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Getting that negative result after our first IVF cycle was one of the hardest parts of our fertility journey.
Looking back, I realise just how naïve I was about IVF. I didn't know anyone who had been through it, so I didn't really have anyone to ask for advice or tell me what to expect. In my head, IVF was our Plan B. We'd tried to conceive naturally for years, so once we reached the point of having IVF, I genuinely thought we'd do a cycle and we'd get pregnant. I never really considered what I would do if it didn't work.
I hadn't thought about how I would feel, what would happen next or whether I'd want to go straight into another cycle. I had spent so much time thinking about getting to IVF that I hadn't really allowed myself to think about what would happen if we got to the end of the cycle and there wasn't the happy ending we'd been hoping for.
When that negative result came, I felt completely lost.
I know now that I wasn't unusual in feeling that way. IVF is often talked about in terms of the treatment itself (the injections, scans, egg collection, embryo transfer and pregnancy test) but not quite so much about what happens emotionally when you reach the end of it and it hasn't worked.
And the reality is that, sadly, more IVF cycles end without a pregnancy than result in one. That doesn't make receiving a negative result any easier, particularly when you've spent weeks or months building up to that moment and allowing yourself to imagine what life might look like if it worked. It is a real grief for the future you had imagined, and it's completely valid to grieve for that.
If you've recently had a negative result, you might be heartbroken, angry, numb, exhausted or completely overwhelmed. You might be all of those things at different points in the same day, and you might find that your feelings change from one day to the next.
There isn't a right way to feel, and you don't have to work out what you're going to do next straight away.
When I support patients after a failed cycle, there are four questions I encourage them to think about, when they feel ready.
Before thinking about another cycle or what you might do differently next time, give yourself some time to think about what you actually need now.
You've probably spent weeks having appointments, taking medication, giving yourself injections, having scans, waiting for results and trying to keep everything else in your life going at the same time. Then, suddenly, the treatment has finished and you may be expected to get back to normal when you don't necessarily feel anything like normal.
So rather than immediately asking yourself “What do we do next?”, try asking “What do I need right now?”
Think about how you've coped with difficult times in the past. What has helped you when life has felt particularly hard? Perhaps it is spending time with people you love, having some time completely to yourself, getting outside, writing things down, watching something that takes your mind off things or talking to someone who understands what you're going through.
You might also need to do very little for a while, and that's OK. You don't have to turn your disappointment into something productive or start making plans for the next cycle immediately. Sometimes your first job is simply to let yourself acknowledge that you're really upset.
There can be a temptation to think that because the treatment has finished, you should be able to move on, but emotionally it doesn't necessarily work like that. You have lost something you had hoped for, and it is completely understandable that you need some time to process that.
When an IVF cycle doesn't work, it can be very easy to look backwards and start looking for things you could have done differently.
You might find yourself thinking, “Should I have rested more?”, “Should I have taken more time off work?”, “Should I have eaten differently?” or “Maybe I shouldn't have done that…”
Please try not to turn this into an exercise in blaming yourself.
A negative result doesn't mean that you did something wrong.
Instead, think about what helped you through the treatment, both physically and emotionally. Was there something you did that made things feel a little easier? Maybe taking some time off work meant you weren't trying to juggle quite so much, or perhaps prioritising sleep helped you feel more like yourself. Maybe counselling gave you somewhere to talk honestly about what you were feeling, or you found that talking to other people going through IVF made you feel less alone.
It could even be something very simple. Perhaps you arranged something nice to do after an appointment, made sure you had your favourite food in the house or found a TV programme that became your escape whenever IVF felt like it was taking over everything.
These things might not have changed the outcome of your treatment, but they may have changed how you experienced it, and that's important too.
If you decide to have another cycle, knowing what supported you this time means you don't have to start completely from scratch. You can take the things that worked for you into your next round and perhaps think about what additional support you might need.
When you're ready, your follow-up appointment can be a really useful opportunity to understand more about what happened during your treatment and whether there is anything your clinic would consider doing differently next time.
You don't have to go into the appointment knowing exactly what you want to ask, but it can help to write down your questions beforehand, particularly if you're worried that you might become emotional or forget what you wanted to discuss.
