IVF, also known as In Vitro Fertilisation, is considered one of the most common treatment for infertility, it is a process where an egg is combined with sperm ‘in vitro’, i.e. ‘in glass’ (or today more accurately in a ‘plastic Petri dish’) outside of the body. 

In this article, we are going to have a closer lock at the IVF stages and what do you expect to see if you are undergoing IVF treatment.

There are different protocols when doing IVF and in the so-called “long protocol” a period of down-regulation is needed before starting hormones that stimulate your ovaries to grow follicles (with the “short protocol” you start stimulation right away).

The purpose of down-regulation is to block your hormone production to prevent your body from ovulating on its own (this could be compared to temporary menopause). In this way doctors can better control ovulation and egg maturation during your treatment. 

You will take hormones, normally in the form of nose spray and/or shots. 

When you start down-regulation depends on your cycle. If you have a regular cycle you normally start down-regulation around 7 days before your next period. If you have an irregular cycle or no cycle at all, you might need to take medications to force a menstruation before starting down-regulation.

It normally takes around 2 weeks to down-regulate.

If you have a regular cycle you should get your period after 2 weeks, which indicates that the down-regulation has been successful. Regardless if your period has come by then or not you should be in contact with your clinic after 2 weeks to set a plan for the next step; starting stimulation (if you started bleeding) or come in for an ultrasound and estradiol test (if you didn't).

If you have an irregular period, you will need to visit your clinic to do ultrasounds and take blood tests to measure your estradiol levels to decide when you’re down-regulated. 

Potential side effects and symptoms of down-regulation

Going through down-regulation can be compared to temporarily going through menopause. This means you might get symptoms related to menopause, both physical and emotional, including headaches, migraines, hot flushes, feeling irritable, down, or even depressed. This might be tough, but not dangerous (hang in there trooper!). 

If your symptoms are affecting the quality of your daily life, don’t hesitate to contact your clinic for counseling.

Sometimes down-regulation takes longer than planned. This does not mean the treatment has failed, it’s just a bump in the road and your clinic should help you set a plan. Make sure you get all the answers you need to feel safe and secure.

Taking your shots at the right time is very important. You can use Tilly's app to keep track of medications. 

If your treatment protocol is updated, don’t forget to update this in the app.

If you feel worried about taking the shots

Taking the shots is something many women worry about when going through IVF. Tell the clinic that you are worried and that you want careful instructions on how to take the shots. Don’t hesitate to ask questions and make them show you several times how to do it.

A tip is to film the nurse during the demonstration so you can look at it again at home.

If possible and if that feels more comfortable to you, maybe you can ask your partner or a friend to help you out with the shots.

In this phase, you will inject hormones daily to help your ovaries grow a large number of follicles - follicles that contain your egg cells. You take the shots at the same time everyday, normally in the evening.

In a natural cycle only one follicle (sometimes two) releases an egg at ovulation, but in IVF you want to generate as many mature eggs as possible to increase the chances of success.

During the stimulation phase you do regular ultrasounds to see how your ovaries react to the treatment. Your doctor checks the number of follicles and their size.

Following how your ovaries react to stimulation will help your doctor to decide if your medication protocol is working or if it has to be changed, and also the optimal time for egg retrieval.

The stimulation phase usually lasts about 9-11 days.

You start with hormones that help your follicles grow, usually FSH or hMG. After 5-6 days you add another medicine, called an antagonist, that prevents your ovaries from releasing your eggs. If your body ovulates too early the treatment will fail since the doctors are not able to retrieve the eggs. 

Finally, you will receive a shot with the hormone HCG to trigger eggs to go through the final stage of maturation. The timing of this shot is vital, it needs to be taken 36-38 hours before egg retrieval.

Alternatives and decisions during this phase

Your doctor will decide on a protocol (medication types, doses and duration) based on your AMH-value and ultrasounds - how many follicles you have is used to predict how you will react to stimulation. You can read more about choosing the right protocol here.

How you will react to stimulation medicines can be hard to predict, and sometimes some adjustments need to be done. This is both common and normal. Your doctor will take decisions after each ultrasound based on how few or many follicles are maturing.

When you have 3 or more follicles around a size of 18-20mm it’s time to take the ovulation trigger shot and plan for egg retrieval (which takes place 36-38 hours later). It’s important to take this shot at the exact time your doctor gives you. 

When taking hormones you might experience some side effects like headaches, tiredness, feeling irritable or down, nausea, bloating or tender breasts. How you will react is individual, some get a lot of side effects and some get few or none at all. 

Side effects can be very unpleasant, but it’s normally nothing to worry about - as a woman you’re aware that hormones can affect how you feel and that’s basically what’s happening now (although we’d rather not have to take tons of hormones of course). 

