests. At my last transfer I had to wait almost an hour past my scheduled time: sheer agony.

[Anonymous]

Really, no one else has helpful tips?

[Anonymous]

Anonymous wrote:Really, no one else has helpful tips?

What do you consider a helpful tip? I've been through DE & PPs' advice is pretty good.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Really, no one else has helpful tips?

What do you consider a helpful tip? I've been through DE & PPs' advice is pretty good.

+1. What tips? Find an employer with a good IVF coverage. Otherwise, buy your meds abroad and/or do your IVF in Europe.

[Anonymous]

If you're going through this with a partner/spouse, make sure your relationship is in a very good place before starting. It can be a long and difficult journey.

[Anonymous]

All right, I'll bite. I've spent a lot of time on this board, and have found it (mostly) to be a place of solace and support over the past year. I certainly don't have all the answers, but I do have some tips and tricks. (But no baby. Yet.)

I can only address my experience, as a woman in her early 40s who married late, has a non-traditional and flexible work schedule, good insurance, a supportive partner, and decent-for-my-age AMH and other levels. Some of my tips and tricks may not be applicable to you, or may not be appropriate for you, or may outright offend you. My perspective and experience is not yours, please don't attack me for not being you! (My particulars: I have been TTC for more than two years. One blocked fallopian tube. Three unsuccessful IUIs. Two rounds of IVF, the second one I had a short-lived BFP, but I had to induce a miscarriage at 8 weeks when the heart stopped beating. No frozen blasts to work with, so I'm starting a final round soon. Then? who knows.)

Here's what I've found helps me get through all of it.

Take a look at your diet and make sure it supports your fertility journey. It may mean that you need to gain weight -- or lose weight. If you drink, cut back. (I did, and lost 20 lbs. But my doctor told me not to lose more weight because estrogen is stored in fat.) If you have a frappuccino with whipped cream and lots of sugar, knock it off, that shit is toxic. But a cup of coffee, savored, is not. Eat foods that are supportive to your fertility, including whole fat dairy, fish and other nutrient-dense foods. Don't drink soda, duh. Get your partner on board with this. Make cooking and meal preparation a thing you do together to support each other. At the very minimum, it's a place of positive focus that can create lifelong good habits.

Take a prenatal vitamin. But don't stress over the other supplements. Unless you're having very specific immune problems or are on a PCOS diet, a good prenatal vitamin is going to cover most of what you need. I take prenatal DHA, too, because my eggs are old. I also eat flax in my daily smoothie, for the same reason.

Take care of your body by moving it. If that means a walk every day, or going running three times a week, or lots of yoga, do it. If you suspect that you are doing too much and your level of activity isn't supportive of your quest to have a baby -- and most of you who are compulsive overexercisers know who you are -- then cut back. Find a slightly less intense activity. Trade a hot yoga class for something gentler. Trade the 10-mile run for a three-mile run and a couple of slow ambles each week. Find levels of activity that support your fertility journey, and make them habits of well-being. Hopefully, habits that will extend into your pregnancy.

Take care of your body by taking time to look good. When we look good, we feel good. That might mean getting your hair cut or colored regularly, a standing appointment for a pedicure or manicure, getting your hair blown out, or other simpler acts of self-care like taking an unapologetic long shower.

Your body will change and that is okay. You're not going to feel good, especially after your egg retrieval, your pants may not fit because you are bloated, you will have sticky progesterone discharge in your underwear. It's all temporary. Remember that. A matter of weeks, not a lifetime.

Acupuncture: This isn't for everyone, but my insurance covers it. There's an NIH study out there that shows there are slightly better IVF outcomes for women who do acupuncture. There's another study that shows that even if pregnancy rates aren't higher, the women who do acupuncture during IVF are happier and more optimistic.

Find a project. Maybe it's renovating your bathroom. Or a work project you can throw your whole self into. Or cleaning out your closets. Or planning a vacation. Find something that takes you beyond the 6 weeks or so that you're consumed with an IVF cycle.

Find something beyond yourself and your own problems. Volunteer somewhere. Help an older person. Heck, introduce yourself to an older person in your neighborhood and see what you can do to help them, whether it's pick up groceries or trim their hedges. Take a class completely unrelated to infertility. Learn a new skill.

Limit yourself to 20 minutes each day on this board or any others. If you find yourself obsessing over it, use it as a 20-minute reward for doing something else more positive for yourself on any given day. Or instead, set a time and spend 20 minutes writing down your feelings, then walk away.

Download the Circle+Bloom meditations and do them. Or something else that turns your attention inward in a calming way. Make it a priority, maybe as a ritual after you give yourself your injection each night.

