fertility meds

A note from the author:

If one’s sole responsibility in life was only to manage their IVF protocol, it would still be challenging. Many women have careers, older children or family members to care for, and other demands of daily life. Going through fertility treatment is just an “add-on”. 

The first time I attempted to freeze my eggs, my treatment cycle was canceled seven days in due to minimal follicle growth. I felt deflated and was an emotional mess. It had taken so much out of me to get to the point where I was comfortable freezing my eggs, and then this happened. I asked myself, “For what?”.

When I tried to understand what had happened, I learned that I needed to administer my twice-daily hormone injections at the same time each day with a small buffer. The nurse may have failed to give me this guidance or due to the inundation of information provided, I simply forgot. 

Focused on my path forward, I knew I wanted to try freezing my eggs again. And I did, eight more times. With time and practice, comes better awareness and mastery. 

I learned many things about myself during the years of going through fertility treatments, and I would love to share them with others so that they can have a helpful tool kit to reference. I even went so far as launching my own company dedicated to creating products designed for fertility patients, Stims Wellness.

A guide on how to address the logistical and emotional challenges of managing fertility medications and how organization plays an important role in reducing the stress of IVF

The success of a fertility treatment cycle (egg freezing, IVF, etc.) is dependent on the medication - the types of medication, dosages, frequency, accuracy in administering, and ultimately how your body responds to the protocol. So it is no wonder that managing fertility medications can create a psychological strain causing stress, anxiety, frustration, and emotional exhaustion.

Through my journey, I’ve learned firsthand how overwhelming the process can feel—especially when it comes to managing medications. In this article, I’ll share practical strategies to help you navigate the logistical and emotional challenges of managing fertility medication protocols, so you can feel more confident and focused on your family-building goals.

Create a daily plan

Adhering to a well–structured plan helps to maximize success rates.

• A nurse may give you a basic medication schedule outlining what to take each morning and evening throughout your treatment cycle, which typically lasts about 14 days. For example, your schedule might say, “Take medications X and Y in the morning, and medications X, Y, and Z in the evening.” In addition to the written instructions, your nurse may also provide you with verbal instructions regarding medications that need to be administered at the same time each day with a small amount of buffer time on each end (e.g., plus or minus an hour). These instructions may differ from what you were previously told, as they are often adjusted based on your latest bloodwork and how your body is responding to the protocol.
• Consolidate the written schedule and verbal instructions into a single, easy-to-follow plan in whatever format works best for you. Some clinics may use digital apps where this information is available to you. Review your plan earlier in the day so you have time to clarify any questions with your nursing staff during business hours.
• Balancing your treatment protocol with daily life can be challenging, especially when juggling work, commuting, evening plans, or childcare responsibilities. In some cases, it may be helpful to create a detailed schedule that integrates your medication regimen with other commitments, ensuring you stay on track. If you know you will be on the go during your treatment, consider planning ahead with travel support products, such as portable storage for medications like Stims, to help maintain consistency and ease any logistical concerns.
• Allow yourself time to prepare your medications and review instructional videos to avoid causing undue pressure and confusion when it comes time to administer medications. 

Organize your medication

The psychological impacts of being organized can lower anxiety and provide a greater sense of control while going through fertility treatment.

• Your fertility medications will arrive in a package from a specialty pharmacy, though some protocols may require shipments from multiple pharmacies. Along with your medications, the package will likely include additional supplies such as a sharps container for needle disposal, alcohol wipes, sterile needles, and syringes.
• Understanding how to store your medications properly is essential. Some can be kept at room temperature, while others need to be refrigerated. Keep in mind that storage requirements may change after a medication has been opened or mixed (for example, when combining Menopur with a diluent). If you are unsure how a medication should be stored, call your doctor's office and ask for clarification.
• Here are some storage ideas for keeping your room-temperature medications and supplies organized at home
  
  • Plastic shoe containers with lids - their open design helps accommodate supplies of all different sizes
  • Caddy with compartments - helps keep medications and accessories neatly separated
  • Toiletry bag with clear compartments- Provides easy visibility and quick access to your supplies
• Here are some suggestions for storing meds and supplies while away from home
  
  • An insulated bag with frozen ice packs- helps keep medications cool and supplies organized while on the go.
  • The Fertility Med Bag by Stims Wellness is the first insulated bag on the market designed specifically for fertility patients’ needs. The bag is discrete, waterproof, and can be repurposed after treatment is done.