It’s also common to get some bruising from the injections.

Another potential side effect is Ovarian Hyperstimulation Syndrome (OHSS), often just called overstimulation. This is when your ovaries respond “too well” to the hormones. The risk is higher for women with many follicles, for example if you have PCOS. 

You should always tell your clinic if you experience OHSS-symptoms like nausea, bloating, stomach pain or breathing difficulties during stimulation so that they can make adjustments. OHSS can become serious since the ovaries can get dangerously filled with fluid that can leak into your belly and chest area - this is uncommon, but it’s important to identify OHSS early on so it doesn’t go that far. 

If not enough follicles grow, the cycle may be cancelled. Most clinics don’t go through with an egg retrieval if there are less than 3 follicles. This can of course feel devastating, having invested so much time and energy already. It’s important to remember it doesn’t necessarily mean it won't work the next time though. Sometimes it takes a few attempts to find the perfect stimulation protocol that will work for you. Make sure your doctor is giving you all the answers you need to feel safe and secure before giving it another try.

A low egg reserve is the primary thing that can make it harder to succeed with this step of the treatment. 

Taking your shots at the right time is very important, which Tilly's app can help you with. 

During stimulation you should avoid sexual intercourse a week before retrieval of the eggs and the days following the retrieval. This is due to the risk of infection, but also because sometimes eggs that have not been retrieved can find their way out and be fertilised which can lead to multiple pregnancy.

3. Egg retrieval & Sperm sample, Fertilisation & Growing embryos, and the rest of the steps...

Add your treatment in Tilly's app to receive timely inforamtion about each step of the journey - download here.

IVF, also known as In Vitro Fertilisation, is considered one of the most common treatment for infertility. Learn what happens throughout treatment.

What to expect during the different stages of IVF

Whether you know it or not, you probably know someone going through infertility. 1 in 8 couples wanting to have a child face infertility, so it’s more common than you might think.

To help you be a supportive friend to someone with infertility, let’s take a look at what infertility is, and then dive into how you can help.

Infertility is a medical diagnosis given to anyone who is not able to become pregnant or carry a pregnancy to term after one year of having unprotected sex (in the case of a man and woman trying together). It’s common for it to take a few months of trying to be successful. But as time passes with no pregnancy, the likelihood that there are physical issues that require medical interventions increases. 

The underlying causes of infertility can differ greatly from one person or couple to another, and there is therefore a wide variety of treatments. Many people think that infertility is always age-related. While fertility does decline with age for both men and women, that doesn’t mean that every woman above 35 will struggle to conceive. There are actually a number of infertility causes that have nothing to do with age. 

For people who do not have eggs and sperm - same-sex couples, for example - their experience can be described as “social infertility,” meaning they will need to go through reproductive interventions or adoption in order to have a child.

After one year of trying to conceive (or six months if the woman is older than 35), the couple can visit a doctor (often a Reproductive Endocrinologist) to begin treatment. They will start by doing some tests to get an initial picture of each person’s fertility. Based on the test results and other factors, a treatment plan can be put in place. The approach can vary greatly from person to person; even the specifics of the same treatment, like doses and timing, can be different for different people.

What are examples of fertility treatments?

Lifestyle changes that aim to correct hormonal imbalances or improve sperm quality

A range of add-on treatments like testing embryos, and medications like blood-thinners or immunosuppressants

Each treatment option can involve a large financial commitment, and usually has a major physical toll. And there are no guarantees that any of the treatments will result in a successful pregnancy.

The physical side effects and stress of infertility treatment are a major part of why infertility can be challenging. But that’s not the whole picture. People with infertility are likely facing many struggles emotionally and socially as well. Whether someone is going through treatment, or they don’t have the option or desire to do treatment and instead keep trying on their own, infertility affects many aspects of a person’s life.

How friends can be helpful when going through infertility

Whenever someone is going through a difficult time in life, having friends who can be supportive is crucial. It’s common for someone in a crisis to isolate themselves because social interactions feel daunting, or they feel that no one understands. This can cause the person even more emotional distress, as we need meaningful social interactions to maintain our mental well-being. 

Infertility is a uniquely challenging experience, but the emotional impact is not well-known or talked about due to the stigma surrounding it. It can affect someone in a similar way to when a person has cancer (research shows that infertility patients have the same emotional distress levels as cancer patients), or loses a close relative (infertility can involve a lot of grief).

But many people with infertility don’t receive the same type of sympathy or support from their communities, or society as a whole. They may even struggle with accepting their own feelings, blaming themselves for having a hard time.

Not having your pain acknowledged can deepen the trauma of a difficult experience. This is where the people in your life can make a big difference. 