You might want to ask what your clinic has learned from this cycle, whether there is anything they would consider changing if you have another attempt, whether any further investigations are recommended and what your options are from here.
You can also ask them to explain anything you don't understand. IVF involves a huge amount of medical information, and there is absolutely nothing wrong with saying, “I'm not sure I understand what that means — could you explain it to me?”
This isn't about looking for something or someone to blame. Sometimes there isn't a clear explanation for why a cycle hasn't resulted in a pregnancy, and it is important not to feel that you have to find one.
It is about making sure you have as much information as possible so that, if you do decide to have another cycle, you can make that decision with a clearer understanding of your options.
It is also worth thinking about what you might want to change from a practical point of view. Perhaps you realised that working throughout treatment was too much and you'd like to take more time off next time, or maybe you need more support from your partner, family or friends. You might decide that you want to speak to a counsellor before starting another cycle rather than waiting until you're struggling.
None of these things mean you did anything wrong this time. They're simply things you've learned about yourself.
This is a difficult one, particularly when you've already spent years waiting to become a parent.
I remember feeling very tempted to want to start again as quickly as possible. When you've waited so long and finally reached IVF, taking a break can feel like you're losing more precious time.
You might worry that if you stop, even for a few weeks or months, you're somehow giving up or making your chances of success worse.
But sometimes your mind and body need some time to recover before you make another big decision.
There isn't a right amount of time that everyone should wait before having another cycle. Some people will feel ready to try again quite quickly, while others will need much longer before they can even think about going through treatment again.
Only you can really know what feels right for you.
If you find yourself saying, “I don't know if I can do this again,” you don't have to make a decision that day. You can give yourself some breathing space and come back to the decision when you're feeling a little more able to think about it.
Equally, if you're certain that you want to try again, that's OK too. Wanting to continue doesn't mean you haven't allowed yourself to grieve this cycle.
You can be devastated that this attempt didn't work and still feel ready to try again.
Perhaps the most important thing I would say after a failed cycle is that you don't have to immediately turn your disappointment into a plan.
There can be a lot of pressure to think about the next step (another cycle, further tests, different treatment, taking a break) when actually you might just need some time to process what has happened.
Whatever you're feeling right now, whether that's sadness, anger, jealousy, disappointment, numbness, relief or complete overwhelm, it doesn't mean you're coping badly. You may feel fine one day and then find something completely unexpected brings all the emotion back again. That's part of it too.
And if you're struggling, please don't feel that you have to get through it on your own. Talk to someone you trust, whether that's your partner, a friend, a counsellor, a fertility support group or someone who has been through IVF themselves. You don't need them to have the answers; sometimes having someone who simply understands that this is really hard can make a huge difference.
Looking back, I wish I'd known before my first IVF cycle that I didn't need to have a plan for what would happen if it didn't work. I wish I'd known that it was OK to be completely devastated, to take some time before thinking about another cycle and to ask for more support.
Take the time you need to recover, think about what helped you through this cycle, ask the questions you need answered and, when you're ready, decide what feels right for you.
It is completely valid to grieve after a negative IVF cycle, and it's OK to take some time to look after yourself before deciding what comes next xx
My online support group is full of amazingly supportive people, who understand and will be there to help you when you need it, and you are welcome to join it on the link below.
If you are struggling, please reach out to me and to people in the support group, we are all here for you and we will support you as much as you need. We understand and want you to be ok xx
When you first start IVF, you imagine it’ll be full of hope and a team of people helping you move closer to your dream of having a baby. And while that’s true, what most people don’t talk about is how IVF can slowly chip away at your sense of dignity.
In this latest conversation in my ‘Taking Control’ series, I’m joined by the lovely Julianne Boutaleb, Perinatal Psychologist, to talk about the emotional impact of infertility and the things we can do to protect our mental wellbeing along the way.
Somewhere around October, that little voice can start getting louder.Could we still fit IVF in before Christmas?Maybe you’ve had that date in your head for months. Maybe you’ve been quietly hoping that by Christmas things will finally feel different.