Hormones and Hustle: IVF in the Workplace
Written by Sandy Russo
The reminder on my Outlook calendar popped up just as I finished up my last conference call of the morning. “LUPRON INJECTION NOW!” it screamed. I reached into my desk drawer, pushed aside the files I’d been working on and grabbed my little black injections bag. Once I was in the very public office restroom, I wrestled with ways to mix and then administer the injection. Do I use a toilet stall? Do I do it right here on the bathroom counter? Where do I dispose of the needles safely? I was anxious, in pain and convinced I was going to do it all wrong. It was my first round of IVF, and I had to trigger my ovulation right in the middle of my workday.
I polled my IVF community friends about the intricacies of going through IVF while balancing a career, and the overwhelming eloquent response was, it sucks. Each IVF cycle has its unique challenges, but I found mine in learning to balance the emotional weight of IVF, the financial implications of treatment, the demanding clinical schedule and my career over three months of treatment.
It probably comes as no surprise that hormone injections make trying to remain professional and focused a serious challenge. The best way I can describe IVF hormones to the average fertile friend is intense PMS, while holding a dozen Easter eggs in your ovaries, combined with the most insane anxiety attack of your life. Sitting or standing or existing for extended periods of time became more unbearable and my pants went unbuttoned more times than I’d like to admit.
But what I really wasn’t prepared for was that IVF absolutely consumes you. My projects at work suffered as I spent hours Googling different ways to increase my chances for pregnancy. (A ton of pineapple, lots of bed rest, keeping my feet warm—all complete nonsense, but if you’d told me to go howl naked at a full moon, I would have. Twice.) I spent hours scouring the internet researching every abdominal twinge to make sure my ovary hadn’t burst or that I wasn’t ruining my egg quality by scarfing down a breakroom donut. The mental and emotional demands of IVF far surpassed the physical ones caused by the hormone injections. I prepared myself with stretchy pants and a flexible schedule, but not with the strength and positivity it takes to come out of such a high-stakes procedure emotionally and professionally unscathed.
The cost of assisted reproductive technology, including IVF, rivaled my student loans. We were the lucky few—my insurance covered a great deal of our IVF costs and both my husband and I had taken up side hustles to make the rest of the ends meet. But our dumb luck isn’t common at all. In the United States, fewer than 25 percent of employers offer infertility coverage for their employees, and typical out-of-pocket costs range anywhere from $15,000 to $25,000 depending on your location and type of therapy. To make matters more complex, higher IVF pregnancy rates are shown to directly correlate with companies that provide coverage. A research study published in 2017 showed higher cumulative rates of live birth through IVF over 10 years in women with employer infertility benefits or state mandated coverage, even though the women were medically similar otherwise.
Before I started fertility treatment, I was not aware that IVF is not a medical package deal. There are additional procedures that actually increase your chances for success—at a price. These procedures include direct injection of the sperm into the eggs, preimplantation genetic testing of the embryos and frozen preservation of the embryos. All of these additional, success-boosting services are out-of-pocket costs that push IVF into the $25,000 range or more. As companies strive to become more woman-friendly in an effort to remain competitive, it appears coverage will become more widespread. The coverage my employer provides for IVF has resulted in my lifetime loyalty and passion to see my company succeed—something every employer should seek in its staff.
Beyond the emotional, physical and financial costs of IVF, less obvious challenges arose. One of the most significant ways IVF challenged me professionally was in keeping a consistent work schedule. I spent hours explaining the potential schedule to my supervisor, preparing for every potential outcome, and yet still managed to miss a few unexpected days. A typical IVF schedule involves roughly 10 appointments that could be squeezed into an hour each, with two full days off for surgeries. While the quantity of time off doesn’t seem too far out of the realm of normal, the real issue is that your body determines when these take place. It isn’t like scheduling airline tickets to Prague three months in advance; the notice is more in the realm of 24 to 72 hours. With my egg retrieval surgery, I had less than a day’s notice that I would be out of commission. Unfortunately, the workplace protections offered to most pregnant women by law do not protect women in IVF treatment until a fetal heartbeat is detected by ultrasound.
With a few months of IVF hindsight, I can offer these tips if you’re considering advanced reproductive technology while kicking ass at work:
1. Plan ahead. Way ahead.
There’s never a guarantee things will go as you’d planned them, but understanding the potential outcomes of your treatment is of monumental importance. Scheduling hormone injections and surgeries are obvious, but experiencing the loss of a pregnancy while continuing to work is something that must be considered and prepared for. Research your leave policies, know the protections in place for pregnant women in your place of business and, if possible, make sure an HR representative is aware of your treatment.
2. Value your cheerleaders in the workplace.
My team was aware of my IVF cycle months before injections began. Find at least one coworker who can cover for you when needed and keep you on task. When those sudden Google-pits-of-hell happen, your coworker can be the one to reassure you and refocus you. I found that being vocal about IVF in my workplace connected me with several other employees who had completed treatment and had helpful insurance and policy navigation tips for me.
3. Give yourself grace.
I’m used to working long hours and devoting myself completely to a project. I’m passionate about my job, highly critical of my performance and I rarely allow myself a sick day. However, during IVF I had to take a significant step back from major projects and allow my body the rest it needed. I felt intensely guilty about my shift in prioritizing my need for a baby over my love of my job, but my attitude eventually changed and accommodated both.
So, now for the news: As surreal as this is to write, I’m now a little more than nine weeks pregnant from my IVF frozen embryo transfer. The professional complications of morning sickness and hormone injections (they don’t end until 10 weeks gestation!) continue. But my time as both an IVF patient and a professional brought lessons I know will carry over into other phases of my career—the importance of planning ahead and being flexible, the difference a company that values you can make to your health, the benefits of giving yourself permission to take time off
… and that you should absolutely always eat the last break room donut.
Sandy has spent all 31 years of her life in Jacksonville, Florida and works in the aviation industry. She and her husband, Daniel, own Tongue and Teak Woodshop and love making Pinterest dreams come true. Her passions include succulent gardening, the Investigation Discovery channel, and petting any animal within a 5 mile radius. Find her on Instagram at @cornbreadandcambria.