Each person’s experience is unique, and how they feel might change from day to day. It’s important to take the time to learn what your friend is going through and what they need. But we can explore some common scenarios and experiences to help give you a head start when it comes to supporting your friend.

Society tends to view infertility like this: Someone wants a baby, but they aren’t able to have one, so they’re sad. Then they go to a doctor and take some medications, and it might be taxing, but once they have their baby, everything is better.

But if you look below the surface, infertility is much more than that. Having children is something that many people plan - consciously or unconsciously - for many years, and it’s a highly celebrated and emphasized life experience in society. So when you’re not able to have this experience that you desperately want, and your future becomes uncertain, it can shake someone’s life and identity to the core.

The research is clear: the psychological impacts of infertility are diverse and profound. A person’s physical health, mental health, relationships and daily life are all affected. Many people facing infertility can be clinically diagnosed with anxiety and/or depression.

Some of the other challenging emotions and experiences someone with infertility may struggle with are:

Feeling excluded, as others have children and they’re not “part of the club”

Feeling stuck, like your life is on pause; it can be hard to make any plans

Deep sadness and grief - for both life before infertility, and the life they wish they were living

Relationship challenges, with their partner and the other people in their life

You are not responsible for their well-being

It’s important to know that to be a supportive friend, you do not need to take on the responsibility for their overall well-being. You are not meant to be your friend’s therapist or entire support system.

Also, regardless of what you do, they will most likely have a hard time. No one can take the difficult emotions away entirely - you can simply be there to help them carry the struggle and feel less alone. 

8 ways you can show support to a friend going through infertility

1. Check in with them - with sensitivity 

When someone we know is struggling, we often wait for them to ask for support, not wanting to intrude or “remind them” of their challenges. In reality, when someone is going through something tough, they may not have the energy to ask for help, or know how to reach out in the first place.

We’ve asked our community, and a majority of those facing infertility prefer when people around them ask how they’re doing. Most feel that silence is always worse than saying something, even if you don’t know the “right” thing to say.

One way to be sensitive is to begin with: “It’s completely fine if you don’t want to talk about this, I just want you to know I’m here.” 

You can remind yourself that even if your friend doesn’t want to talk about it with you, at that specific time or ever, showing that you care and validating their emotions can still be really helpful.

Ask how they’re doing, instead of how’s it going

It is most likely more helpful to ask about how someone is feeling rather than only focusing on practicalities like “Did the treatment work?” or “When is your next doctor’s appointment?” Sometimes, all they’ve been doing is thinking about the practicalities, and no one has stopped to talk to them about how they feel.

Infertility can span over years with many ups and downs and long periods of just waiting. Even if your friend stops talking about it, it’s not over, and they might still be deep in the experience. Understanding that and simply sending an “I’m thinking of you” text now and then can really make a difference.

You don’t have to ask about it all the time, but bringing up the subject yourself can take the pressure off of your friend to do so. 

Some friends might not tell you about their infertility in the first place. This can be difficult from a friend’s perspective, because we have to respect their needs and boundaries.

If you are wanting to check in with someone whom you think is struggling with infertility, bringing up the subject gently is important. Make it about checking in with them, rather than your own nosy curiosity.

You can try asking something like, “I know trying to get pregnant can be difficult for some people, and I wanted to check in to see how you’re doing.” You can add something like, “We don’t have to talk about it if you don’t want to, I just want you to know that I’m thinking of you,” to help them feel that it’s their choice to talk about it or not.

Unfortunately, many people don’t have an awareness of how common and difficult infertility is, so they ask questions that might be difficult for the person who is struggling.

Questions like, “When are you going to have kids?” and “What are you waiting for?” can be painful for a person with infertility to hear. So in general, it’s a good idea to avoid questions like that altogether.

When we see someone we love struggle, it’s natural to want to be encouraging and say something like, “I’m sure it will work out!” or, “Stay positive, it will happen for you!” Unfortunately, you don’t know that it actually will work out. And even if it does, it may still be a tough road getting there. 

Even if that’s not your intention, comments like these are likely to make the person feel like you don’t understand, or that you think their feelings aren’t valid. That can lead to them not wanting to share their experience with you and isolating themselves, which can make the process even more difficult.

And after a while of being told what I should be feeling (positive and hopeful), I just stopped telling people how I was actually feeling (hopeful but sad) - it was much less triggering to just cry alone on a park bench.

If your friend expresses hopefulness and positivity you can of course encourage that. But don’t force a positive outlook on them.

This doesn’t mean that optimism is forbidden. But instead of saying, “It will happen when the time is right, everything happens for a reason,” you can say things like, “I really hope this will happen for you,” or “No matter what happens, I am here for you.” You can even let them know that you’ll hold onto hope for them on days when they don’t feel it themselves.

