12 frequently asked questions about undergoing IVF

How long should I wait before seeing a specialist, how much does IVF cost in Ireland, are there any supplements I should be taking? We answer the most common fertility questions

Going through fertility treatment is an important time in anyone’s life. Whether you’re just starting out on the road to parenthood or have been through it all, there is still so much to learn and understand.

IVF, or in-vitro fertilisation is one of the most common types of fertility treatment and rounded up the 12 most frequently asked questions about the treatment to help you on your way to parenthood.

When should a couple consider seeking out a fertility specialist?

This depends on the age of the female partner. If you’re under 35 with no indicator of subfertility that you know of, then it’s recommended you see a specialist after a year of trying. If you’re over 35, it’s recommended you see a specialist after six months.

However, peace of mind is really important and you can see your GP or a fertility clinic for some basic fertility tests when or even before you start trying for a little one. If there’s anything you need to do or correct to help you conceive naturally, you can then make those adjustments. Remember too that you are conceiving as a couple, so both of you should be fertility tested if you decide to go for investigations.

How much does a round of IVF cost in Ireland?

Typically in Ireland, IVF costs between €4,000 to €5,000 and this should include the treatment and aftercare of one round of IVF. It’s important to explore exactly what’s included in the costs and find out what additional costs there could be (such as fertility testing and embryo freezing) so that you can budget appropriately.

Is weight an important factor for IVF treatment?

If you are trying to conceive, it is important to be at a healthy weight. Often people put off tackling their weight until they have their treatment plan, but starting right away will put you in the best position. Being underweight or overweight can impact your fertility as this affects the normal production of hormones. For men, it can impact sperm count so it’s an important issue for both of you.

Being a healthy weight can increase your chances of becoming pregnant naturally and potentially improve the success of fertility treatment. While BMI is not the only indicator of health, it is still a useful one and a good goal. It’s important to ensure you are giving yourself every chance of success when trying to conceive or progressing with fertility treatment. Looking ahead to your pregnancy, you’ll have a healthier pregnancy and delivery if you’re nearer the ideal weight at the start of your pregnancy.

How long does it take from the initial consultation in a fertility clinic to a pregnancy test?

The first step is to get in contact with the fertility clinic. They will book you in to meet a consultant fertility specialist and advise you on any tests and information you and your partner need to have to get the most out of your consultation. At your consultation, the fertility specialist will review your medical history, perform an ultrasound scan and discuss all of your test results together as a couple. They will then give you some recommendations, which might be to have some further tests, some advice to help you conceive unassisted, or they might recommend a course of treatment.

If they recommend IVF to you, the consultant will advise a particular protocol based on your test results. Once you are ready to begin your cycle, the team will give you instructions for when and how to take your medications, and some expected dates for scans and your egg collection procedure (although these dates can change, depending on your response to the medication).

Your cycle will start when your menstrual cycle starts. The first part of the cycle focuses on daily hormone injections. to stimulate the ovaries to produce follicles (a follicle is a small bubble of fluid that contains an egg). This process usually takes about two weeks and during this time you’ll have some ultrasound scans to monitor the progress and growth of the follicles. Once the follicles reach the right size, your egg collection will take place, a procedure where the eggs are collected from the ovaries. The eggs are then brought to the lab to be fertilised and developed to embryos. A few days later, an embryo (or two – but this can result in twins or even triplets) will be transferred back into the womb. It’s then a two-week wait until you can take a pregnancy test.

Does a history of ovarian cysts affect fertility?

A history of cysts can impact fertility but not always. A specialist can assess whether you have any cysts that could interfere with your plans before and during your treatment so it’s important to flag this with your doctor from an early stage.

How should I prep my body for its first round of IVF? 

The central thing to keep in your mind is that you are preparing for pregnancy, not for treatment. Keep that in sight. Getting your body ready in terms of being physically healthy for your pregnancy is so important. If you do smoke or vape, quitting will improve your chances of conceiving. A balanced diet, good water intake and a regular exercise routine are important for all aspects for health. Cook at home as much as you can, with a good supply of organic fruit and vegetables and avoid fried and fast foods.

Think about your support system and what you enjoy doing, what relaxes you, and make time for those people and things: they are your support network and will help you through from treatment to baby. There are also a number of complementary therapies that patients find helpful, such as mindfulness and acupuncture as a way to help them relax.

Are there any supplements I should take during IVF?

All women who are actively trying for a baby should take 400ug of folic acid per day and well as vitamin D, Omega 3, CoQ10 and a good source of vitamins and minerals. Generally, these can all be found in all-round supplements. For men, folic acid is also recommended, Omega 3, vitamin D, Zinc and Selenium are beneficial.

Remember that you will get most of these vitamins from a healthy, balanced diet. Eating organic fresh fruit and vegetables, particularly dark leafy vegetables will really help your intake.

Any advice on juggling IVF appointments alongside work?

Balancing the needs of your cycle with the needs of your work can cause a lot of stress for anyone undergoing IVF. If you’re comfortable, discuss your plans with your manager and with your GP. While companies in Ireland are not yet obligated to give you paid leave for reproductive healthcare treatments, the majority of managers are very supportive.

The Organisation of Working Time (Reproductive Health Related Leave) Bill 2021 is currently being discussed, which may in time allow leave for those seeking care. If you’re planning to do a cycle, once you’ve had your consultation, your IVF cycle will have 5 or 6 appointments and they are very quick appointments, usually 20-30 minutes, flexible appointments. The only day you’ll need off is the day of your egg collection.

Is there any advice on having sex while undergoing IVF?

Although you’re trying to get pregnant, it is important not to have unprotected sex during your IVF cycle since you are stimulating your ovaries to produce multiple follicles. Protected sex won’t have any impact on your treatment, but keep in mind that superovulation can be uncomfortable for some women.

What if I’m really terrible with needles?

This is a very common fear. The needles that are used for the injections are quite small and short and shouldn’t cause anything other than some mild initial discomfort. Consider having someone with you for the first or second injection just for support. After this, you’ll feel more confident and it will just become second nature.

Doing the injection for yourself is much more comfortable than having someone else administer it, and it will give you the independence to continue your regular routine – you can take injections with you – and keep your stress levels down.

What are the most common side effects of hormonal injections?

The most common side effects reported during IVF treatment are typically hormonal ones, such as headaches, tiredness and mood swings. Everybody is different but most patients report little to no side effects.

Should I have some mental health supports set up to help me through IVF?

While it is a straightforward medical process, IVF can be an emotional process: everyone needs support at times. Allow yourself to lean on your support network if you need to and give yourself space for relaxation. Don’t stop the things you enjoy during your treatment cycle.

Even if you think you don’t need it, it’s a really good idea to see a counsellor in your clinic as they will help you build resilience and good coping strategies. Most clinics offer it free of charge, so avail of it if you can and it will feel easier to see the counsellor again if you’re struggling at any point. You can also ask for help from your clinical team too: telling them if you’re finding it hard won’t affect your treatment, and it’ll give them an opportunity to reassure you and give you support and resources. There are plenty of online support groups out there too and your doctor may be able to advise other suggestions to ensure you’re in the best place going into and during treatment.

Part of the IMAGE Talks Fertility series, published  27 Jan 2022 on IMAGE.ie