Welcome to IVF This, episode 163, IVF and realistic expectations. 

Hello, hello, hello, my beautiful friends. I hope you are all doing so, so well. We are back from vacation and ready and excited to bring you several new episodes. I've been working with both a graphic designer, and my virtual assistant, and we've got a lot of great things in store for you. So I'm very excited. I am particularly excited about this episode because I think the idea of realistic expectations, we kind of all know it, right? We kind of know that walking into a situation with unrealistic expectations is kind of a recipe for disaster, but I don't think that we take time to calibrate the type of expectations that we have going into an experience like IVF, because it's not just a journey, it's not just an experience, it's all of those things all at the same time. So that's what I wanted to talk about today. So, I'm gonna talk a little bit about understanding realistic expectations why they're important and then how you can set some or how you can start to set them for yourself. So let's talk about setting realistic expectations and why it's so important for the IVF journey. So there are different types of expectations that I think that we have for ourselves when we go through IVF. So I think that there's the emotional expectation that we have of ourselves. I think there's the physical expectation that we have for ourselves. And then of course the outcomes based expectations that we have for the entire process, right? So I wanna cover kind of all three of those, right? So the emotional journey of IVF, we all know that that is a very taxing, very challenging experience, right? It's in the process, we're going to experience kind of a wide array or a wide range of emotions, hope and fear and excitement, despair, exciting. Expecting yourself to stay positive all of the time is unrealistic. And it's actually very damaging, right? Because I think people understand, right, you can't be expecting, no, you can't be, hmm. I think people understand that you can't necessarily be hopeful or excited all of the time, right? I think intellectually we understand that those unrealistic expectations.

But I think that because of how much of the verbiage that's used within the IVF infertility community, that toxic positivity, just stay positive, you've got this, right? I think that that warps our sense of understanding around these expectations. So what I mean by that is this. When we set these expectations and we say, know, I just wanna be positive or I just wanna be excited or I just wanna be hopeful throughout this journey, what you're then telling yourself is that your expectation, mostly unconscious, is that that should be the only emotion that you're experiencing through a very tumultuous experience. That's not a realistic expectation, right? You're going to sometimes go through 15 emotions an hour, depending on where you are in the IVF process, what the news that you've received, test results, outcomes, all of those sorts of things. That's the first thing, right? And you guys know that because I talk mostly about the emotional and mental aspects of IVF, of course I'm gonna spend most of my time talking about the emotional implications of unrealistic expectations. When we set emotional expectations for ourselves, we have to understand and accept, right? I think most of us do a good job of understanding our emotions. Acceptance is a very different story. So we have to accept the fact that we are going to experience emotional upheavals throughout this process. And that is actually a very normal and human expectation to have for ourselves. So understanding and accepting that we're going to feel despair, I think that's a really big one that is very challenging for people to feel, mostly because it feels like absolute crap to feel despair or hopelessness, but those don't last.

Most of our emotions have a pretty short shelf life. And of course, you know, the asterisk on the end of that statement is there are many of us that do suffer from diagnosed or undiagnosed depression and anxiety, which can make those despair, the hopelessness, the more uncomfortable feelings, it can make them much larger and much more prevalent, much more recurrent, much more, much more just much more of everything, right? That's not necessarily what I'm talking about. What I'm talking about is the normal range of emotions that you can expect to experience at all parts of your IVF journey, right? And that hope and excitement, while wonderful emotions and they fill you up and you feel so warm and good inside, or at least I do, they will be there. They're gonna have to share space with fear and anxiety and maybe even hopelessness sometimes, right? And that's okay. They're supposed to share space together. They, the emotions, are much better at sharing space than we, the humans, okay? So, the physical expectations. If you've been through an IVF cycle, you know that the physical demands of are basically akin to, especially in like a stimulation cycle, you're asking your body to run a marathon all day, every day, inside, for, I mean, up to 14, 15 days sometimes, right? So the hormone injections, the blood tests, the ultrasound, and all of the different procedures or tests take a very big physical toll on your body. So, expecting to feel super good or super great physically around the entire process, probably not a realistic expectation, right? You do want to listen to your body and most importantly, and I'm gonna slow my cadence down so you can hear me, want you to give yourself permission to rest, to rest and take care of yourself. You are not, expected to do 100 % 100 % of the time and certainly not when you are taxing your body in the way that you have to tax your body while you're going through IVF, right? A transfer cycle is a little bit different, kind of. You're not stimulating your ovaries and having them grow four or five times their actual size, but you are still doing hormonal injections, you're doing blood tests, you're doing ultrasounds, you are preparing your body for what could be a massive transformation over the next nine months. And that's no little thing. So setting unrealistic expectations that you won't experience any physical upheaval is probably not the most realistic. The other side of that coin is having the expectation that you are just gonna lose all semblance of yourself and turn into some sort of raging Hulk monster is also not a realistic expectation, right?

