I spent years helping patients understand IVF. I knew the science, the language, the numbers and the next steps. Then I became the patient—and learned that medical knowledge does not protect you from the emotional toll of treatment.
The first time I looked at my husband’s semen analysis, I knew exactly what it meant. Not because someone explained it to me, but because explaining semen analyses was part of my job.
At the time, my days were spent helping couples make sense of test results, treatment options and probabilities. I knew which numbers mattered and which ones didn’t. I knew what usually came next.
I opened the envelope outside the laboratory on a beautiful day. I remember the white stones under my feet, the neat garden in front of me and the strange sensation that came over me, like a dark veil had dropped in front of my eyes. The world around me hadn’t changed, and yet it felt as though it had.
Looking at those results, I knew our chances of conceiving naturally were low. I knew IVF would likely become part of our story. I knew it might take years. Looking back, I think I also believed that this knowledge somehow gave me an advantage. It didn’t.
What I discovered over the years that followed was that understanding a process and living through it are two entirely different things.
When IVF Stops Being Something You Explain
Nothing about the medicine surprised me. The medicine was familiar: the protocols, the appointments, the scans, the blood tests, the careful waiting. I knew the treatment pathway. I understood the reasoning behind each decision. I could follow the medical logic.
What surprised me was how quickly my life stopped feeling entirely my own. I’d have an appointment here, a blood test there, a treatment decision that could only be made after the next ultrasound…Slowly, my calendar began to revolve around my body, even as my body no longer felt like it belonged only to me. There was always another date to wait for, another result to interpret, another possible outcome hovering just ahead.
One evening, before joining my family for dinner, I sat alone in my car to do an injection. What strikes me now is not the image itself, but the fact that it felt completely normal. Treatment had quietly woven itself into every corner of my life.
That is one of the things people who have not lived through fertility treatment often don’t understand. IVF does not only happen inside a clinic. It follows you into parking lots, bathrooms, family dinners, work meetings, vacations you cannot book and conversations you do not have the energy to explain. It becomes part of the atmosphere of your life.
The Difference Between Information and Control
The science never felt difficult. The loss of control did. That realization unsettled me because it challenged something I had believed for years. As a physician, I had assumed that information and empowerment naturally went together. I believed that helping patients understand what was happening would help them feel more grounded inside the experience.
And sometimes, of course, it does. But my own experience taught me something more complicated: information and control are not the same thing. You can understand every step of a process and still feel trapped by it. You can agree with every medical decision and still resent the space treatment occupies in your life. You can know exactly what is happening inside your body and still feel powerless.
That lesson stayed with me long after my own treatments ended. In the years that followed, I found myself drawn toward questions traditional medical training had never fully answered for me. I trained in sexology, which taught me how profoundly fertility struggles affect identity, intimacy and relationships. I trained as a hypnotherapist, which taught me something different—not how to “let go,” not really, but how to reconnect with resources that already exist within us and find some sense of agency when circumstances themselves remain largely outside our control.
At the time, these interests seemed unrelated, but I think they emerged from the same place. I was trying to understand where people find strength when certainty is no longer available. Both experiences changed me. Still, neither erased a memory that comes back to me often.
The Grief We Don’t Always Have Language For
After a failed embryo transfer, I called my grandmother. I wanted comfort, but what I did not want was to explain embryo grading, implantation failure or hormone levels. I had spent my professional life explaining reproductive medicine to other people. That day, I did not have the energy.
So I told her I miscarried. I still feel slightly uncomfortable writing that sentence. Medically, what I had experienced was a failed implantation, not a clinical miscarriage. But at that moment, I was trying to describe a loss for which I did not have simple language.
Part of me worried I was naming the grief incorrectly. Failed implantation belonged to a language my grandmother did not speak. Loss, she understood immediately. I don’t really remember what she said. I remember the relief of not having to translate.
Looking back, that conversation taught me something I had never fully appreciated as a physician. The burden of infertility is not only created by uncertainty. It is also created by the constant effort required to live inside an experience that many people around you do not fully understand.
There is the medical experience, and then there is the explaining of the medical experience. The definitions. The timelines. The acronyms. The careful distinctions between what happened and what almost happened. The emotional labor of making your grief legible to someone else.
Sometimes, silence feels easier. Sometimes, imprecision feels kinder. Sometimes, the word that is not medically exact is the only word that allows someone else to meet you where you are. That does not mean language does not matter. It does. But so does the ache underneath it.
Where Patients Actually Live
As physicians, we are trained to focus on outcomes: pregnancy rates, protocols, test results, treatment plans, what happened, what comes next and what we can adjust.
Patients live somewhere else—in the space between appointments, in the parking lot before a family dinner, in the meeting that must be rescheduled, in the vacation that cannot be booked, in the event they cannot RSVP to because they do not know what their body will be doing that week and in the conversations where explaining feels harder than remaining silent. They also live with the strange split between appearing functional on the outside and carrying an entire treatment cycle quietly inside. You can be at work, at dinner, on the phone, in a room full of people, and still be living in a private world organized around dates, doses, numbers and hope.
If you are living in that space now—the waiting, the explaining, the silence—I want you to know that your exhaustion makes sense. You are not weak because this feels hard. You are not uninformed because you feel powerless. You are not doing IVF wrong because you understand the science and still feel undone by it.
How Becoming a Patient Changed the Way I Practice
My journey never made me question fertility medicine. It changed my understanding of care. Care is not only about providing the right treatment. It is not only about explaining the next step clearly or choosing the right protocol. Those things matter deeply, but they are not the whole of it. Care is also about understanding what treatment asks of the person receiving it. It asks for time, privacy, flexibility, hope and endurance. It asks patients to make room for uncertainty over and over again. It asks them to carry medical complexity into ordinary life and somehow keep moving.
Medicine taught me how to explain fertility treatment. Becoming a patient taught me everything that happens around it. For years, I focused on helping patients understand the road ahead. Now I understand that the road is not only medical. It is emotional, relational and deeply personal. I thought I understood my IVF patients. Becoming a patient taught me that understanding is only the beginning.
FAQs:
What is the emotional toll of IVF?
The emotional toll of IVF can include anxiety, grief, loss of control, relationship strain, decision fatigue and the exhaustion of organizing daily life around appointments, medications, test results and uncertainty. Even when someone understands the medical process, IVF can still feel emotionally overwhelming.
Why does IVF feel so out of control?
IVF can feel out of control because so much depends on timing, test results, embryo development, medication response and outcomes that cannot be fully predicted. Many patients understand the steps of treatment but still feel powerless because their lives, schedules and hopes are shaped by factors outside their control.
Can failed implantation feel like a loss?
Yes. Medically, failed implantation is different from a clinical miscarriage, but it can still carry real grief. For many people going through fertility treatment, a failed embryo transfer represents the loss of possibility, hope and emotional investment, even when there is not a simple word for that experience.
Can fertility doctors struggle emotionally with IVF too?
Yes. Fertility doctors and reproductive health professionals can understand IVF medically and still struggle emotionally when they become patients themselves. Knowing the science does not erase the waiting, uncertainty, disappointment or grief that can come with fertility treatment.
How can loved ones support someone going through IVF?
Loved ones can support someone going through IVF by listening without trying to fix it, avoiding overly optimistic clichés, respecting privacy and acknowledging that the process can be physically and emotionally exhausting. Sometimes the most helpful thing is simply allowing someone to be sad, uncertain or quiet without needing them to explain everything.