3. Focus on listening instead of giving advice

Your friend has probably spent countless hours researching infertility. Between conversations with doctors and online searches, they almost certainly understand their diagnosis and treatment options better than you do. 

You might have read about a new supplement they can take, or saw someone post about a new technique to analyze embryos, and it’s great that you want to help. But they have probably already considered, tried, or ruled out anything you might suggest, and it is likely that what you suggest isn’t relevant to their case. It’s important to remember that infertility is a really complex diagnosis, and there’s no such thing as “one size fits all.”

Giving advice therefore often comes off as condescending or ignorant, as if you’re oversimplifying what they’re going through. It’s usually best to refrain from it entirely. If you really want to share an idea, you can first ask them, “Are you open to hearing an idea of something to try?” 

And the dreaded two words that almost everyone with infertility has heard countless times? “Just relax.” There is no science or data to suggest that relaxing is the cure for infertility. So that “advice” is probably not going to be helpful.

Giving your friend your full attention, making space for them to talk about what they’re going through, will likely help them feel more supported.

Focus on their experience instead of other people’s stories

Most people going through infertility have heard about their neighbor’s cousin’s college roommate who did IVF 7 times without success and then magically conceived spontaneously.

It’s wonderful that such stories exist. But they don’t change anything about the situation that your friend is in now. When it comes to infertility, there are no guarantees. Hearing about other people’s success stories can make your friend feel like you’re minimizing what they’re going through and taking the focus away from their experience.

Just like with any advice you want to give, you can always ask your friend if they’d like to hear about someone you know who has been through this. Sometimes it helps people with infertility to hear things went well for someone, giving them hope. But for the most part, while your friend is still in the middle of their infertility experience, it’s a good idea to focus on them instead of other people’s stories.

4. Educate yourself about infertility basics

Even if you may be more helpful supporting your friend emotionally than giving fertility advice, they may still appreciate it if you understand some of the basics.

They might want to talk to you about what they’re going through, but the idea of educating you about the basics of fertility feels exhausting and daunting.

How to support a friend going through infertility. How friends can be helpful when going through infertility

How to support a friend going through infertility

Most women produce just one mature egg per menstrual cycle, but during an IVF doctors prescribe drugs to be taken at the start of the cycle that trigger multi-follicular development, i.e. the growth of more ovarian follicles containing more eggs. 

‘Protocol’ in this sense refers to the combination of drugs and their dosage. It’s a complicated decision and so relies on you trusting your doctor to steer you in the right direction. Ultimately, there may be some trial and error as it’s not always easy to anticipate how a patient will react to different protocols. You can read more here about the practical aspects and potential side effects of this part of the treatment.

It’s frustrating but unavoidable that eggs and embryos will be lost as the IVF process progresses, and it is most likely to occur while the embryos are being grown in the lab. Consequently, the best scenario is to start off with as many eggs as possible. At least to an extent. Once about 15-20 eggs have been retrieved, your chances stop increasing while the risk of developing ovarian hyperstimulation syndrome (OHSS) becomes greater. Not only can OHSS be incredibly painful, but in some rare cases it can also prove life threatening. And so, the most important question to ask at this stage is: which protocol will result in the highest number of eggs without leading to OHSS?

When learning about the protocols, it might initially feel as though you are getting an information overload. Really they can be boiled down to three core options:

The “Long Agonist” and “Antagonist” protocols, often just called long and short protocol, are the two most common ones, and it’s not always clear why one or the other is chosen. The “Flare” protocol is not used as often, only for patients with specific challenges (often poor responders).

There are two main differences between the protocols: how much of the drug that causes the follicles to grow (gonadotropin) is used, and what other drugs are used alongside it.

Gonadotropin is an injectable hormone that causes more follicles, and therefore more eggs, to grow simultaneously. The dose is important because too little gonadotropin means too few eggs, and too much may result in OHSS. The dose is commonly measured in International Units Per Day (IU) and can range from 0-900 IU with the majority of women prescribed 250-450 IUs per day.

Gonadotropin is the principal drug in most protocols, and will typically be prescribed alongside two other drugs. The purpose of the other drugs is to stop the eggs from maturing before the retrieval procedure and to force the eggs to mature so that they can be retrieved. 

At this stage, the question you will no doubt be asking yourself is: Which protocol is most likely to result in a pregnancy? When we look at general IVF statistics, they show that Antagonist and Long Agonist have a similar rate of success. However, when we break it down and look at sub-groups of the IVF population, it becomes clear that different protocols work better for some than others. It’s important to say that the choice of protocol should be done by your doctor, but to feel in control and to be able to ask better questions, understanding the difference between protocols can be good - especially if you belong to one of the groups below.