This comes up a lot in my one -on -one clients, sometimes even in my group, that people who have maybe never gone through IVF, like the first timers that we love so much, they have this expectation that they won't be able to control themselves, right? That the hormones are just gonna make them so angry or they'll just fly off the handle at everything, or maybe that they won't even be able control themselves, regulate themselves in work or with their relationships, with their friends, in social settings. And that's also not a realistic expectation. And I love that you can see, or I hope that you can see, the dichotomy of you can set unrealistic expectations in that everything's gonna be glorious, and you can set unrealistic expectations that everything's gonna be terrible. The pendulum can swing to the extreme either way. It's always somewhere in the middle, right? Are you going to experience hormonal ups and downs and maybe lose your temper and be more agitated or frustrated more easily? Are you gonna be more tired? Yes. Yes, all of those things are true. One's not necessarily gonna be dominant over the other. Now, there are people who do experience really adverse reactions to medications, right? But that's talking in the extremes.

Most of us don't, right? And if you are someone who is experiencing really, really adverse reactions, that is something to bring up to your reproductive endocrinologist, to your medical team, right? And they'll be able to adjust it. But for the vast majority of us, it's not gonna be in these extremes. It's gonna be somewhere in the middle, and that's okay, right? So you will definitely, probably, experience bloating, fatigue, mood swings. Right, these are normal side effects of what we are putting, the, these are normal side effects of the medications that we are putting into our bodies. And so setting realistic expectations in this process would mean understanding that your body is going through a lot and then just again, giving yourself permission to rest, being very gentle with yourself, loving yourself compassionately, okay? And kind of the third outcomes, no. The third expectation that I discussed earlier was the outcome -based expectation. The reality is that IVF does not guarantee a pregnancy. It doesn't. rates vary, numerous factors are involved, age, medical history, diagnosis, setting an expectation that IVF will definitely work, especially when we're going on the first try, can set you up for significant disappointment.

And I gotta tell you, I was that person, right? It was actually the second transfer that I was walking in with so much unlabored confidence that it was gonna work because the first stim cycle worked so well. We got two chromosomally normal embryos. The first transfer was successful. The embryo had just kind of been waiting for us. I had created in my mind this entire world where I had these three little boys, you know, I already had my oldest, my second child was, he was the product of our first IVF round. And so this third little boy that I had already named was, know, in my head I could almost see him graduating from high school, right? I was sending him off to college in my brain. That was an unrealistic expectation. Is that like a normal thing to do? I think so. I think as kind of untethered as we would like to be to the outcome, I think it's very normal when we have something to kind of hold onto. It's very normal to think and fantasize. Does everyone do it? Probably not. Do a lot of people do it? Probably. Okay. That's why we don't live in extremes. We live in the middle. We live in the gray part. Is that boring? Sometimes. Can that, can boring be okay?

Boring can be grounding, boring can be neutral. That's where we want to be, okay? So we wanna consider having flexible expectations in terms of outcomes, right? So instead of saying, I will get pregnant this cycle, try saying something like, I'm gonna do everything I can to increase my chances of getting pregnant or to support my pregnancy, right? Depending on if you're in stem cycle or transfer cycle or whatever.

