In the first part we explored the hard facts of IVF - the planning, the tests, the pain and the results. In the second part we will explore the mental faculties of the couple and the counselling process.

I continue my conversation with fertility specialist Dr. Munjaal Kapadia

• Thanks to easily available information, in general people equate IVF to being a painful process. As a fertility specialist how do you help navigate your patients through this?

The first thing is acknowledgment, that it is a painful and a difficult process. Nobody wants to do IVF for fun, your eye is on the bigger target of starting a family and begin a dream of parenthood and you have to be mentally prepared that you will have a few difficult weeks or months. But as a couple you need to know that you are not alone in this process and the experts are with you and aligned on the greater goal of you having a healthy pregnancy and starting a family. Once the couple accepts this, it usually becomes easier for them. What doesn’t work, is trying to minimise the issue because it’s not just about the physical pain, for some it’s the financial burden and for most the emotional toll is significant. The wait for a positive result or having to deal with the negative result that can shake you to your core. And that is the most common reason why most people find IVF so difficult, despite everything correctly, it may just amount to nothing.

• How do you counsel the couple if the results are negative?

First, regroup and the doctor goes through the results and analyses what could have potentially gone wrong and next time something different can be tried. But that happens for a small percentage of patients, for the large percentage everything is and still the results are negative, so it’s difficult to convince them to try the exact same thing and hope for a different result. But in IVF that’s how it works, you have to keep trying the same thing and hope for a different result. In our counselling we are very careful in informing the patient, even on the day of transfer that it’s a great embryo, it is a great lining, everything is fantastic but your results will not exceed 50 percent. So even if it is negative, the couple is prepared and realise that it’s not something they did wrong and can be fixed in the next round, IVF doesn’t work like that.

• What are lifestyle changes that the couple/patient should undergo for IVF? 

Something which is really fertility specific and we insist the patient to absolutely stop is smoking, chewing tobacco, substance abuse and drinking every single day. When it comes to men with low sperm counts, switch to boxers from briefs, make sure that you don't take hot showers or long hot bath because heat is the enemy of the sperm, so to speak. Among other considerations would be your standard - eat healthy, exercise, get fresh air, some sunshine, avoid junk and processed foods, get more proteins and of course sleep and rest. Sometimes families ask that should the female partner quit her job or give up work to reduce the stress. To them I say only one thing that there is no point in giving up your current life in the hope of another life that hasn’t started yet. Pregnancy should not mean compromising on your chosen paths of life, it should be a valuable addition, unless of course job involves you working in a factory with noxious fumes, radiation, etc. then of course one must consider. But these are very fringe cases. IVF process doesn’t dramatically change your regular life going-ons, so one should continue doing what they are.