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What I Wish Every Couple Knew Before Starting IVF: An OB/GYN Gets Real

Shannon M. Clark, M.D.
Board-Certified OB/GYN By Shannon M. Clark, M.D.
Board-Certified OB/GYN
Shannon M. Clark, M.D. is a double board-certified Maternal-Fetal Medicine Specialist and OB/GYN at UTMB Galveston. She is the founder of Babies After 35, a site dedicated to fertility, pregnancy and motherhood after 35.

Whether a couple goes through just one cycle or five, the experience of in vitro fertilization (IVF) can significantly affect an otherwise stable and healthy relationship. I know this firsthand.

I'm both an OB/GYN and a woman who has gone through many cycles herself. I know that the experience is rife with stress, fear, and worry.

And over the last two years of procedures, I've come to know my husband in a very different way. Sometimes he knows how to help me, and sometimes he doesn’t — not because he doesn’t want to, but simply because he doesn’t always know what I need from him.

That's why I wish all couples — especially the partners who won't physically be going through the process — knew a few important things up front. It's my hope that by sharing my insight, it will make things a bit easier for those about to embark on the IVF adventure.

Here's what I wish every couple knew before starting IVF:

1. It's incredibly stressful and time-consuming.

For obvious reasons, women bear a majority of the responsibility for the IVF process, which only adds to the enormous potential for anxiety.

We think about it daily — quite possibly every minute of the day. We have to take pills, wear patches, use suppositories and get injections, have blood work and ultrasounds done nearly daily, and keep track of changes that might arise in our IVF schedule while somehow maintaining a sound mind and carrying on with our regular daily activities.

If we don’t do something exactly as planned, we worry that one mistake will throw everything off and result in an unsuccessful cycle. We tend to have “performance anxiety” when thinking about what the end result will be. Will we produce enough eggs and enough quality embryos? What if we don’t get pregnant? What if we have to go through this again?

The potential for stress and anxiety is limitless.

IVF can result in the best thing that will ever happen to you — but it will be a long road getting there.

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2. The hormones are REAL.

Going through the hormonal changes during IVF can be brutal. I became depressed, which was very hard for me because I'm normally a very even-keeled, structured person. I knew that I wasn’t being myself.

To put things in perspective, a normal estradiol level (estrogen sex hormone) is around 25 to 300 at baseline. In some of my IVF cycles my level spiked to 4,000-plus!

I finally started giving my husband verbal memos so he would know the hormones were kicking in.

Even with my efforts, though, he still didn’t “get it” right away, which made me even more frustrated. It wasn’t until he started saying, “What can I do to make it better for you?” that the tension between us finally got better.

3. It's physically painful for women.

When most people think of IVF, they think about all the injections women have to get. The truth is the injections — except those awful progesterone shots — aren’t really that bad.

The time will come, though, when our ovaries get bigger and bigger and every step we take makes our insides ache. Going to the bathroom and even passing gas can feel like someone is stabbing us in the gut.

I’m also going to bring up a topic that most people won’t: sex. Just thinking about another activity jarring my baseball-sized ovaries made me want to hide in my own home. The desire might have been there, but the end result simply wasn’t worth it.

Now, back to the progesterone shots. The needle is huge, the medication is thick, and the shot goes into the muscle, daily! It’s like getting a flu shot every day for weeks … in your rear!

4. It'll add stress and worry to your relationship.

No matter the reason for pursuing IVF, the woman tends to worry enough for both partners. And if the reason for IVF is due to a ”female factor,” try multiplying that worry by a dozen.

We worry that the stress will drive a wedge between our partners and us. (Is our relationship really strong enough to withstand such pressure?) We worry about the consequences of not achieving a pregnancy. (Will he resent me? Can we be fulfilled in a childless marriage?)

Finally, we worry about the lack of intimacy that often results from repeated cycles of IVF. We feel guilty for not being “in the mood," for being grumpy or “hormonal,” and for being scared to be intimate because of the discomfort.

Women are said to be worriers; IVF definitely puts that stereotype to the test.

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5. Both partners have the right to fears and frustrations.

Women going through IVF must respect and recognize that their partners are going through something, too. For many men, it's something that they can't "fix," which can be very hard to accept.

Yes, it's true that women bear the brunt of the IVF burden, but their partners also have the right to ask the doctor questions when they don’t understand what's happening. They have the right to worry, be stressed, and feel disappointment and loss. They have the right to feel anguish and despair when things don’t go as planned.

Having great communication and empathy is the only way a couple can successfully go through the IVF process. IVF can result in the best thing that will ever happen to you — but it can also be a long road getting there.

The best thing my husband ever said to me after multiple IVF disappointments is, “We are in this together.” Maintaining a strong, healthy relationship during times of tribulation is what will make that end result even sweeter.

Dr. Shannon M. Clark is the founder of the pregnancy and fertility site

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