The Antagonist protocol has proven to be comparatively successful for women with polycystic ovary syndrome (PCOS) or other patients with a high AMH that are at risk of ovarian hyperstimulation syndrome (OHSS). It lowers the risk for OHSS since, in the Antagonist protocol, the drug used to force the eggs to mature (known as the ‘trigger shot’) is one called Lupron instead of hCG (Human Chorionic Gonadotropin). As a result of Lupron’s properties, the chances of hyperstimulation are much lower. It isn’t possible to use Lupron in the Long Agonist protocol as it is already used elsewhere.   

The Flare protocol has proven more successful for women with a diminished ovarian reserve, or those who have had a low number of eggs retrieved in past stimulation cycles. This protocol doesn’t use a Lupron trigger shot to prevent OHSS; however, poor responders don’t typically have a strong reaction to gonadotropins (as evidenced by previous low egg retrieval numbers) and so aren’t considered at risk of overstimulation. 

The Flare protocol instead deploys Lupron (or another Gonadotropin-releasing hormone (GnRH)) on day two of the menstrual cycle in which the eggs will be retrieved, as opposed to a week before the onset of menses. This is to take advantage of the initial flare effect of the follicle-stimulating hormone (FSH) and luteinizing hormone (LH) released by the pituitary gland which typically occurs in the first three days of Agonist administration. If used for more than three days, Lupron temporarily suppresses the pituitary gland and lowers the output of FSH and LH. 

The FSH product is started on day three in the hope that the Lupron has stimulated a large release of FSH and LH that accelerate the follicles (known as the ‘flare-up’). The intention is to enhance the response of the ovaries to grow more mature follicles and thus more eggs. 

Birth control pills are commonly prescribed for the month before the Flare protocol begins to avoid a leftover cyst (corpus luteum) that could cause discomfort or more serious complications if reactivated by high LH levels at the start of the stimulation process.

Different IVF patient groups require different protocols. Learn more about the difference and which one is right for you to optimize treatment results.

IVF stimulation - How to choose a protocol

5 steps to processings your feelings about using donated eggs

Because we are all unique, no two people will have the same journey to accepting our donor eggs decision. This process might not be linear, and you might find yourself circling back to some of these steps time and time again.

But these steps are a starting point to help you work through the different things we might think about when using donor eggs.

1. Make space for feelings about losing your genetic connection

It’s common for people to comment on how similar children are to their parents. People love to exclaim, “He has your nose!” or ask, “Which of your parents do you look like more?” 

The assumption that children are genetically related to both of their parents leads to comments and questions from both strangers and people you know. When you choose to use donor eggs, you might worry about how it will feel to see unknowing people squint at your child to try to see a resemblance, or say things like, “Your child has your eyes!”

It can be helpful to recognize that people don’t usually care that much about resemblances. It can be fun to connect the dots, but mostly it’s just something people say, similar to talking about the weather. Plus, it’s common for even genetic children to not resemble their parents, or for two siblings to look completely different from each other, so the world is already prepared for children to not look like their parents.

You probably wouldn’t have strong feelings about your genetic child not looking like you, so the pain point here likely isn’t only about resemblance, but also about your journey to parenthood being different from what you thought it would be. We’re usually triggered by things we haven’t healed ourselves. So if you are able to work through these feelings - the resentment that your path looks different from others’, the loss of a genetic connection, etc. - then people pointing out a lack of resemblance between you and your child might not bring up negative feelings in the end.

Beyond what other people say, you might have had your own expectations for seeing a genetic link. In my case, my brother walks just like my grandfather, and I wondered if my child would walk like him too. I also have a distinct nose that I got from my father, and I thought my child might have our same nose. Now that we’re using donor eggs, I am having to accept that I won’t pass on the personal and family traits I thought I would.

But the truth is, a donor-conceived child might still have your laugh, or dance like you, or even look like you. Between nurture affecting children’s behaviors and expressions, and findings in the field of epigenetics which point to a connection between birth mothers and babies from donated eggs, it’s possible that your child will resemble you more than you think. But again, even with genetic children, any resemblance is out of our control and a game of chance, so it can be freeing to let go of those expectations altogether.

Plus, there are so many things you can pass on to your child outside of your DNA. You can teach the life lessons you learned from your grandmother, share your passion for cooking or sports, and bring your family traditions to your own home.

Even still, this path is probably not what you expected, and it’s okay to feel sad about losing that genetic link. It’s common to wish that you could conceive your child the way so many others seem to: easily, and with their own DNA. The sadness and resentment you feel are understandable, and it’s important to let yourself feel these feelings so you can move through them.

