Questions about IVF and time off work/FET

[SunsetsAndSandwiches]

Hi,

I am currently TTC with PCOS. On my 5th round of letrozole and am seeing the consultant in a couple of weeks to switch to IVF/ICSI (we have already been approved to go down this route).

As I have high AMH, they have said that I will likely need a frozen egg transfer to minimise the risk of OHSS. I was wondering though, how does the freezing defrosting process work as I understand not all frozen embryos survive defrost? Would they defrost a few to be on the safe side? If so, would that mean possibly wasting a few or could they be refrozen? If not and they just defrost one, is there a good chance the transfer day could be cancelled?

Also would like to know how people have dealt with the build up to egg collection and also post-transfer in terms of work. I am very fortunate to have paid time off for all fertility appointments and I also have a generous paid sick leave policy. I am quite unhappy at work and a bit stressed, and am concerned about this impacting the success if I'm full of cortisol as well as the hormones (I'm sure its the reason I had a day 18 ovulation (ie. Delayed) this month on letrozole). Has anyone asked their doctor for a sick note for time off, e.g two weeks pre- egg collection and 1 week post transfer? I don't want to be unreasonable at all, and know I need to find a long term solution for the stressful job, but after 15 months TTC I'd like to give our first round of IVF the very best chance of succeeding.

They defrost one embryo at a time. If it doesnt survive, they defrost another, and so on. But it is very rare for embryos to die during that process.

As for time off, it is completely up to you, but it isnt needed, apart from the day of egg collection, as you will be sedated.

In most cases clinics dont even recommend staying home, as all you can do is think about it, which actually increases stress.
After my transfer the doctor who performed it told me to resume normal life completely, including sex life, as there was nothing I could do or not do to make the transfer be more of less successful.

Thank you for replying.

That's reassuring to know that they defrost one at a time.

That's a fair point about keeping your mind off it all, I will have a think and perhaps request a few days of annual leave (but make some actual plans and not just sit at home) to try and keep myself occupied but less stressed.

I recently did my first IVF cycle, egg collection with a day 3 transfer. I wasn't at risk of OHSS.

During the stims I didn't need any time off apart from to attend the scans, my work are also good with paid appointment time and sick leave but didn't feel I need it. My job isn't super stressful but very emotionally challenging and can be sat for a few hours at a time.

I took EC day off due to sedation, this fell on a Friday, weekend was days off but would have been fine to return the day after as felt okay.

Transfer on Monday and and then took the rest of that week off, more due to emotionally drained and just felt surreal that it had happened.

I guess for you as it sounds very likely you will be doing a frozen then you could get a sick note for time off to cover stims to egg collection and a day or 2 after. A GP will do it if you say it's stress related. I would definitely say try book things in to keep you busy though and things that will lift your mood and make you feel hopeful, it's so easy to fall into a Google rabbit hole.

I would just say that if you took off the stims to EC would you then be able to take off the time for FET and would you want all the fet stims and the 2WW off?

I guess atleast the EC stims prepares you for what to expect for FET but usually less meds. I didn't find the stims difficult at all, just the ovary ache from about day 7 to EC I felt aware of.

Alot of articles I read around stress suggest it doesn't impact the IVF process during the cycle and actually the 3-4 months prior to the cycle starting are the ones that need to be less stressful and eat better etc, it's the events of those months that will have gone into creating the eggs the will be recruited and that you will use. It's called folliculogenesis.

Thank you so much, some really good points about managing stress now in the build up! Thats definitely something for me to consider how I manage that. I am being careful with diet and taking appropriate supplements so have that angle covered at least.

I think perhaps I am overturning it re having time off and maybe I should just aim to continue working unless physical symptoms give me issues pre EC. It sounds like some time off post transfer might be the one to consider, if anything.

I hope your transfer proves to be a success, sending you lots of luck x

I took egg collection day off and the next day off after each of my three collections but no more. I wanted to save up as much time off for the 2WW. My work was also great at supporting me where they could with wfh etc.

@CR7 that's great that your work are supportive. How long did you have off during the TWW?

@SunsetsAndSandwiches just over a week with each. Two fell in one year and one the next, holiday wise x

I booked 3 days of sick leave for EC + weekend off, in total spent 5 days on recovery. Worked until stim day 11, from home, had no emotional issues at all. So the day of EC you definitely need to be off and do nothing but rest. Technically I could work from home next day onwards but I wanted to focus on healing from the surgery, without work stress. Took 4-5 days before the aches were completely gone.

My clinic advised to eat protein to prevent OHSS (my protocol was high dose antagonist) and drink plenty water with magnesium to prevent constipation. I still constipated but was better than after the first round when i didn't know the tricks.

FET I still haven't figures out how many days I need to take time off but in theory you just need the day of transfer.