TRYING TIMES
Couples shared how they stayed strong during multiple IVF cycles
IF at first you don’t succeed, see a fertility doctor and wait nine months, right? Sadly not. While many think in vitro fertilization is a fast-track to a tot, that’s often far from the truth.
“Yes, some are lucky and only require one round of treatment,” said Dr. Joshua Hurwitz, reproductive endocrinologist and partner at Illume Fertility in Connecticut and New York. “But undergoing multiple rounds of IVF before successfully conceiving can be common.”
Some of the most frequent reasons for multiple tries of IVF include low quantity of eggs and poor egg quality, said Dr. Taraneh Gharib Nazem, a reproductive endocrinologist at Reproductive Medicine Associates of New York’s Midtown location.
“Women are born with all the eggs they’ll ever have. The number of eggs and the quality decline with time. Women who do IVF in their late 30s and 40s often require more than one cycle,” she said.
Or, as Dr. Jenna Turocy of Columbia University Fertility Center in Manhattan puts it: “By age 41, approximately 70% of our eggs are considered genetically abnormal. It may take several IVF cycles to find the ‘good egg’ that can lead to a healthy pregnancy.”
Along with sperm issues, other typical reasons causing multiple rounds include lifestyle factors like having an unhealthy weight, smoking, exposure to environmental toxins and medications, and genetic disorders or diseases.
“Which is why it’s important to get a full fertility workup and consider genetic testing prior to IVF treatment,” noted Hurwitz.
That’s good advice, since the average cost of IVF in the US is over $10,000 not including hormonal medications, which could add another $3,000 to $5,000. Additional procedures such as genetic testing of embryos can also significantly increase the cost of IVF.
New York state requires fully insured employer groups of more than 100 employees to cover three cycles of IVF for infertility; companies like Progyny and Carrot also offer corporate fertility benefits.
Medical guidance aside, no one knows how to chart the course better than those who have been through the IVF ringer, like these three such women.
Jess, Washington, DC
“After marrying at 36, I decided to get some fertility checks done,” said Jess, 39. After the numbers returned normal in January 2020, she wasn’t too concerned, but they decided to bank some embryos.
After some COVID-19 delays, they were finally able to commence with their first egg retrieval that summer. Jess and her husband got two genetically normal embryos.
In fall 2020, their third cycle yielded no blastocysts (the stage the human embryo enters around the fifth or sixth day after fertilization). Their fourth cycle was canceled because Jess was at risk for ovarian hyperstimulation syndrome, a life-threatening condition.
“Now we’re $30,000 in,” Jess said, adding that they started with a new medication protocol for their fifth and sixth rounds, which brought their count to six embryos.
“The prep for transfer often involves more medications, shots, and pills before you even get to the transfer day. But in June, we transferred the most perfect little embryo,” said Jess.
They were ecstatic — but everything fell apart at the viability scan.
“It was determined that I was experiencing a blighted ovum,” said Jess. “The placenta starts to develop, but the embryo does not. I was utterly heartbroken.”
After another egg retrieval (the seventh, which yielded two more embryos), Jess prepped for their second transfer, but that procedure was canceled. In January 2022, they got the green light for another transfer. The couple is now expecting their first child in October. “I am so grateful for this pregnancy and at the same time, terrified it will be torn from me,” she said.
Among the things she wishes she had known, a few stand out. First, be your own advocate. “Learn as much as you can early on — which nurse is most empathetic, who to call when you need something, what meds you need,” Jess said.
While it’s important to trust your doctor, she’s glad she spent time researching independently in order to know what questions to ask. “The staff have a lot of patients. Things fall through the cracks,” she said.
She’s also found strength in a
community of IVF warriors on Instagram, where she shares her story at @waiting_impatiently.
She is sticking to her exercise routine as much as possible and looks to her circle of loved ones. “IVF can be extremely isolating and having people you can rely on has been critical to my ability to stay somewhat sane,” she said. “No one can prepare you for the pain, but you pick yourself back up and find a path forward.”
Lisa Richards, East Village
Richards, 46, has two daughters from a previous marriage, both conceived on the first try, so when she married Christopher Sadler, 47, she didn’t foresee any problems. When they started trying, they both were in their early 40s, and waited three years before meeting fertility experts.
“Both my egg reserve and blood work were strong. I thought it would only take one round,” Richards said.
While Richards retrieved 13 eggs in 2021, none of them made it to the blastocyst stage. Ultimately, they did four egg retrievals. Richards tried everything from fertility shakes to seeing an energy healer, but no embryos were viable.
“We have spent over two years, $250,000, countless hours at the doctor’s office, shots, tears and blood tests,” said Richards, who also gained 40 pounds from all the medication.
Though Richards says “we are both at peace with it,” she hopes her experience can help others. “Since I am older, I had to get approval from every doctor (cardiologist, primary, OB-GYN). I had every test performed on me, but during our first retrieval, during the live transfer, all of Chris’ sperm were dead. We were shocked,” said Richards. “I suggest that both partners get extensive testing before starting IVF.”
Chief among her other regrets? “In my 30s, I had no idea about egg freezing. I would have frozen my eggs,” Richards said. “I hope my story encourages others to explore this.”
Forging a deeper bond through the hardship has also been an unexpected blessing.
“Weirdly, the IVF process has brought us even closer together,” she said.
Kate Ziskind, Oceanside, LI
Ziskind, 42, and her husband Brian, 39, started trying for a second child in November 2017. After six months of trying to conceive naturally and then two failed rounds each of intrauterine insemination and IVF, her work fertility benefit was maxed out, so she thought they were done.
Then, in 2020, her benefits changed. In September of that year, they got one viable embryo.
“I was scheduled to transfer the embryo in November, but I got into a terrible car accident the day before,” she said. “I walked away without a scratch but mentally was in no place to do the transfer. This might have turned out to be fate as I later found out the blood work I had drawn a few days before showed issues with my thyroid, which can cause miscarriage.”
After addressing these problems, in May 2021 they transferred that embryo, and their son was born in January.
“When I started IVF, my biggest worry was how I would choose between a male or female embryo,” she said. “Not one part of me considered that I might not have any embryos to choose from. I was so naive. I thought all I needed was a little help. I also know I’m one of the lucky ones; I did three rounds, not 13.”
Recalibrating expectations proved pivotal for Ziskind.
“Nothing goes as expected; at every turn there’s a surprise,” she said. “Be it an early ovulation or a global pandemic, the IVF road is paved with bumps.”