Assemble a network of trusted advisors and prioritize self-care

Having a support group made up of family, healthcare providers, and friends can help provide coping skills and a sounding board to share your experiences.

• Along with organizing your day and medications, it is equally important to prioritize your mental well-being.
• Selectively choosing who will be in your inner circle during treatment can be helpful in prioritizing self-care.  Choosing people who understand your experience and can offer guidance or encouragement will help you feel more supported throughout the process.
  
  • A partner and family members can help alleviate the emotional labor as well as provide hands-on support (i.e., helping administer injections)
  • Medical professionals, such as therapists trained to work with patients undergoing fertility challenges, can also be helpful. They have the benefit of listening to other's experiences and can provide an objective perspective and suggest coping skills
  • Friends who have been through similar experiences can be a great source of support and encouragement. While not everyone may fully understand the unique challenges of fertility treatments, focus on those who uplift you, and remember that support can come from many different places.
  • There are also fertility support groups, both in-person and virtual, where you can share your experience and hear from others 
• Techniques like journaling, therapy, meditation, or relaxation practices can help you cope
• Make time to do the things that bring you joy, as these moments will stand out more than the fleeting discomfort of injections and help alleviate stress

Final thoughts

Undergoing fertility treatments can be a demanding journey, but with the right tools and mindset, it can be a transformative experience. Staying organized, building a support network, and prioritizing your emotional well-being can help you navigate the ups and downs with confidence. Remember, this process is about more than just medication schedules and injections—it’s about taking steps toward the future you’ve envisioned. Give yourself grace, lean on those who uplift you, and trust that every challenge you overcome brings you closer to your goal. 

With advances in reproductive technologies, more and more families are turning to in vitro fertilization (IVF) to build their families. While some may experience smooth IVF journeys, others may face obstacles such as poor ovarian response (POR). POR is a condition that can affect your ability to produce an optimal number of eggs during fertility treatment. 

In this article, we will explore what POR means for patients, its prevalence, diagnostic methods, potential treatments, and available options for those diagnosed with this condition.

What is meant by low response to ovarian stimulation?

Poor ovarian response (POR) refers to a suboptimal response (actual or predicted) of the ovaries to stimulation during fertility treatment. 

During IVF, fertility medications are used to stimulate the ovaries, which culminates in the retrieval of multiple eggs. However, those with POR may produce fewer eggs than expected, which can significantly impact their chances of successful conception or even lead to a canceled cycle. 

POR is often associated with reduced ovarian reserve, which refers to the diminished quantity and eggs remaining in the ovaries.

How common is POR?

The estimated prevalence of POR ranges from 6% to 35%. This wide range is primarily due to researchers and clinicians having varying definitions of POR. In fact, one systematic review of 47 studies focusing on POR patients found a staggering 41 different definitions of POR being utilized. 

The likelihood of encountering POR increases with age, as ovarian reserve naturally diminishes over time. However, it is important to know that POR can occur in women of all age groups, including younger patients.

What is considered a “poor response” to IVF? Diagnosing POR

The European Society of Human Reproduction and Embryology (ESHRE) working group established criteria for defining a poor response in IVF. 

According to their report, having two or more of the following three features is considered having poor ovarian response: 

• Advanced maternal age or any other risk factor for POR 
• A history of previous POR
• An abnormal ovarian reserve test 

Or, if you experience two episodes of POR after IVF, it is considered a poor response, even without advanced maternal age or low ovarian reserve. Since the term POR specifically refers to the ovarian response, at least one egg retrieval is required for diagnosis. 

However, patients of advanced age with an abnormal ovarian reserve may also be classified as poor responders because both factors indicate reduced ovarian reserve and can serve as predictors of the outcome of an ovarian stimulation cycle. If that’s the case, a more accurate term would be "expected poor responders."

How IVF can fail

Each fertility journey is unique, and various factors, including underlying medical conditions, genetic factors, and individual response to medications, can influence the ovarian response to IVF.

Sometimes, IVF isn’t even a viable option due to low ovarian reserve. Ovarian reserve refers to the quantity of eggs remaining in the ovaries. Assessing ovarian reserve through markers such as anti-Müllerian hormone (AMH) levels and antral follicle count (AFC) can provide insights into your potential ovarian response to IVF. A predicted poor response may be indicated by low AMH levels or a reduced number of antral follicles observed during ovarian reserve testing.

