My Fertility Treatment Was Canceled – Now What?

I held back my tears until I reached my car, and then grieved the loss of this cycle the best I could.

– Tara Engelberg, Trying To Conceive in Denver, Colorado

These are unprecedented times. Our lives have all changed since COVID-19 became a reality for Americans in recent weeks. A world is in mourning as this pandemic continues to take its toll. Many of us are becoming shut-ins, in an effort to try and slow the spread of the virus. Those of us watching the news, are bracing for the worst.

Last week, a task force with the American Society for Reproductive Medicine (ASRM), which includes top physicians and embryologists, called for an indefinite suspension of procedures like: in vitro fertilization (IVF), intrauterine inseminations (IUI), egg retrievals and transfers. Now fertility clinics are closing across the country, and canceling all procedures except for urgent care. For the hundreds of thousands of Americans struggling with infertility, many without the luxury of time to waste, having to postpone fertility treatments adds to an already painful situation.

Dr. Lora Shahine, of Pacific NW Fertility: “We are finishing cycles that have already started, but I had to tell patients who were planning treatment soon, that we need to delay. It’s the right decision, for the greater good – supporting social distancing, saving medical resources. But the right decision can often be the hard decision.”

Tara Engelberg and her husband have been trying to conceive for more than three years. “We didn’t share our struggles with our friends or family for two years. It was a big secret we carried in our hearts for a long time. We had finally found the right doctor and the right clinic, and it felt like the stars had aligned just right for us to get started.”

But that all changed at Tara’s doctor’s appointment last week, which was scheduled a day or two before her Intrauterine Insemination (IUI) procedure: “When I went in for my ultrasound, a nurse brought me into a private room to discuss the new guidelines they received overnight. I was asked to cancel my cycle based on their recommendations. I had the option to disregard their medical advice and complete my IUI by signing a waiver, since I was so close to finishing that round of treatment. But, their recommendations were clear. I sat there completely stunned and unsure of how to move forward. My head and my heart were at war.”

“I sat there completely stunned and unsure of how to move forward. My head and my heart were at war.”

Tara ultimately decided to cancel her IUI procedure, even though she may not be able to start it up again in the future, “I knew there was a chance the clinic may need to close in the coming future. I’d also be increasing my exposure to the virus and potentially putting others at risk as well. When our fertility clinic reopens we are unsure if we’ll be able to afford care at that time. Before COVID-19, we had set aside money for treatments. But with a partial loss of income due to the virus, we may need to reallocate that money for essential needs.”

Many of us are feeling the loss of plans we were excited about. We might even be sad about canceling plans we weren’t looking forward to – like those painful hormone injections, or getting your blood drawn for the gazillionth time. So what can you do during this pandemic if you’re trying to conceive and can’t start fertility treatments? We have some suggestions:

Educate Yourself

This is a great time to be learn about your body. You might want to start with the fundamentals, like understanding how your reproductive system works. I didn’t know how much I didn’t know, until I struggled with infertility. For example, if you haven’t already figured out when you ovulate each month, and if it happens regularly each month, is an important first step in cracking your personal fertility code. You can track your cervical mucus, and cervix position – which changes throughout your cycle – and can tell you when you’re likely the most fertile. There are many fertility testing options available to do at home – like using a basal body thermometer, or ovulation predictor kit.  

Beyond the basics, you can get at home tests that may be able to help you discover why you haven’t been able to conceive. Two FDA approved options we found and really like are: Proov and Yo Sperm.  The Proov test confirms that you are ovulating by measuring PdG – a metabolite of Progesterone, 7 to 10 days after ovulation, so you’ll know if you have healthy ovulation and PdG levels.  YO Sperm is a kit that tests sperm health with a device you attach to your smart phone which analyzes sperm count and motility.

“If their procedures are delayed a few months, that is a few months they can use to improve their odds and time to conception.” Eric Carver, General Manager of the YO Home Sperm Test says, “Learning to predict ovulation, confirming ovulation, checking and improving sperm health, and learning to time intercourse during the month- are all best practices for a couple that does not have an underlying infertility condition.”