You can talk to a therapist, your partner, or a trusted friend or family member about how it feels to be pursuing parenthood without your eggs involved. If it feels right to do so, you can do a ritual or ceremony to grieve your genetic connection, making space for you to be open to this new step in your journey to conception.

2. Prepare for questions and input from friends and family

If you share your process of using donor eggs with people in your life, they might have all kinds of questions and comments.

Some people might not understand what this means, so you could face some ignorance and insensitive comments. You can decide in advance how much energy you’d like to put into educating and discussing the topic with these people. You can always share podcast episodes or articles (like this one!) so they can gain an understanding without you having to explain yourself.

People who are genetically related to you, like your parents and siblings, might have their own feelings about you using donor eggs. In some cases, talking about your feelings together can be healing. When I talked to my parents, I asked them how they felt. I said to them, “If this works, you might feel sad that your grandchild doesn’t share a genetic link with you, and I would understand that.” I was filled with relief and gratitude when they reassured me, “Any child you have will be our grandchild, 100%. We don’t give that a second thought.”

But not everyone will have that reaction. For some people, it might be better to encourage them to process their feelings on their own, and not share any concerns or sadness they have with you. You might want to share about your process via text, or at a distance in some way, so you have some control over how you receive people’s reactions and don’t have to have the same conversation over and over again. It all depends on what feels right for you and your relationships.

Remember that this is your journey to having your child, so whenever possible, prioritize your needs above any perceived obligations to other people. It’s okay to keep things to yourself, share things on your own timeline, and have boundaries around what you’re open to discussing with others.

Though if you do have a child, it’s important to consider their perspective. It is highly recommended that your child knows about how they were brought into the world, and that there is no shame around the story of using donor eggs. So in the long run, it can be a good idea to make sure the key people in your life know this information, and that there are no secrets that your child could one day receive as shame.

3. Consider what it means to you to be a parent

A common concern for people using donated eggs is if the child will feel like it’s theirs. It’s completely understandable to worry if you will feel connected to the child, so it’s okay to let yourself feel these feelings.

I have a cousin who was adopted, so I grew up seeing that parents can love a child who is not genetically related to them wholeheartedly. But I still had a concern that if I do get to have a child through donor eggs, it wouldn’t feel like mine, and I wouldn't feel like a parent.

I found so much reassurance as I read both personal accounts and research on donor-conceived children. Everything I read showed that parents of donor-conceived children feel incredibly connected with their children.

One study even found that “egg donation mothers were found to represent the relationship as higher in joy, compared with sperm donation and natural conception mothers.”

Now, I’ve come to understand why that could be the case for some people. I have gone through so much to have a child, so if I finally get to hold my child after all this, I can imagine feeling a different kind of joy and connection from what I would feel if this had come easily. To me, being a parent means showing up for your child physically, emotionally and energetically, and I can do that regardless of what’s in my child’s DNA.

Of course, that study doesn’t mean that all parents of children who are genetically linked to them don’t feel as connected to their children as parents of donor-conceived children. It’s just helpful to see data that counters my fears that I won’t feel like my child is mine.

4. Recognize that this is still the same journey you’ve been on

As I mentioned above, at first, I was not interested in pursuing donor eggs. I thought that my path to parenthood would be using my own eggs, so I was determined to keep trying with my eggs, or accept childlessness.

Then, I bought the book Let’s Talk about Egg Donation: Real Stories from Real People, and followed some Instagram accounts of people who did egg donation. While I had my doubts, I was allowing myself to consider alternate paths to parenthood.

Eventually, I arrived at a visualization that really helped me feel great about pursuing this path. It feels like my husband and I have been looking for our children in a house. We thought they would be there as soon as we opened the door and stepped inside, but they weren’t. We spent a few years going from room to room, more frantically as time went on, thinking, “Surely, they must be here somewhere!”

My fifth failed IVF round was like looking through the same rooms over and over again, expecting my child to be there even if they weren’t there before. And for some people, maybe they find a hidden room in the house and their child is there.

But our children weren’t in that house. So now we’re going to look somewhere else. Officially deciding to use donor eggs was like finally stepping out of that house that I’ve been stuck in for years. I breathed in the fresh air, and felt a renewed energy as we walked away from the house and into the garden, or a different house, or somewhere completely new.

We’re still looking for our children. We’re still on the same journey. We’re just looking somewhere different from where we were looking before. And from what I’ve read about others who have donor-conceived children, if this works for us, we will have the baby we have been looking for all along.

As you probably know all too well, hope plays a tricky role in infertility. It slips away slowly, and sometimes all at once, as the months pass by with no success.

It feels silly to hope when the odds are against us. It feels impossible to hope after so many failures. It feels scary to hope when we know it can all come crashing down.

Choosing to use donor eggs brought me a lot more hope than I’d had in a long time. At first, I basked in the feeling, enjoying this new sense of: “This could actually work.”

