It’s an emotional quagmire: your journey to motherhood has got you as far as the fertility clinic. Grief? Distress? Worry? You’ve probably felt it all and then some. But the feeling stronger than all of that pulling you down is the yearning to have a baby. This is what buoys you to go on.
Your journey is not a simple one; resuming from the fertility clinic, it has ups and downs between what might seem like mountains and bottomless pits. The best thing you can do for yourself is be prepared. Consulting with your reproductive endocrinologist should get you vital information, including treatment options, procedures, success rates, costs and insurance. While this information is paramount, it is equally important to remember that you’re going to need emotional support. Part of being prepared is to consider what to expect emotionally.
It’s the emotional battle that beats the physical, says H.N.K, a proud mother of Greek origin who has been living in Dubai for 20 years. Now a mother of twin boys, H.N.K. underwent in vitro fertilisation (IVF) in 2013 to become pregnant.
“Physically, every step had its difficulties, but I’d say IVF’s greatest challenge is emotional, not physical. All the hormones, anticipation and disappointment if a round fails; that’s worse than any physical pain,” says H.N.K.
IVF involves retrieving eggs and a sperm sample, then manually combining an egg and sperm. The embryos are then transferred back to the uterus.
“The first step was stimulating my ovaries with a series of injections to produce as many eggs as possible. Follicular growth was monitored through ultrasound and hormone levels tracked. Forty hours before the scheduled egg retrieval, an injection of human chorionic gonadotropin (hCG) was given to induce maturation of the eggs.
"The egg retrieval is done under full sedation; it leaves your ovaries feeling sore and a few days of bedrest is required. Seven days after egg retrieval, the embryos are transferred back to the uterus in a minor procedure without sedation. Hormone levels are then tracked through blood tests to confirm pregnancy within two weeks or less of the embryo transfer.
“The hormone injections made me feel down. The ovarian stimulation and egg retrieval was uncomfortable because the ovaries multiply in size, producing six or seven eggs each before shrinking back to their normal size after retrieval. That feels like severe menstrual cramps,” says H.N.K.
Looking back, the treatment itself is not as bad as the emotional turmoil that can take your life by storm, says Gulshah Ucuk, a mother of one and computer engineer from Turkey, who has been living in Dubai for eight years. Worse than “the discomfort of being in your own body” is the anticipation that builds while waiting and hoping for positive results.
“I’d get butterflies in my stomach and these beautiful feelings would suddenly be replaced by my worst fears. It was a seesaw of hope and fear,” says Ucuk.
Part of the fear, Ucuk explains, was the possibility that she’d never have a baby. The rest was that a round of treatment would be unsuccessful and she’d have to repeat it – again. After five previous rounds, financial pressures and family strains, she felt she’d invested too much to stop, but to what end? The reality is that one doesn’t need to be emotionally prepared for success; emotional groundwork is required for failure, and generally, only about 50 per cent of perfect IVF cycles end in pregnancies.
“IVF is so hard on your body and mind, but on the other hand, I couldn’t live with the idea that maybe, if I’d just tried one more time, then I’d have a baby. That ‘what if’ can torment you and wanting to avoid it, I also feared yet another round – and how many more?”
The answer came; there’d be no more treatments. Ucuk was pregnant.
“With a baby, all that IVF pain and desperation ceases to exist in a heartbeat,” says Ucuk.
For H.N.K., pregnancy after two rounds of IVF was followed by an emotional rollercoaster, she says, noting the things she wasn’t prepared for. Her twin babies were premature, which is common with IVF pregnancies, as is the high risk of losing the baby, especially with multiples.
“The partner also needs preparation. The man is completely ignored after sperm collection, forgetting that he’s going to be the main caregiver when the wife comes home. I believe maternal instincts help women handle the pain and pressure, but paternal emotions only kick in when a father holds his child. Meanwhile, nine moths of a stressed, hormonal wife, the heavy responsibilities of becoming a parent and the financial stress of IVF make him second guess his decision every day,” says H.N.K, adding that hypnotherapy helped her stay focused and positive.
Additional things that help include talking with others undergoing the procedure and using an in house counselor.
“It can be difficult sharing emotional aspects of this journey with people unfamiliar with infertility. However, not talking about the process can feel very isolating,” says Dr Monika Chawla, Consultant Reproductive Endocrinologist, Infertility Specialist, Obstetrician and Gynaecologist at Fakih IVF Fertility Center in Abu Dhabi.
“Get creative in relieving stress. Laughing helps, while yoga and meditation aid in emotional strength and stability. Acupuncture and massage are beneficial. Describe some of the things you’re most grateful for. Incorporate cardio into your daily routine. Realise that not every day is going to be a good day, and that’s ok. Eat high quality, wholegrain and low glycemic index foods. Surround yourself with friends and relatives who understand you. This, in turn, will make your IVF journey a lot easier,” concludes Dr Chawla.
* The true identities of the women in this article have been withheld upon request