The IVF Process—Again

If At First You Don't Succeed

Doctor's appointments, tests, treatments, medications: all these things related to IVF can not only interfere with your career, your life, and your relationships, but they can also take them over. Many feel overwhelmed, saddened by failure, angry at not conceiving, and even depressed and guilty. According to the American Society for Reproductive Medicine (ASRM), this is normal. In contrast, the ASRM says that it may be these very emotions that motivate a couple to keep trying.

"I wanted a baby so badly that I had to snap myself out of what seemed to be a never-ending cycle of anger and depression," says Becky Forris, a medical transcriptionist from Oklahoma City. "It was the anger at myself and the depression at not having a baby that made me think, 'This is not what I want; I want a baby.' So, I—we—kept trying."

Level of Difficulty

In many things, practice makes perfect. Unfortunately, this concept is not always true with the procedure of IVF. While the procedure's terminology and testing may be more familiar the second time around, trying to conceive may not be easier. In all actuality, for some, it is more difficult.

"From a patient's perspective, a second attempt is easier because of familiarity," says Dr. Gloria Richard-Davis, director of the reproductive endocrinology program at the Ochsner Clinic Foundation in New Orleans. "Knowing what to expect because they have already gone through the injectables, tests, procedures, etc., makes the process a little less stressful and may keep the couple from being as nervous. However, knowing what may or may not happen can often add an entirely new stress."

It's About the Benjamins

The cost of a single cycle can be significant. When the first try fails, costs can accumulate quickly. According to Dr. C. Maud Daherty, co-author of The Fertility Handbook, setting a spending limit prior to a second try may be wise. "Couples must know going into IVF that there will be some costly procedures," says Dr. Daherty. "Setting a financial limit is wise. By almost anyone's standards, infertility treatment is expensive. Countless couples have gone into debt to try 'just one more time.' [We] advise against this, saying those who reach this point may be suffering from a compulsion much like any other activity they feel 'driven' to accomplish. It helps to have a plan in place, one based on logic rather than unsettled emotions."

Your Feelings

Feelings of guilt, anger, or disappointment from a failed first attempt can frequently offer a new set of stressors to a couple trying to conceive. "IVF the second time may be harder because it didn't work the first time," says Dr. Richard-Davis. "Different sets of stressors are associated with going through repeated attempts. One of the ways to help cope with this or lessen the harsh emotional involvement is to address with the doctor what happened the first time and whether or not anything can be done in terms of change of protocol to improve outcome for the second attempt."

Taking the Time

A substantial time commitment is required by both partners to complete an entire course of IVF therapy. If the first attempt is unsuccessful, additional time will be needed in order to make a second attempt. "It will be necessary for couples to adjust their schedules to undergo additional testing and therapies associated with a second attempt at IVF," says Dr. Richard-Davis. "This type of situation often creates or exacerbates marital conflict and may require a bit of extra effort on both parts. Find time to talk about it and decide if it's conflict within your relationship or if it's created by your infertility experience. It is normal for marriages to have problems during this time."