But shifting from focus on the outcome which you cannot control to shifting from an outcome that you cannot control to acts and behaviors and things that you can control will also help not only immediately set realistic expectations for yourself, but will also provide a grounding neutrality for you because the things that you can actually control, well, you can actually control them. You can function in that space. You can do those things. And then you get to be working and living from a place of empowerment rather than this enormous external pressure for something you have no control over. Okay? So emotional expectations, physical expectations, outcomes -based expectations. 

Okay, so now I think everybody has kind of a clear understanding of what it looks like when we set in realistic expectations for ourself and how that can be damaging. Now I want to talk a little bit about how you set realistic expectations, right? I'm gonna give you some practical tips in this as well. So the first one I believe very strongly in is educating yourself. I was raised, in a household where my parents repeatedly said, education is the one thing that they can never take from you. I'm not sure who they were referring to, who the they was in that, but my parents are a little bit anarchists by nature, so I imagine they were talking about like a greater force trying to take education away from you. But I mean, it's still sound advice, right? Education cannot be taken away from you. And education also comes in many forms, right? There's formal knowledge, right, that you gain through learning in a formal fashion, reading, things like that, and experience. And experience is, can be, it's a tough teacher, right? It can be a challenging experience, but an invaluable one, right? So the first one is educating yourself. You wanna understand more about the IVF process as a whole that can help you kind of calibrate your expectations, right? If I had known at that time of doing the second transfer that you need three embryos, three chromosomally normal embryos for one life birth, I probably would not have had such confidence going in, right? Not that having confidence going into a transfer is bad, but what happened to me, my experience, was that I never considered other possibilities because of that confidence.

Right, I never considered the idea that it wouldn't work, right? Even the possibility that it might not work. And so what happened was when it didn't work, I was flattened. Absolutely flattened. Like I had been hit by a truck and they ran over me 15 times, right? And so had I known that, I probably could have recalibrated my expectations to be like, okay, I only had two embryos and we've had one successful so there is a possibility that this doesn't work, right? And statistics aren't, you know, the final word, but they can help you with kind of understanding and setting those realistic expectations.

And I think kind of a practical tip for that would be preparing a list of questions when you go to either your initial consultation or any of your doctor's appointments, ask them about success rates, ask them about potential side effects and what you can expect at each stage of the process. I've had kind of a growing concern from some of my clients that, especially clients that are going through their very first cycle that they're only getting piecemealed information. We're gonna get to this point, we're gonna get to this point, we're gonna get to this point. Now I'm not suggesting that the doctor has to provide you with the exact protocol or the exact timeline of what each stage of the process would look like, but I think it is a fair and realistic expectation for the doctor, for your medical team, to provide you an understanding of what each stage of the process will or can look like.

That can help you feel much more informed, much more empowered, which can help you feel less anxious because there's less unknown, right? So that would be step one. The second option, the second option. The second thing to help you with setting realistic expectations is I want you to reflect on your own emotional resilience. Take time to think about what you have gone through in your past. How have you handled difficult situations in the past? When you can understand your own coping mechanisms, you can give insight to how you might deal with the ups and downs of IVF, right? The coping thing, the coping thing, the coping skills that worked and maybe even take a little inventory on the things that you've done to cope in the past that weren't really effective or that didn't really help you and things that you would want to avoid, right? I talk about all of these things in my coaching practice. You can find any number of these kind of topics in all, like interwoven in all of my podcast episodes. The understanding, I think what happens is we kind of go through experiences like it's in a vacuum, like it's never happened before.