Amy Beckley, Founder and CEO of Proov agrees that this doesn’t need to be wasted time for people who are trying to conceive, “These are uncharted territories for essentially everyone. If you have decided to stay on the path to try to conceive as soon as possible, there is a lot you can still do from home. While you wait for the clinic to open, try a few home-based test kits to help you answer what might be preventing you from conceiving. That way, when clinics do open back up, you are that much more prepared to hit the ground running.”

Another option to consider is a do-it-yourself insemination kit. For some people, it’s a good time to try to do everything you can on your own, before moving on to more invasive and costly procedures. Maureen and Marc Brown struggled with unexplained infertility for years, which led them to develop Mosie Baby. Their safe, comfortable, and affordable home insemination kit includes a specially designed syringe that transfers sperm to the cervical opening.

Maureen Brown, Mosie Baby CEO/Co-founder: “Family planning in a newly uncertain world is something we’re all navigating together. Whether you’re actively trying or hitting the pause button, we hope everyone can find a way to make the most of this time. That means planning, budgeting, and mastering your ovulation cycle so that you’re ready to seize the moment when the time comes!”

Get Healthy

Another challenge, one that I’m personally battling, is: “The Quarantine 15”. It’s not easy to avoid packing on the extra pounds when your gym is closed, you’re working from home, and you’ve been trying to eat your worries away. Here are some great tips from health experts that can help stop the cycle of stress-eating:

• Plan your meals out each day – so you know exactly what you’re eating throughout the day, including snacks. Then write down what you actually eat, so you can keep track.
• Try not to graze all day. Have a start and end time – for example only eat between 9am and 7pm.

• Don’t eat out of the bag or container. Put snacks on a plate or into a bowl, so you can see exactly how much you’re consuming. And don’t go back for refills.

• Try to fill up on the healthy foods first. Wash and cut up vegetables and fruit ahead of time, so they’re just as easy to grab as those cookies and chips.
• Wait 30 minutes after each meal, before going back for more. That way you’ll know if it’s really hunger, or it’s just boredom.
• Make sure you’re moving your body in some way every day. Get outside for a walk, try out an exercise video, join the “push-up challenge” on social media, or turn up your favorite playlist and have a 10-minute dance party. This is going to help manage your stress, improve your mood, and keep you out of the kitchen between meals.
• Take time to meditate. I’ll admit, this has been a tough one for me to practice consistently, but I know it’s important. Meditation is key to alleviating the stress and anxiety we’re all experiencing right now. It’s a perfect time to try out one of those apps that guide you through the process.

Do the No-Pants Dance

Sex is much more than just about procreation. Even if trying the old-fashioned way doesn’t lead to pregnancy, it’s important to make time to connect with your partner. Showing how much you love and appreciate each other is another great way to relieve stress, relate, and get your heart rate up.

There’s a lot to deal with right now. We need to be kind to ourselves. So, don’t be too hard on yourself for eating some comfort food, and binge watching Netflix. But these ideas to get healthier – physically and mentally – can really help when you’re an isolation-induced funk. Maybe just try one of the above suggestions each day. Or if that’s too much, just incorporate one new thing each week. That is enough to make a big difference.

You are not alone – Even when it may feel like it

This situation is hard and unexpected. I understand it, I accept it, but that doesn’t erase the pain.

-Tara Engleberg, IUI Procedure Was Canceled

Like Tara, we’re all feeling pain and heartbreak for those plans we can’t reschedule, and also for the many people fighting for their lives. We’re all trying our best to stay healthy and sane right now. It’s completely normal to be feeling a range of reactions including: depression, frustration, helplessness, anger, and sadness. If you’ve been struggling with infertility, or experienced a miscarriage, these are emotions you’re already very familiar with.

I’m going to be honest with you. I am typically an optimist. When things are hard, it always helps me to focus on the light at the end of the tunnel. But I don’t see the end of this pandemic right now. So, I’m going to work hard every day, to find that light within – so it can lead me and my family down this path we’ve never traveled before. But I can’t do it alone. Will you join me?

Please visit our COVID-19 Fertility Forum – and let us know what’s in your head right now, and what you’re going through. Are you going to try to conceive at home? Do you have any tips, or advice to share about how you’re dealing with the lock down? We’d all love to hear from you. We are all in this together. We need to keep talking, sharing, connecting, and supporting each other.

Every day is a new chance to do better, be better, and feel better.

– Talking Fertility