Create a ritual around your injections. Some women put on a kettle and steep tea while they're doing the injections, then enjoy a cup of tea with their partner. Others reward themselves with an episode of Orange is the New Black. I light a candle, recline on my yoga mat, and listen to the Circle+Bloom meditations.

Find someone supportive to confide in. A counselor, a good friend...someone who unconditionally supports you who is not your partner.

But limit your exposure to unhelpful people and situations that are hurtful. This may mean turning off Facebook or other social media for awhile. Don't go to baby showers. (Send a gift, but don't apologize for not being there. Babies should be celebrated, but the modern American baby shower is a retrograde, ridiculous ritual, anyway.) I cannot be around my friends with babies right now, and I know it. I am afraid about the effect it is having on friendships, but it's just not good for me right now, so I don't see them because it hurts me in a way that is physical. I had to stop watching the Mindy Project when it became about a fertility clinic. I walked out of "Into the Woods" when I realized it was about a couple trying to have a baby.

Don't be afraid to set stupid people straight, kindly, about infertility misconceptions. No, you don't "just" adopt. No, going on vacation and getting it on isn't the answer. No, I don't need to "relax," I am a pool of inner calm and poise, thanks. No, it's not cool that you're telling your birth story again, at this cookout. No, I don't want to hear about how surprised you were at how fast you got pregnant!
(But, you know, be nice. People say well-meaning but stupid shit all the time. We all do. You can even say that to them. "I know you are well-meaning, but your comment is hurtful and misguided.")

Limit the number of people who know the specific timing of your procedures. The more people who are invested in the outcome, the harder it is to have to tell them bad news later when you yourself haven't even processed the news. Also: their interest isn't always concern, it's sometimes gossip or prurient curiosity.

*Caveat: You may find that it is more helpful to be open about what is happening to you, especially with miscarriage. We have more in common with people than we sometimes know. Suffering is universal, after all. Reminding people of our commonalities makes us all more compassionate.

Remember: Each day is another opportunity. You can't change past outcomes, but you can live your life in a forward-thinking, positive way.

[Anonymous]

I wish I hadn't told as many people as I did that I was going through this. Now friends watch me like a hawk and will comment if I am eating crackers, not drinking/drinking and will ask constantly, "so......any news?", "have you tested yet?", etc. Makes it more stressful when it's already very stressful.

I found acupuncture to be very helpful.

I joined a support group that has been great.

You need to advocate for yourself when there is a doctor/med recommendation etc that you don't like. You are allowed to switch doctors, nurses if you are not happy.

[Anonymous]

Anonymous wrote:

You need to advocate for yourself when there is a doctor/med recommendation etc that you don't like. You are allowed to switch doctors, nurses if you are not happy.

+1000. Do not be afraid to ask questions! So what is the dr./nurse seems annoyed? They're not your friends, they're your medical providers and, ultimately, it's your body. Also, I just wanted to add that PP @ 10:25 provided a GREAT list, but don't worry/feel bad if some of her suggestions aren't right for you. There's no right or wrong way to do infertility and we all make our own paths. Try different things (meditation, yoga, etc) and see what works for you. But don't feel bad if that's not the same as what works for someone else. GL.

[Anonymous]

Can't beat the last poster--what a great list. I'd only add to be kind to yourself. I unfollowed all acquaintances with babies on facebook (and probably some friends who posted too much), and avoided baby showers (and any events with a lot of kids/parents of young kids). You process how you feel the way you need to, and it's okay--just worry about taking care of yourself right now. Don't tell anyone the exact timing of your procedures so you can process on your own first if you need to before sharing any news with anyone. I found a blog entry with a good list of "what not to say to someone with infertility" and sent it to the few friends I had opened up to about what I was going through (with a nice note about how they had not necessarily done these things), so they would stop accidentally saying ass-hatted things to me.

For the IM injections, I found that icing the spot beforehand helped numb it enough, and then I put gentle heat on it after the injection. I warmed up the needle in my hand (or against my chest or belly) while i had the ice on. I left the heat on for a few minutes and then walked up and down the stairs a few times (or around the house for a few minutes), which helped prevent the painful knots that I had gotten the first few days. If you get a rash like I did, cold helps, along with some hydrocortisone cream, and alternating sides. I found my left side was more sensitive than my right side, so I did one-shot nights on the left side, and 2-shot nights on the right side. I did my injections around 9pm, but I think next time I'll do them pretty much before bedtime. 9pm injection made it hard to schedule any outings with friends since I couldn't explain why I needed to leave so early. Any progesterone will give you pregnancy symptoms so will echo what others said and recommend NOT symptom-spotting. Don't take any pregnancy tests before that blood test. Chances of seeing a positive that early are low and it was harder on me emotionally to see that negative than to just wait. Not to mention, they are expensive, and you have enough to spend on.

