In Vitro Fertilization, or IVF, is a lot to go through. Between the ambiguity of not knowing what’s going to happen, the “wait and hurry up” rhythm of it all, and the emotional hangover from trying to conceive which, for most people, preceded the first doctor’s visit, it can feel overwhelming.
I have many front-row seats to this experience. I work with a lot of clients who have gone through or are going through IVF, I have many friends who had (or didn’t have) children through the magic of reproductive science, and I, myself, am an IVF veteran. Here are some ways that my clients, friends, and I have emerged from this journey with our mental health intact.
1. Focus on true, neutral thoughts.
I’ve found that most people’s thoughts tend to veer in one of two directions (or bounce back and forth between them).
On the one hand, people “rehearse disappointment”. They tell themselves, “don’t get your hopes up, it probably won’t work.” This makes sense for a lot of reasons – hope is vulnerable, they’re burned out from months of trying to conceive, they’ve heard other people’s sad stories. But as Newt Scamander says in Fantastic Beasts and Where to Find Them, “when you worry, you suffer twice.” Rehearsing disappointment doesn’t actually help you feel less sad if IVF doesn’t work. It just makes you feel sad for longer.
On the other hand, people get carried away with optimism. “Finally,” they say, “this is in a doctor’s capable hands, and now everything will definitely be okay.” They map out optimal IVF schedules, calendar potential due dates, and start choosing a theme for the nursery. It can feel like such a relief to finally have a medical professional use science to achieve something that felt like a mystery when you were doing it on your own, so many people treat it like a guaranteed success. But the problem with this is that when you climb this high, you have farther to fall.
Or, in that same vein, some people fall into the trap of toxic positivity: “I have to keep a good attitude, or my bad attitude will cause this to fail.” This can be so shaming – the idea that if you are unlucky, it’s because you failed to manifest good fortune. And furthermore, for most people, these thoughts activate your bullshit detector and make you feel worse.
Instead, here’s the balance: True, neutral thoughts. This is a tool derived from cognitive behavioral therapy (CBT), but therapists of all stripes keep it in their toolkit. Ask yourself, “if I remove all of the emotion from this, what do I know to be true?”
“A smart, capable doctor who I trust is using extraordinary scientific technology to help me maximize my fertility outcomes. It might work, and it might not, but I have been through a lot to get to this point, and no matter what happens, I know that I am resilient.”
Or…
“They only retrieved 2 eggs. That is fewer than I hoped for, and I feel disappointed. However, one of those eggs could become an embryo that becomes a baby. And if it doesn’t, I will decide how to move forward when I have more information.”
You get the idea. True, neutral thoughts.
2. Get a hobby
When I was going through IVF round 1, I started taking piano lessons, and it saved my mental health. I’m a bit of a hobby dabbler. I’ve written blog articles about how some of these hobbies – scuba, rock climbing, fandom, board games, yoga and float tanks – can be great for your mental health.
But each of those articles misses the broader point, which is that hobbies in general are amazing for your mental health.
Broadway and TV’s Sutton Foster wrote about this in her recent book Hooked, which is a combination memoir and crafting guide, about how her crafting hobby helped her overcome some of the most challenging parts of her life (including, among other things, IVF). And I think this is broadly applicable to anyone who is going through something tough.
An ideal hobby to pick up during this time is something that you’re new to, and that requires a lot of focus. That’s because when something checks both of those boxes, it inherently anchors your attention in what you’re doing. In other words, it’s a way of practicing mindfulness.
But it also achieves something subtler, which is that it gives you a way to define your identity outside the merry-go-round of shots and ultrasounds. It’s so easy to let IVF become your entire identity. Your new hobby gives you something that expands your self-concept, something that’s just yours, and something that isn’t graded on a pass/fail scale.
3. Practice gratitude
A gratitude practice is the #1 thing that’s been shown to boost happiness and resilience. But to be clear, this does NOT mean that you should think about all of the ways you’re lucky, and then beat yourself up for not feeling happier.
