When you’re trying for a baby, every month can feel like a lifetime – even more so for couples having difficulty conceiving. By the time a couple has made the decision to go through IVF, chances are they’ve already been waiting a very long time for their baby.  In fact, approximately 1 in 10 women experience difficulties in becoming pregnant, with half of women aged 40-44 unable to fall pregnant at all.

But while IVF does help most couples improve their chances of conception, it’s important to remember that pregnancy may not be immediate. Even after you begin fertility treatment, for many couples there is still have more waiting to do. The process is highly emotional, often challenging and complex, and when pregnancy doesn’t happen straight away it can particularly distressing. It is important to stay positive during the IVF process, especially if it is taking longer to conceive than expected.

 

Why didn’t I get pregnant

One of the most difficult challenges when undergoing IVF is not getting pregnant, despite an embryo being successfully transferred. The problem is often people have been given misleading information either by well-meaning friends and family, via misleading websites, or even sometimes by family doctors and even obstetricians/gynaecologists and therefore have unrealistic expectations about IVF. To avoid this, it’s important to understand the basics of conception so you can develop realistic expectations about your IVF journey.


What really happens when people try to conceive

One of the ways to help us understand how conception works is to view the two main building blocks, the egg and sperm, as very small machines – like teeny, tiny computers. And just like any computer, the egg and sperm will only work according to what they are made up of and how they are put together.

Inside the eggs and sperm are the codes (DNA) which form the operating system for these tiny computers. In eggs and sperm this operating system (like Windows) controls how the rest of the egg/sperm machine works. This operating system is made up of genes. Bundles of genes together are called chromosomes. Unfortunately for humans, our bodies are not always very good at making operating systems (perhaps a lot like Microsoft itself) and most of the time the body makes an egg, the code is not normal.

By the time many people reach the point of needing IVF, perhaps only one in 10 eggs has a normal operating system within it (or contains normal genes or chromosomes). It is likely that the same conditions also apply to sperm. Therefore, most of the eggs and sperm that are received by scientists who undertake the IVF techniques, will not have operating systems capable of making a normal embryo.

 It would be very useful if the IVF scientists could determine which of the eggs and sperm had a normal operating system before the process gets underway. Unfortunately however, current technology does not allow this to happen. So although you may have embryos created and placed during IVF cycles, these embryos might not be made from egg and sperm with normal operating systems, resulting in another month without a pregnancy.

 

Miscarriage

Now just to make things more difficult, embryos that have an abnormal operating system can still result in pregnancies. Not all embryos with an abnormal operating system (or genes) necessarily result in miscarriage; Down Syndrome is one of the most common abnormalities of genes that can still result in the birth of a live child. However, most embryos that end up as a miscarriage have abnormalities that are much more severe than those seen in Down Syndrome. Miscarriage is therefore nature’s way of dealing with abnormalities that are usually associated with either death at delivery or severe retardation.

For any couple trying to conceive, a miscarriage can be heartbreaking. But for couples with fertility issues who’ve taken a long time to conceive, a miscarriage can feel like the cruellest form of punishment. This is why it’s so important to understand how conception works and understand that miscarriage can sometimes be a natural part of the process when trying to conceive.

 

Building the eggs or sperm in different ways

As eggs and sperm are being matured, what is happening in a person’s body over that time can have considerable effects on the quality of the egg or sperm. There are many factors that can interfere with the quality of human eggs; the commonest issues include an individual’s metabolism – largely affected by their weight – and their overall health. Issues such as diabetes, infections, malignancies, immune system problems will all have an effect in reducing egg quality.

Lifestyle factors are also important in improving the quality of the maturation of eggs. Having a good dietary habit with appropriate ratios of carbohydrate to fat and protein can help. For women who smoke, cessation of smoking is very important for improving egg quality.

Therefore, the ability to become pregnant is not simply whether eggs and sperm are together at the same time. It means the eggs and sperm need to have a normal operating system, and also need to have been manufactured (or matured) properly. If, and only if, all of these conditions are met is there the possibility of a normal pregnancy occurring.

 

Dr Jessup’s top tips to staying positive during IVF:

Have realistic expectations

You may become pregnant with the first cycle of IVF which would be great, but even if you don’t conceive the first time around it doesn’t mean anything is “wrong”. It is still highly likely, you will become pregnant with the next embryo or next IVF cycles. Some women take a little longer to conceive, especially if they are older, but all the research shows that if you keep going with IVF, your chances of eventually having a baby keep going up.

Don’t let the treatment consume you

Knowing it may take some months, keep having fun. Maintain a good sexual relationship with your partner. It is part of many people’s normal life to have a coffee in the morning and/or a glass of wine when they go out to dinner. If you stop things your enjoy, you will have many constant reminders every day that “you are not pregnant yet”, which makes the treatment phase of IVF seem to go on forever. Get on with your normal life. Make a decision to do a number of IVF cycles ( maybe three) without overthinking the process. If you are not pregnant by the end of that time, sit down with your partner and doctor and talk about whether anything needs to change or whether it is just a matter of continuing. It is more likely than not that you will have conceived within those three cycles, and by not agonising over each embryo development stage in each IVF cycle, you will have avoided an enormous amount of anxiety and still ended up with a baby.

Friends & Family

Some women or couples going through IVF have family or friends who are aware of what they are going through and provide much support. Others prefer not to let friends and family know they are going through IVF as they don’t want to deal with the constant questions of “are you pregnant yet”? Do what feels right for you and or your partner.

Be positive

Couples without fertility issues don’t conceive each month either. Remember, IVF was not even an option for most people 30 years ago, and now we have access to processes that massively increase our chances of conceiving a baby. Aren’t we lucky to live today!