I binge-watched tv shows, found a new book series to obsess over, or threw myself into work during cycles/the 2WW as much as I could. It helped take my mind off things. I also tried to fit in acupuncture, yoga, walking, and tried to eat a healthy diet (I roasted lots of things on Sunday to help get me through the week with some healthy options). I found that loose-fitting tops and dresses helped when I was feeling bloated at the end of the cycles. I figured I could also use them for early pregnancy which I have. Good luck to you and take care!

[Anonymous]

Also, if you have the option, choose the insurance plan that covers your fertility issues (My Kaiser plan covers 50% for fertility treatment). Also max out the FSA (flexible spending account) if you have that option, which should help cover some of the medication.

[Anonymous]

A practical thing:
Set a reminder on your phone to do your injections. I keep most of the meds in my basement refrigerator. Everything else -- syringes, wipes, hand sanitizer, sharps container, etc. -- gets stored in a plastic basket in the kitchen. When I've done my injection for the day, I get everything ready for the next day and store it in the little follistim pen carrying case, in the kitchen refrigerator. That way it's all ready to go each day, with minimal fuss.

Also: I try to smile at all of the women I encounter coming in and out of the clinic. Everyone always smiles back. I like to think we all feel a little more hopeful that day, even if things aren't going well.

[Anonymous]

Anonymous wrote:All right, I'll bite. I've spent a lot of time on this board, and have found it (mostly) to be a place of solace and support over the past year. I certainly don't have all the answers, but I do have some tips and tricks. (But no baby. Yet.)

I can only address my experience, as a woman in her early 40s who married late, has a non-traditional and flexible work schedule, good insurance, a supportive partner, and decent-for-my-age AMH and other levels. Some of my tips and tricks may not be applicable to you, or may not be appropriate for you, or may outright offend you. My perspective and experience is not yours, please don't attack me for not being you! (My particulars: I have been TTC for more than two years. One blocked fallopian tube. Three unsuccessful IUIs. Two rounds of IVF, the second one I had a short-lived BFP, but I had to induce a miscarriage at 8 weeks when the heart stopped beating. No frozen blasts to work with, so I'm starting a final round soon. Then? who knows.)

Here's what I've found helps me get through all of it.

Take a look at your diet and make sure it supports your fertility journey. It may mean that you need to gain weight -- or lose weight. If you drink, cut back. (I did, and lost 20 lbs. But my doctor told me not to lose more weight because estrogen is stored in fat.) If you have a frappuccino with whipped cream and lots of sugar, knock it off, that shit is toxic. But a cup of coffee, savored, is not. Eat foods that are supportive to your fertility, including whole fat dairy, fish and other nutrient-dense foods. Don't drink soda, duh. Get your partner on board with this. Make cooking and meal preparation a thing you do together to support each other. At the very minimum, it's a place of positive focus that can create lifelong good habits.

Take a prenatal vitamin. But don't stress over the other supplements. Unless you're having very specific immune problems or are on a PCOS diet, a good prenatal vitamin is going to cover most of what you need. I take prenatal DHA, too, because my eggs are old. I also eat flax in my daily smoothie, for the same reason.

Take care of your body by moving it. If that means a walk every day, or going running three times a week, or lots of yoga, do it. If you suspect that you are doing too much and your level of activity isn't supportive of your quest to have a baby -- and most of you who are compulsive overexercisers know who you are -- then cut back. Find a slightly less intense activity. Trade a hot yoga class for something gentler. Trade the 10-mile run for a three-mile run and a couple of slow ambles each week. Find levels of activity that support your fertility journey, and make them habits of well-being. Hopefully, habits that will extend into your pregnancy.

Take care of your body by taking time to look good. When we look good, we feel good. That might mean getting your hair cut or colored regularly, a standing appointment for a pedicure or manicure, getting your hair blown out, or other simpler acts of self-care like taking an unapologetic long shower.

Your body will change and that is okay. You're not going to feel good, especially after your egg retrieval, your pants may not fit because you are bloated, you will have sticky progesterone discharge in your underwear. It's all temporary. Remember that. A matter of weeks, not a lifetime.

Acupuncture: This isn't for everyone, but my insurance covers it. There's an NIH study out there that shows there are slightly better IVF outcomes for women who do acupuncture. There's another study that shows that even if pregnancy rates aren't higher, the women who do acupuncture during IVF are happier and more optimistic.

Find a project. Maybe it's renovating your bathroom. Or a work project you can throw your whole self into. Or cleaning out your closets. Or planning a vacation. Find something that takes you beyond the 6 weeks or so that you're consumed with an IVF cycle.

Find something beyond yourself and your own problems. Volunteer somewhere. Help an older person. Heck, introduce yourself to an older person in your neighborhood and see what you can do to help them, whether it's pick up groceries or trim their hedges. Take a class completely unrelated to infertility. Learn a new skill.