But after a few days, I backed away from it. I realized that it was a similar feeling to what I had when we were going into our first IVF round. “We weren’t having success, but now we get to try something that will give us a much better chance!” Recognizing that IVF didn’t work for us, and that feeling was built on sand the first time, I realized that I had to be careful with how much I took on that same feeling this time.

But the thing is, failure hurts whether we allow ourselves to hope or not. There are already so many negative feelings associated with infertility - we don’t have to block out any good ones that show up.

So as we are getting ready for our first ever embryo transfer, I’ve decided to embrace the hope that comes with deciding to use donor eggs. After all, this is the best chance we’ve had throughout this whole process. I can recognize the reality that this might not work, while also enjoying feeling hopeful for the first time in a long time.

You don’t know what will happen. There are still a lot of steps between where you are now, and having your child. But that doesn’t mean you can’t feel hopeful that you will get there. Try welcoming any feelings of hope, gratitude and joy that show up for you, because with everything you’re going through, you deserve to experience those positive feelings too.

Maya Maria Brown, M.A., is an infertility mental health expert. She has a master’s in Counseling Psychology, and has worked with individuals and couples on infertility and relationships. She also has personal experience with infertility and is currently in treatment. 

Support for moving through the thoughts and feelings you have about egg donation

Most of us don’t expect to use an egg donor to have our child. Like with anything in life that doesn’t turn out how we planned, accepting and feeling good about this decision can be a process that takes time.

When my husband and I started trying to conceive, we had no indications that we would have trouble. When the months went by and we weren’t having any success, I started to feel more and more anxious. I had a sinking feeling that this wasn’t going to happen for us - at least not easily.

After a year of trying, we went in for testing, and everything came back normal. No one could give us a reason for why this wasn’t happening, so I tried to keep my hopes up.

Fast forward one more year. We had gone through five rounds of IVF at two different clinics. We had no embryos, and still no explanations. With no clear reason why, we had the option to keep trying with low chances of success, or to try something else.

I had been thinking about egg donation for several months. The doctors assumed we had an egg issue, because my husband’s sperm always looked good. At first, I couldn’t imagine using an egg donor. But now, this feels like exactly where we’re supposed to be. Keep reading to see how I got to this point - and how you can, too.

People turn to egg donors for all kinds of reasons. You might have a diagnosis or physical circumstance that means your eggs are not viable. Or maybe there is a fertilization issue, or another reason why your eggs and sperm are not able to work together. Perhaps your relationship doesn't include someone with eggs, or you're pursuing parenthood solo and you don't have eggs. Or like me, you might not have a reason to point to, but you believe that donor eggs will give you a better chance at having a child.

Whatever your path is, if it has brought you to donor eggs, it’s important to process the thoughts and feelings that come with this way of having a child. It makes perfect sense that you might have worries, fears or grief about the way your path is unfolding. At the same time, it’s possible to find happiness and peace about what lies ahead too. It can take some time to adjust and arrive at this new reality. Let’s go through this together.

How I processed my feelings about using an egg donor

People with infertility are used to hearing all about positivity. Well-intentioned instructions like, “Keep your hopes up!” “You have to believe it can happen,” and “Stay positive!” are flung at us left and right.

But forced positivity when we’re having a hard day is no more helpful than thinking happy thoughts when we get a paper cut or twist our ankle. We can’t wish the pain away.

With infertility, it makes sense that we don’t always feel great. The goal isn’t to ignore the hard feelings. Instead, we can find ways to accept the difficult feelings and find tools to help us handle them and not let them take over our lives.

So the next time you’re having a hard day with your infertility, try some of the things on this list to help you get through it.

Feeling good feels good; it makes sense that you’d prefer to have a happy day. But the reality is, today feels hard. Maybe you got some bad news from your doctor, another friend announced their pregnancy, or you’re just plain sick of the neverending uncertainty. These are tough things to be sitting with. Let yourself recognize that you’re not okay today, and that it’s okay to feel that way. If you tend to beat yourself up about having a bad day, you could find a mantra like “Infertility is difficult, it makes sense that I struggle” to tell yourself.

Today might be the busiest day ever, when you have deadlines at work and dinner plans with friends and seven loads of laundry to do. But whenever possible, your mental health comes first. There might be things you absolutely have to do today, but anything that doesn’t have to happen can be canceled or moved to another day. It will be hard to process your feelings if you don’t make any time or space for them. You don’t have to clear out half your day - even just a short moment with yourself can make all the difference.