Sometimes, even with normal ovarian reserve, you can experience an inadequate ovarian response to stimulation medications, which leads to fewer follicles developing than you would hope. Follicles are fluid-filled sacs within the ovaries that contain developing eggs. During an IVF cycle, hormonal medications support the growth and development of multiple follicles to increase the chances of obtaining viable mature eggs for fertilization. In general, 10–15 follicles is considered to be the optimal response to fertility medications during IVF. In cases of poor ovarian response, the ovaries may not respond adequately to these stimulation medications, resulting in limited follicular development. This poor response may be indicated by a reduced number of developing follicles observed during ultrasound monitoring throughout the stimulation phase of the IVF cycle.

Typically, a good IVF response involves the retrieval of a sufficient number of eggs, allowing for a higher likelihood of successful fertilization and subsequent embryo development. But sometimes, you simply don’t get enough eggs. A poor response can also be characterized by a lower-than-expected number of eggs retrieved, which may fall below the average range for your age group.

Is POR curable?

While POR poses challenges, it does not necessarily mean that you cannot conceive. The severity of POR can vary, and treatment options are available to optimize the chances of successful conception.

Treatment strategies for POR aim to improve ovarian response and enhance the chances of successful egg retrieval. The specific approach will depend on a lot of factors, including the underlying causes of POR and any other reproductive health obstacles you face. Some common treatment options include:

• Adjusting stimulation protocols: Your fertility doctor may modify the medication protocols used during IVF to enhance ovarian response. This may involve altering the dosage or type of fertility medications administered.
• Adding supplements: There is some evidence that DHEA and CoQ10 may improve IVF pregnancy rates for those facing POR. 
• Human growth hormone (GH): Some evidence suggests that treatment with GH for POR patients could lead to a higher number of retrieved eggs. 
• Third-party reproduction: In certain cases, fertility doctors may recommend alternative approaches such as the use of donor eggs or embryo adoption. These options can increase the chances of success.

What comes next after POR

Navigating a poor response to IVF can be challenging, and you’ll want to work closely with a fertility doctor who can evaluate the specific circumstances and develop an individualized treatment plan. The treatment approach may involve adjusting medication protocols, exploring alternative techniques, or considering options such as donor eggs.

While a poor response to IVF can be disheartening, it does not signify the end of the fertility journey. Advances in reproductive medicine continue to offer new possibilities and hope for those facing challenges in conceiving. With the right support, guidance, and perseverance, individuals and couples can explore alternative paths and find the best course of action to achieve their dream of building a family.

Get the emotional support you need

Dealing with a diagnosis of POR can be emotionally challenging. It is crucial to recognize the emotional impact and seek support from loved ones, support groups, or mental health professionals who specialize in fertility-related concerns. The journey to conception can be complex, and emotional well-being is an essential aspect of the process.

We are here to help you find the perfect egg donor

At Cofertility, our program is unique. After meeting with hundreds of intended parents, egg donors, and donor-conceived people, we decided on an egg donation model that we think best serves everyone involved: egg sharing. We didn’t invent the concept of egg sharing, but we are the first to take it national (and even global!).

Here’s how it works: our unique model empowers women to take control of their own reproductive health while giving you the gift of a lifetime. Our donors aren’t doing it for cash – they keep half the eggs retrieved for their own future use, and donate half to your family.

We aim to be the best egg sharing program, providing an experience that honors, respects, and uplifts everyone involved. Here’s what sets us apart:

• Baby guarantee. We truly want to help you bring your baby home, and we will re-match you for free until that happens.
• Donor empowerment. Our model empowers donors to preserve their own fertility, while lifting you up on your own journey. It’s a win-win.
• Diversity: We’re proud about the fact that the donors on our platform are as diverse as the intended parents seeking to match with them. We work with intended parents to understand their own cultural values — including regional nuances — in hopes of finding them the perfect match.
• Human-centered. We didn’t like the status quo in egg donation. So we’re doing things differently, starting with our human-centered matching platform.
• Lifetime support: Historically, other egg donation options have treated egg donor matching as a one-and-done experience. Beyond matching, beyond a pregnancy, beyond a birth…we believe in supporting the donor-conceived family for life. Our resources and education provide intended parents with the guidance they need to raise happy, healthy kids and celebrate their origin stories.

We are obsessed with improving the family-building journey — today or in the future — and are in an endless pursuit to make these experiences more positive. Create a free account to get started today!