Five Things We Wish We Knew Before Starting IVF
Unfortunately, we're still in the middle of our IVF journey, but it's been over a year, and we've learned so much along the way. There are so many things I wish I knew before we started, and I wanted to share the five that have stayed with me the most.
Before we jump in, I want to be clear: I'm not a fertility expert or a doctor, and this isn't medical advice. These are just our own experiences and what we've learned firsthand. Everyone's journey is so personal, so please lean on your own care team for what's right for you.
1. Your care team matters as much as your research
Before we started, I read everything I could about IVF, especially IVF for males with Cystic Fibrosis. What I didn't research was our care team. Charlie's Cystic Fibrosis doctors were already part of a well-respected health system, so I assumed its fertility clinic would be a great fit for us too, and I liked the idea of keeping all of our doctors under one roof.
What I didn't realize is how different clinics and doctors really are. Two reputable clinics can look at the same patient and build completely different plans.
If I could go back, I'd approach it like interviewing candidates for a job. I'd meet with a few clinics, ask how they'd approach our situation, and ask whether they've worked with other Cystic Fibrosis couples. Most of all, I'd look for a doctor whose values and communication style matched mine.
And it really is a team. It's been Charlie, me, our doctor, and even the woman at the front desk who remembers my name and wishes me luck on transfer day. A fertility clinic can be a really hard place to smile, and she made me smile every time.
2. Everyone’s journey is different and so much is out of your control
In our experience, most IVF cycles follow a pretty standard path: initial testing, medications and monitoring, egg retrieval, fertilization and embryo development, and eventually transfer. You can lean on those steps, but what happens within each one, from how many eggs are retrieved to how many embryos you end up with, is so personal.
When we started, I wanted a checklist. Do all of these things and you'll be golden: lots of eggs retrieved, healthy embryos, a successful transfer. I can't tell you how many times I typed our details into Gemini and asked what would happen next, like there was a formula I just hadn't found yet.
Honestly, if there had been a paid upgrade that unlocked “IVF Premium: Now With Answers,” I would have entered my credit card before reading the price.
Of course, there's no formula. You'll find a million things people swear by, from supplements to transfer day rituals to two week wait rules. Some might help you feel grounded, but so much of IVF is out of your control.
Do the things that make you feel good, let go of the rest, and please don't blame yourself for the parts you can't control (sometimes the hardest part).
3. Advocate for yourself, and push when an answer doesn’t sit right
You know your body. When I raised a concern early on, I was dismissed. Our second doctor agreed something wasn't right and wanted to figure it out before our next transfer. That's how we found out I had silent endometriosis, which had likely been affecting our transfers all along.
If you're not happy with an answer, push. Ask why. Ask what else it could be. Get a second opinion. Who cares if they think you're asking too many questions? You don't need a medical degree to know when something feels off, and your gut is usually right.
AI is not a doctor and shouldn't be treated like one, but it helped me connect the dots between appointments and show up with better questions.
4. PGT-A is worth the extra few weeks
For our first three transfers, we didn't test our embryos, based on our doctor's guidance given my age. None of them stuck, and we had no way of knowing why. Was the embryo chromosomally abnormal, which we later learned is one of the most common reasons a transfer fails? Was it something with my body? Or just bad luck? Without testing, every failed transfer led to more questions, but not more answers.
The myths
You'll hear that testing damages embryos, or that clinics throw away healthy ones. Dr. Lucky Sekhon, a reproductive endocrinologist, takes this on in “No, PGT Is Not Throwing Away Your Healthy Embryos.” She walks through the actual data on both claims, and it's worth a read before you make this call.
Why I wish we’d tested from the beginning
Yes, testing can push your transfer back a few weeks, which feels like forever. Still, it gives you real information and real confidence. If we'd tested from the start, a failed transfer of a euploid (chromosomally normal) embryo would have been a clear signal that something else was going on, and we could have paused much sooner to dig deeper with more testing.
PGT-A isn't right for everyone, and it's a call to make with your care team.
5. For Cystic Fibrosis couples: male infertility is likely more than just a plumbing issue
Unlike the first four, this one is specific to couples affected by Cystic Fibrosis, so it won't apply to everyone going through IVF. It's also the one we're most passionate about.
We went into this thinking Charlie's infertility was a plumbing issue. In a literal sense, it is. From what we've learned, over 95 percent of men with Cystic Fibrosis are infertile because they're born without the tube that carries sperm out of the body, even though most of them still produce sperm normally. The sperm is usually there. The delivery system isn't.
That's not the whole picture, though. Through our own reading and conversations with our doctors, we learned that sperm from men with Cystic Fibrosis can carry higher DNA fragmentation, which broader fertility research links to lower fertilization rates. It's genuinely under-studied in men with Cystic Fibrosis. For us, the extraction process seemed to matter too: the surgical approach, where the sperm was retrieved from, and whether it was used fresh or frozen.
We don't think the research is where it needs to be yet, but we see that as a real opportunity. In the meantime, we'll keep asking these questions and pushing our care teams to look at the whole picture, and we hope other families will too.
Why we’re sharing this
Maybe none of this would have changed our outcome, but we're huge believers that knowledge is power, and no family should have to learn all of this the hard way. That's why we're building the Fox Family Foundation: to share what we've learned so others can go in with more information than we had.
