Navigating the Realities of IVF: Fatigue, Hope, Grief & Loss

By Saff Mitten

When I sit with women in therapy who are going through IVF, I often see a very particular expression in their eyes - a blend of profound exhaustion and a flicker of fragile hope. On paper, IVF is a medical procedure. In reality, it is a relentless test of human endurance that touches every part of your life.

If you are finding this harder than you expected, that’s because it is far harder than anyone prepares you for.

The Practical Grind of IVF

There is a logistical weight to IVF that is difficult to grasp until you’re in the middle of it. The endless blood tests. The scans you have to squeeze in before work. The procedures that leave you feeling physically sore and emotionally stretched.

And then there are the daily injections, on a timed schedule, regardless of what else you have to contend with. You may be injecting in the bathroom or bedroom, trying to get the angle right while the dinner is half‑cooked or your laptop is still open from work. You might even find yourself injecting in the toilets at work, trying to stay calm while the world carries on outside the cubicle.

It’s the ordinariness of it that can feel so surreal - doing something huge and life‑altering in the middle of an everyday moment. You’re running a full‑time medical protocol alongside a full‑time life, often without telling anyone. The “normal” pressures don’t pause just because you’re doing IVF.

It is exhausting. And it can feel incredibly lonely.

The Excruciating Cycle: When Hope Becomes Pain

While the physical demands are significant, the emotional “hope–loss” cycle is often the part that cuts the deepest. When you’ve been crushed by disappointment and loss, hope stops feeling comforting and starts feeling dangerous.

Trying to keep hope alive can feel raw and exposing. You push yourself to try - because you feel you have to - but after a while it can feel like dredging up a memory of a feeling rather than actually experiencing hope the way you once did.

For many women, hope also becomes tangled with fear. You want to believe, but you’re terrified of what it will cost you if it doesn’t work. Whether it’s a failed cycle or the heartbreak of a miscarriage after a positive test, the emotional toll of being lifted up and then dropped again is brutal.

It’s hard for anyone who hasn’t lived it to understand quite what it’s like to hold your breath for weeks at a time, feeling as though one phone call or one test result could undo you.

Why a Positive Pregnancy Test Isn’t Always the End of Your Journey

There is a common belief that a positive pregnancy test is the moment you can finally relax. That you have been successful. But when you’ve fought this hard to get there, this news doesn’t necessarily feel like an ending - it often feels like the beginning of a new kind of fear.

Unlike a pregnancy that happens easily, an IVF pregnancy is often layered with trauma. You don’t simply “enjoy it.” You may find yourself checking for blood every time you go to the bathroom or bracing for something to go wrong.

For some, a positive test is followed by the quiet devastation of an early miscarriage or an embryo that stops developing. And in an instant, the baby you had already imagined holding in your arms is gone.

When you’ve put your body, your finances, and your heart through so much, these losses feel monumental. The emotional overwhelm doesn’t disappear - it shifts into a hyper‑vigilance that can feel exhausting to carry.

The Power of Being Supported by a Therapist Who Has Lived It

When you’re in the middle of a cycle, the people around you - however well‑meaning - often respond with platitudes. “Just relax.” “Stay positive.” These comments, though intended to be helpful, often feel insensitive and triggering.

This is where therapy becomes less of a luxury and more of a lifeline. IVF isn’t just a medical journey; it is a profoundly challenging experience that can impact every part of your life. Therapy offers a space where you don’t have to hold it all together.

There is a particular shift that happens when you work with a therapist who has personal experience with fertility challenges and IVF. You don’t have to explain the jargon, the timing of the trigger shot, or why a “chemical pregnancy” can feel like a world‑ending loss. And you don’t have to worry that your therapist is going to say something insensitive or make it about themselves.

When your therapist has walked this path:

• They understand the reality of the IVF journey, and you don’t need to sugar‑coat anything.
• They have lived through the hope, fear, and loss that you are experiencing.
• The silence is understood: The quiet after a difficult phone call, the stillness of waiting for results, the moments where grief leaves you without words and hope feels like it has vanished. They know that heavy silence because they’ve been in it themselves.
• Your thoughts feel less “crazy”: They can validate the hyper‑vigilance and the symptom‑spotting because they’ve lived those two‑week waits themselves.
• You are able to share anything with them about your experiences - no holds barred - without fearing you’ll be judged, misunderstood, or invalidated. This includes moments of rage, envy, fear, jealousy, and so much more besides.
• You are met with true empathy, not just sympathy: They understand the emotional toll of living in cycles of hope, fear, and loss, and they know how heavy it feels to keep going.

Working with someone who “gets it” allows you to stop translating your pain and start processing it.

Finding Your Way Through

IVF may be one of the most emotionally challenging experiences you ever face. Because the stakes are so high and the journey so demanding, it makes complete sense to seek support.

You are not “failing” at being positive; you are responding to an extraordinary amount of pressure. Whether you are at the beginning of your first IVF cycle or years into your journey, you deserve a space where you don’t have to put on a brave face and can be completely honest about what the experience is like for you.

If you would like to learn more about how I support women going through IVF, read more here.