But as a person who moves through this world, you have very likely experienced trauma and loss and crises and emotional upheavals and emotional like wonder, right? Like you get exactly what you wanted. And taking inventory and recognizing, yes, that, know, even if it was just, you know, in third grade I was, humiliated in front of my class. This is treading into more personal water, apparently. But in third grade, you were embarrassed in front of your entire class because you asked a question that you thought was an important question. It was important to you, but maybe your classmates or your teacher thought it was irrelevant. And so maybe that's preventing you from asking questions to your doctor. No, no, no, no, no, no, no, no, no, no, no, no, no, no, no. You handled that embarrassment.

Right, you did not die because you got embarrassed. And the same thing will happen if you ask what you might perceive to be an embarrassing question to your doctor or to your medical team, to your husband, to your friends, to your family, right? You're not gonna die of embarrassment. It can feel that way at the very beginning. I understand that, but that's not gonna happen, right? But the alternative to not asking, say that embarrassing question is that you don't get the knowledge that you need to feel grounded and secure in moving forward or in the next stage or where you are in that exact moment, okay?

Third one for setting realistic expectations, communicating with your partner if you and your partner are going through IVF, right? There are many women who are not going through IVF with a partner and I absolutely love that. However, you probably do have a buddy or a friend or a mentor or a therapist or somebody, a coach like me that you are working with that you can communicate this to, right? So, but if you're going through IVF with a partner,

Open and honest communication, right? That is key. Discuss your hopes, your fears, make sure that you are on the same page about what you expect from the process. And this can help prevent misunderstandings and provide mutual support, right? If I had a client not too long ago who we were talking about finding out the results of her transfer cycle and I was asking her, you know, have you and your husband discussed how he would like to be informed, right? Does he wanna be on the call? Does he wanna be put on a three -way call so that he can hear the results with you? Does he wanna take the day off of work so he can be right there with you or both of you take the day off of work, whatever your work schedules are? Is he okay with just getting that information from you after the fact, like you hear from the clinic and then you call him or them? Those are the things to think about because I think when that unknown exists even between you and your partner, you and your friend, you and your medical team that amplifies the feeling of uncertainty that we experience naturally through this. Like it's a very uncertain process, but it doesn't have to be intensified with his other uncertain uncertainties that we experience.

Number four, I want you to set small and achievable goals, right? Instead of focusing solely on the end of the cycle or the, you know, getting pregnant or the end of the pregnancy or, you know, what you're gonna be like as a mom, that's not a problem that you do, right? Again, you're allowed to fantasize, you're allowed to believe, and you're allowed to like soak up all of that imagination. That is a wonderful thing. On the other hand, that equal airtime option, I also want you to think about kind of the smaller picture, right? More achievable goals along the way. Those smaller victories can help kind of give you a little bit of a morale boost, honestly, and help you stay grounded and focused and maybe even a little bit energized through this process. So breaking down the IVF process into milestones, right?

Like completing a round of medication or getting through a test, attending all the scheduled appointments for the week. Like the lives that we lead right now, the fact that you have to be in clinic, like sometimes two to three times a week during a STEM cycle, that is a big lift because most of us are working full time. And so being able to just do that, that is a big thing and you do deserve to be celebrated for those things, whether it's just you patting yourself on the back or being like, I did that shit, or even, I think at the end of my last stim cycle, I think I even got myself a cupcake, because I love cupcakes, and that was my favorite thing. And so I told myself, I'm gonna get through this week, and I'm gonna go get myself, no, was a bundt cake from Nothing Bundt Cakes, that's what it was. And it was,

