Most people don’t consider IVF as something that concerns them. But when you find yourself among people in the 30+ and later age groups trying to have children, you see how common it is for couples to encounter difficulties starting a family. It is estimated that since 1978, over 8 million babies have been born via IVF worldwide. So what can you expect, and what not to expect, from an IVF procedure?

The legislation is very different between various countries

For example, in the Czech Republic, IVF treatment is only available for heterosexual partners, where a woman is younger than 49 years old. While in some other countries and states, there are no limitations to who can access IVF. There are also significant legal differences between donor programs and surrogacy.

It will cost you something

The cost will vary a lot depending on where you live and which clinic you use. In some countries, IVF is covered by public health insurance. In the Czech Republic, health insurance covers 3-4 rounds of IVF for women 22 – 39 years old (or from 18 years sometimes). Even in this case, you will still pay for medication and some additional laboratory procedures, but this cost is small compared to paying the whole process.

The coverage differs not only between states but even within one country. For example, in the UK, different rules for coverage might apply in Scotland and Northern Ireland. In Canada, coverage differs between provinces. The most diverse seems the system in the USA, across states, in terms of legal and commercial.

If you need to cover IVF completely from your pocket, it’s a significant amount. In continental Europe, the starting price of one IVF cycle typically ranges between EUR 4,000 to 6,000 depending on country and procedures done. In the USA prices can be much higher, USD 10,000 to 20,000. Canadian prices are bit lower than in the US, approximate cost of one cycle can be between CAD 8,000 and 12,000.

“Fertility tourism” is quite common these days, and it’s clear to see why. The lower price tag doesn’t mean lower quality of services or lower success rate, provided you choose a reliable clinic. Some countries regulate the industry better than others by restricting opportunism among clinics. There are countries and clinics which are known to promote add-services, some of which may have unproven efficacy, but can increase the overall cost substantially. It’s an emotional process so it’s not difficult to fall victim to such service and fee schemes.

Be your own advocate

You should be prepared. There is a lot of material online. Learn all the essential terms* so that you can talk to the doctor on the same level and use the time of appointment only to ask additional questions. Especially for those who have some unique condition, learn about all the options there are for the treatment. Ask why they are choosing precisely this protocol, this type of drug or this dosage. The more you will be informed, the more you will feel in control and the calmer you will be going through the process.

• Examples of the terms: egg retrieval, OPU, embryo transfer, Oocyte, Follicle, Micro-fluid sperm sorting, ICSI, PGD/PGS, Extended cultivation, Embryo Glue, Assisted hatching, Cryopreservation, Vitrification, blastocyst and more.

Don’t expect to start immediately

Even if you get an appointment at a fertility clinic immediately, it will take some time, until you can start. First, you will need to undergo various examinations and testing. The tests might include, for example, sperm analyses, cervical smear, ultrasound, genetic consultation, and numerous blood tests to check hormone levels, antibodies, HIV, hepatitis, and syphilis. Count on average, two months from the first appointment to stimulation.

Don’t expect it will work the first time

The success rate depends on many factors, and most clinics publish their rates. The main factors are age and specific conditions pertaining to a couple. Let’s say the average success rate of one clinic could be 65%, but that could mean 57% success for < 30 years, 28% > 44 years and 69% for the donor program. Ask your doctor his estimation of the success rate for your specific situation. Even if you are young and healthy, with no known reason for infertility, it doesn’t guarantee you immediate success. The last step of the IVF process is implantation, and that is still very much depended on your body, whether it accepts the embryo or not. Be positive but realistic; you might need more than one round to get to your rainbow baby.

It’s an emotional rollercoaster

IVF is a physically and psychologically demanding process. You feel both expectations and fear of failure, not to mention financial pressure. Physically it means taking a lot of hormones, mostly in the form of shots in the stomach. Hormones that change your mood and make you feel bloated and nauseous. There will be countless doctor appointments and the final procedure is under full anesthesia. Anybody who hasn’t gone through it, will not understand. Sometimes even the closest people around you, might not be able to give you the support you need or might unwittingly be insensitive. You might not be able to share it with friends, because you don’t want people to know and in case it doesn’t work out, to feel sorry for you. The best support you can get will be from somebody who has gone through the same thing. If you don’t have any friends like that, you can always turn to IVF support groups. There are many groups on Facebook and many women forums. You will appreciate being able to ask questions and talk with women, who will not judge you. It’s a place where women share their experience, success tips, and give emotional support.