If your path to the discovery of the fact that you are infertile has been anything like mine, then you would have gone through a roller coaster of emotions.... namely shock, anger, acceptance and finally you would have made a decision to act. Well at least in today's times there is a possibility to act, but wait a sec, there is still no guarantee of a positive outcome.

If you know anything about statistics, you can use a decision tree to map out the IVF process; if you are a statistics freak you can even populate it with probability scores to help you decide the best approach. While it's easy to map a statistical model , the IVF process is more complex mainly because emotions are involved - and we all know that women are very emotional creatures. It is not easy to handle the stress of unknown outcomes; particularly when the issue is so personal. While the IVF process gives us infertile couples hope, the journey to a successful cycle is paved with lots of hurdles. Add emotional highs and lows and you can see how even one cycle can turn out to be a harrowing experience.

I have experienced a failed IVF cycle and when asked how I remained positive through it all I thought about my approach. I discovered that I did a few simple things that helped me maintain my cool and remain upbeat. I share this with you in the hope that your IVF cycle doesn't turn into a depressing and unpleasant experience for you.

I discovered that the best way to manage the emotional stress related to an IVF cycle is to be prepared - understand your problem and draw your decision tree (see my example below). Start by identifying your milestones - this helps you map out the important steps in the process. At each outcome stage, identify the best and the worst outcome and know your action plan for both. Depending on your situation, you can also have more than one decision tree with varying processes and outcomes e.g. IVF with own eggs or IVF with donor eggs. For a woman with poor ovarian response the 2 decision trees will have significantly different outcome probabilities.

If the outcome of your IVF cycle is the desired outcome, hurray. If not, with preparation you minimize the shock, anger, acceptance time and go directly to action. Imagine if you did not draw the tree. You commence an IVF cycle and superovulation was not a success i.e. you failed at the first milestone. If you were already mentally preparing for the embryo transfer and thinking of pregnancy, what would be the emotional impact of this outcome?

My take - Anything can happen, hope for the best but prepare for the worst AT EACH STAGE.

By way of example, I have appended my decision tree below so you can see how we prepared for the good and the bad outcomes at each stage.

Please be aware that this process can lead to name calling J My husband called me a pessimist as I thought of all the possible failure steps; everything that could possibly go wrong (hey, I consider Murphy a friend these days). But as I pointed out to my ever optimistic husband, it's me who has the fastest recovery time when outcomes aren't always positive.

Preparing in advance does not mean that you won't feel sad when you see your negative BHCG test. I cried my eyes out. But by preparing in advance, I got over it quickly and focused on what's next.

Support system
If you can, find yourself an IVF buddy, someone who has been through this process. With the emotional upheaval and my raging hormones I was finding it very difficult to communicate with relatives who had no clue about this process. I was irritable and began to hate the questions So what did the doctor say? What happens next?. I know they meant well but I did not have the patience nor the desire to explain the process to them so that they could begin to understand what I was going through. My husband, bless him for putting up with my moodiness, was extremely supportive but it was my IVF buddy who got me through my down days. I cannot thank her enough just for being available. Having someone, even an online someone, who can empathize / relate to your experience, I learned can help alleviate the unnecessary stress.

Look on the bright side
My philosophy in life is simple. No experience is a waste - Everything happens for a reason and there is always a bright side to every situation. If you concentrate on identifying the positive experiences you tend to forget to crib about the rest.

While my first IVF cycle was a failure as far as the desired outcome is concerned, I don't regret the experience. When I look on the bright side, I am now not afraid of injections and being in an operation theatre (I was petrified of needles and had never even the inside of an operation theatre before). I got to experience the best sleep of my life (those who were under anesthesia will know what I'm talking about) - twice J. I know that I am emotionally stronger today and can handle another IVF cycle with way less stress. In fact I am now in the midst of my second IVF cycle with hopes for a better outcome this time.

I wish all IVF couples success the first time around. But if not, here's to counting the positives of the experience.

You can email me at [email protected]

My IVF Decision Tree

Authored by : Dr Aniruddha Malpani, MD and reviewed by Dr Anjali Malpani.

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