It was everything that I needed in that moment just to give myself a little bit of a celebration, right? So one of my clients, I have several clients, I guess I should say, this is probably a combination of several clients. We don't like the injections. I don't think any of us go into IVF like, yes, I have always wanted to give myself upwards of 100 injections. I've never felt more inspired to be a person who just jabs herself constantly, day in and day out, multiple times a day sometimes. So if that is you and maybe even, like less lighthearted than what I just said, and you have a true fear of the injections, maybe it's like you set a daily goal of doing a deep breathing exercise before or during the injection. And so celebrate each time that you achieve that, right? Like if your husband is giving you injections and you're doing deep breathing, allow yourself to like celebrate that with your partner, without your partner and know that you can do this, right? And those are the little, little gifts that you're gonna give yourself along the way. It would not be an IVF This podcast episode if I did not talk about practicing mindfulness and self -compassion. When you can stay grounded in the present moment, right? Even if you're in the throes of fear or sadness or grief, right? It is temporary.It never feels temporary in the moment, but it always is. And so what we can do in those moments, even in those moments where we are in absolute emotional upheaval, we can remind ourselves this isn't forever, right? Because your brain is gonna tell you, I'm always gonna feel this way. It is always gonna be hard, it is always gonna be horrible. I'm always gonna feel this bad. But you're not. You're not, people, We get better, right? And even in the throes of absolute grief and loss, they're gonna come in waves. You're going to get a respite from that pain. You just gotta wait it out, right? And so reminding yourself, this isn't forever. I'm feeling this right now, and I don't like it, but it's here, and here we are. And that can give you a feeling of groundedness that you desperately need in that moment. Definitely. And then the idea of self -compassion is much more focused around if you and your best friend, your mother, your beloved pet, your partner switched places and they were the ones going through what you're experiencing.

If you two switched places and they were experiencing what you are, what would they say to you? Would they talk to you like an absolute jerk and be like, well, you never deserved this anyway. What made you think this was gonna happen? What made you think that you deserved a happy ending or your fam? No!

And if they did, you'd need to punch them in the throat right now and get them out of your lives completely. That might be extreme, but you know what I'm No, they would probably say something like, this is horrible. I'm so sorry. It is okay to let sucky things suck. You don't have to automatically turn around or punish yourself for feeling a negative emotion, right? It's okay. Your best friend, I know my best friend and I when we're talking about something that's really difficult, we're like, God, this sucks. It's okay that it sucks. You're not gonna stay there forever, okay? All right, two more, I promise. I'm gonna wrap this up, because I know I'm getting long -winded here. Last two things. We want you to build a support system, right? And this can be, the support system can be as large or as small as you want, right?

Ideally, it would include your family and friends, right? You always get to decide who knows and who doesn't. I'm not in the position to tell you that you need to advertise it to everyone. But with the people that you feel like you can trust, let them know, I'm dealing with this, I'm experiencing this, I'm feeling this, and this is what I need for you, from you. This is what I need from you, right? You're allowed to tell people what you need from them. Most people don't and most people are terribly disappointed by how people show up in their lives, right? But if you tell them, know, I just need you to listen. I don't need advice, I don't need platitudes, I don't need blah, blah, right? They always get to choose how they show up, but at least you've given them some sort of guide for how you need them to show up in your life, right? I always, always support having a therapist or coach in your corner as part of your support system. Your medical team is also a support system, right? So building a support system. And finally, I want you, and I've talked about this part of the episode already, focus on what you can control. Focus on what you can control. You can only ever control three things, how you think, how you feel, and what you do. And by remembering that and staying focused, right? I can't go too far in the future, I don't have any control over that. I can't go in the past, I don't have any control over that either.

Right? If you're beating yourself up because you should have gone to the doctor three years ago, no point. At that point, it's just like you're beating yourself up for sports because you can't go back in time three years to make different choices. You made the choices you made. They were probably exactly what you needed at the time. Let it be. When you can stay in that place of this is where I am, not grounded neutrality present on what you can control. I swear to you, your experience of IVF as a whole will be drastically different. The way that you will be able to access compassion for yourself, patience for yourself, is gonna be next world, okay? I know this was a little bit long. I got caught up in my stories. I appreciate you being here.

I do wanna say that if you find this podcast helpful, this episode or any of the other episodes that you have listened to, if you find them helpful, please share them with other people. Share them in maybe like a Facebook group or a Reddit string or a support group or with your therapist. Share them with people who also could be going through something similar or experiencing something similar that could benefit from this. Okay, I hope you have a beautiful week and I'll talk to you soon.