3. Bring yourself into the present moment.

In order to not have your emotions overpower you, bring yourself into the present moment. One of the most efficient ways to calm our nervous system is by taking a few deep breaths. It helps your body relax and puts your mind at ease. Try breathing in counting to 5, holding your breath for 5 counts, exhaling for 5, and holding for 5 again before the next inhale (this is called “box breathing”). You can also try some breathwork activities in Tilly's app - they're adapted for common infertility challenges. Breathing is a great tool for getting through difficult moments, and preparing you to work through tough feelings.

The only way to truly get rid of a difficult feeling is by actually feeling it. We need to move through our feelings and let them express themselves if we want to heal and grow from them. There are so many ways to process feelings, from doing something creative to deep breathing, from talking it out to working out. There’s no shame in sitting on the floor and crying until you have no tears left. In fact, that might be just what you need to feel release and catharsis. Journaling is also a great way to externalize your internal world, and work through your feelings. You can journal about what has triggered you, what your feelings feel like, what you need, what you’re grateful for, or anything else that helps you gain perspective and understand what you’re experiencing. There are lots of guided journaling sessions Tilly's app.

Now that you’re in a journaling mindset, it’s time to focus on what you might need today. Do you need space, community, love, fun, sleep, nature? Considering what you need, and making sure you get it, isn’t selfish. Our needs are not frivolous or extravagant. Our needs are basic requirements to get us through the day. But so many of us aren’t used to even figuring out what we need, let alone pursuing it. Today, on this difficult day, go after what you need.

You might prefer to cry alone, and that’s okay. But at some point, sharing your pain with someone can do you a whole world of good. It could be a friend, your partner, a family member, a therapist, someone from an online fertility forum, or anyone you trust who can give you some time today. Whether you need someone to talk things through with, cheer you up, or let you know you’re not alone, asking someone to support you is a huge investment in your well-being. They’re not there to heal you; it’s about being in community and not carrying the impossible weight of infertility on your own.

Remember, we’re not here to bury the difficult feelings in positivity. But feeling joy alongside our pain can make it more bearable. It can be something really simple, like eating your favorite candy bar, listening to your favorite song, or curling up in a cozy blanket. By giving yourself something that makes you smile or feel warm and fuzzy, you’re showing yourself that you are taken care of. That there are still good things even when there are lots of bad things. That's important to remember.

Remind yourself that this part won’t last forever. The not knowing, the failures, the seemingly endlessness of it all - at some point, you will move on from all of that to another part of life. No matter which way this fertility journey takes you, there will come a time when you have certainty about your infertility. When you’ll know a little bit more about what your future looks like (though of course we never really know for sure), when your days won’t be filled with tracking and medications and doctor’s visits and medical bills. One way or another, you won’t be in this part forever, and you will get through it.

Practical tools for working through hard feelings, and living with infertility day-to-day

8 ways to get through a difficult day with infertility

Many people who are suffering from infertility need support. Infertility is not a choice, and can be a long and difficult journey. Psychologist Anders Möller answers your questions and offers ideas for what support can look like for you.   

In the mid-1970s, I started working as a psychologist in a hospital. One of the areas I came in contact with there was involuntary childlessness and infertility. 

At that time, there was no IVF, but affected couples had to undergo many examinations in order for them to possibly receive treatment or donated gametes.

It was clear to me very early on that infertility was to be regarded as a life crisis. I was captivated by the fact that the problem was so all-encompassing.

It touches us as individuals, as couples, and as patients, and it really raises questions about life and our existence at its core. However, there was very little research on the psychological aspects of infertility, both internationally and in Sweden, and the little research that existed was neither well done nor well thought out.

Therefore, I decided to do a study of couples struggling with infertility. This became my doctoral dissertation, which I defended in 1985 (Psychological aspects of infertility, Department of Psychology at the University of Gothenburg). After this, I have continued to work with this problem at various hospitals and fertility clinics.

Many who struggle to have children experience grief. How can you mourn something you have not really lost? 

Many ask this question. To me, it's clear that you can just as easily mourn dreams, hopes and desires that are not fulfilled the way you would mourn anything else. 

The dreams, hopes and desires can also have even more weight than anything that has actually existed because they are unlimited and unseen. 

This in turn makes it more difficult to imagine and provide a concrete value, which can make the process longer and more complicated.

When the desires for a child are unmet, many things are challenged for us. We all need belonging, to be a part of something. It can be about feeling connected with our partner, which we feel will increase if we have a child together, or belonging with other women and other men who have children.

A man once said to me, "Why can't I do what all other men can?" Many women may feel that they are not "real women" if they cannot have children, even if they know intellectually that this is not the case. 

The connection we feel with the child we desired also goes unfulfilled if we cannot have children - but it can be fulfilled if we have children in some other way.

Many people who are suffering from infertility need support. We answer your questions and help you discover what support can look like for you.

Fertility Facts