The right way to practice gratitude is to make a daily list of specific things you’re grateful for, as influenced by moments from your day. So instead of broadly saying, “I’m grateful for my health,” say, “When Sienna told me she was bedridden with the flu for 3 days, it made me feel grateful that I am healthy and have the energy to do things that are meaningful to me.”
And then – and this is key – hold that gratitude alongside any hard feelings. Your gratitude doesn’t mean you have to only feel happy. (That’s not gratitude, it’s toxic positivity!) Instead, it means that even though you have totally valid hard feelings, because IVF is a hard thing, there are also positive things in your life. This nuance makes all the difference.
4. Find levity
Humor is such a core piece of resilience, and it can be deeply healing to label the absurdity of IVF.
So it’s okay to laugh about how much poking and prodding you’re undergoing, while all your partner (or donor) has to do is masturbate into a cup. “I’ll take the giant ultrasonic dildo, provide several pints of my blood, and make myself nutty with hormone injections and steroid medications, and you can just take this Playboy Magazine into a quiet room for some quality me-time.”
It’s true what they say: Sometimes, if you don’t laugh, you’ll cry. In therapy, sometimes I use laughter as a sign to dig deeper. I’ll say, “If you weren’t laughing right now, what would you be doing instead?” Because jokes are a potent defense.
There are two opposite skill sets that are both really important. First, the ability to put hard feelings into a box and compartmentalize them so that you can live your life. Second, the ability to open that box – in safe places, and with safe people – and let the feelings pour out.
Finding levity, along with getting a hobby, are great ways to compartmentalize. The next two items on this list – checking in with your body and building a support system – are focused on the latter set of skills.
5. Reconnect with your body
It’s so easy to disconnect from your body when you’re going through IVF. You’re a pin cushion, an egg manufacturing plant, and hopefully, at some point, a vessel.
But you are also still a human person. And just like levity, disconnecting your sense of self from your body – or depersonalization – is a powerful defense mechanism. But unlike laughing, it isn’t one that most people find pleasant.
The best thing you can do while you’re going through IVF is to ways to reconnect with your body. Do yoga or meditate. Focus on your breathing.
Or, try a grounding exercise. Here’s an example: Sit in a chair and put both of your feet on the ground. Notice the shape of your footprints on the ground. Move your feet slightly, and notice how the footprints change, based on where you’re putting the pressure. Mentally scan upwards in your body, looking for a body part that feels good, or at least neutral. Focus on that body part, on that good or neutral feeling, and take some deep breaths.
There are infinite variations on this exercise, and if that one doesn’t appeal to you, just google “grounding exercise” for more options.
6. Build a support system
When I was about to start IVF, I texted an acquaintance who had been vocal on social media about her experience conceiving her son. We scheduled a call for later that week, and she shared her story with me. It was so healing to feel like someone understood, and she and I have since become close friends.
Aside from wanting to destigmatize infertility, and reproductive health challenges more broadly, this is why I’m so vocal about my own experience with IVF. Just like I reached out to my friend, I want friends and family members who are going through this to know that they can reach out to me.
IVF is such a marathon – a much longer process than I expected it to be when I started it – and having a team to rally behind you is imperative. These are people you can laugh with, cry with, and celebrate or grieve with. They get it because they’ve been there.
If you know people in your personal life who have been there – even if they’re not people you’re close with – that’s ideal. But if not, you may want to seek out a support group. (I recommend something with a fixed group of people, rather than an open group – and ideally not an internet forum, as those message boards tend to bring out the worst in people.)
This is also where therapy comes in – a built in 50-minute hour every week to talk to someone supportive about what you’re going through.
IVF mental health support
If you’re thinking about reaching out for support, infertility is one of my areas of focus. You can read more about how I support people going through this, or reach out to schedule a phone consultation.