Limit yourself to 20 minutes each day on this board or any others. If you find yourself obsessing over it, use it as a 20-minute reward for doing something else more positive for yourself on any given day. Or instead, set a time and spend 20 minutes writing down your feelings, then walk away.

Download the Circle+Bloom meditations and do them. Or something else that turns your attention inward in a calming way. Make it a priority, maybe as a ritual after you give yourself your injection each night.

Create a ritual around your injections. Some women put on a kettle and steep tea while they're doing the injections, then enjoy a cup of tea with their partner. Others reward themselves with an episode of Orange is the New Black. I light a candle, recline on my yoga mat, and listen to the Circle+Bloom meditations.

Find someone supportive to confide in. A counselor, a good friend...someone who unconditionally supports you who is not your partner.

But limit your exposure to unhelpful people and situations that are hurtful. This may mean turning off Facebook or other social media for awhile. Don't go to baby showers. (Send a gift, but don't apologize for not being there. Babies should be celebrated, but the modern American baby shower is a retrograde, ridiculous ritual, anyway.) I cannot be around my friends with babies right now, and I know it. I am afraid about the effect it is having on friendships, but it's just not good for me right now, so I don't see them because it hurts me in a way that is physical. I had to stop watching the Mindy Project when it became about a fertility clinic. I walked out of "Into the Woods" when I realized it was about a couple trying to have a baby.

Don't be afraid to set stupid people straight, kindly, about infertility misconceptions. No, you don't "just" adopt. No, going on vacation and getting it on isn't the answer. No, I don't need to "relax," I am a pool of inner calm and poise, thanks. No, it's not cool that you're telling your birth story again, at this cookout. No, I don't want to hear about how surprised you were at how fast you got pregnant!
(But, you know, be nice. People say well-meaning but stupid shit all the time. We all do. You can even say that to them. "I know you are well-meaning, but your comment is hurtful and misguided.")

Limit the number of people who know the specific timing of your procedures. The more people who are invested in the outcome, the harder it is to have to tell them bad news later when you yourself haven't even processed the news. Also: their interest isn't always concern, it's sometimes gossip or prurient curiosity.

*Caveat: You may find that it is more helpful to be open about what is happening to you, especially with miscarriage. We have more in common with people than we sometimes know. Suffering is universal, after all. Reminding people of our commonalities makes us all more compassionate.

Remember: Each day is another opportunity. You can't change past outcomes, but you can live your life in a forward-thinking, positive way.

It's a good list. One thing I think is overdone and overblown out of proportion is nutrition. At this point it's a cottage industry of people peddling books, products and services. It's a very seductive thought - hey I'll eat more of this, cut out that and it will help with infertility. No. It doesn't. You need to get a balanced diet that has proteins and healthy fats in it, but it applies to everybody, including men and children, not just those with IF or TTC. No amount of brazil nuts and raspberry tea will change anything. Otherwise every frigging clinic would require it. And we wouldn't need the clinics to start with. Same with coffee, a cup or 2 a day will not affect your chances. If it did, then we wouldn't have teen pregnancies - they would just drink lots of coffee and not get preggo from unprotected sex.

Acupuncture, massage and meditation - if you're highly neurotic during your fertility treatments, sure. Otherwise these also do only two things: 1) jack 2) squat. Having said that, I go to acupuncture because my insurance covers it and I like a nap in the middle of a work day.

As for the tips: research everything and question your dosages, protocol and everything else. Be your own advocate, explore options, read studies on PubMed, get second opinions. If you research buying a car, this should be x100.

Be prepared for your body being ravaged by the process. Bloating will go away but only partially. You may get a 70 day cycle without ovulation after an unsuccessful IVF. All that crap is likely to happen, don't wear rose glasses going in. In short, you're going to war, be ready.

[Anonymous]

Anonymous wrote:
Don't take any pregnancy tests before that blood test. Chances of seeing a positive that early are low and it was harder on me emotionally to see that negative than to just wait. Not to mention, they are expensive, and you have enough to spend on.

I agree with every you said except this. I think it depends on what kind of person you are whether or not you POAS before the blood test. For some people, like you, seeing a BFN is too emotional. And seeing a BFP and it being a chemical pregnancy I'm sure would be devastating. For myself, not POAS is the worst. I can handle a BFN, because I just say "today I'm not pregnant" and it helps to put the symptoms I'm having into perspective (it's just the PIO, even though I know that logically. It helps to see it) And even if I get a BFP, I just say "I'm pregnant today", but don't get super excited until I get my beta (and 2nd beta). So I buy the super cheap Wondfo's on Amazon and pee away.

TLR-- if POAS stresses you out, don't do it. If not POAS stresses you out, do it.