As I’m now undertaking my third attempt at IVF within a calendar year I’ve been thinking about how IVF and work fit together.

A lot of women work when they are doing IVF.  Not all of course, I have heard of plenty who have never worked or who give up work to try and get pregnant.  But the IVF clinic has everything set up to be convenient for working women.  The vast majority of the appointments are between 8am and 9.30am with the intention of women being able to drop in before they go to the office.

I’m a self employed consultant, I work mainly from home on short term overlapping contracts.  It is a strategic job and I am experienced, so I would be pretty high up if I was doing the same thing in a bigger company.  In many ways this is a great way to live my life.  I love my job, I’m in control of my own destiny, I can work as much or little as I want, and should I be lucky enough to have a baby I will be able to ramp the work up and down to suit my childcare needs.

But how does this fit in with IVF?

Even at the best of times IVF is hugely inconvenient and often unpredictable.

But as a self employed person it is within my power to work around all this.  If I have a planned IVF appointment, I can go.  If I need to drop everything for a short-notice IVF appointment, I can.  If I feel ill or sad or am taking a new drug and am not sure how I will react to it I can cancel meetings or turn down opportunities or take time off.  I can arrange and rearrange my diary as necessary.  I have no colleagues or boss to answer to and no need to explain myself or my actions.

But it isn’t quite as simple as that.

I don’t have to tell my clients why I’m not available, but I do need to be very careful that I’m not messing them about and that I’m not failing to deliver on my promises.  I cannot damage my reputation, I need a good reputation and delighted clients in order to win new business in the future.  And that’s tough with IVF, because you simply cannot know more than a few days in advance which days you will need to be out of the office and when you can and cannot take meetings and promise delivery of tasks.

There is no-one to do admin or service contracts or make decisions but me.  I can’t call in sick and leave it to someone else.  Every time I drop things or cancel appointments or get behind it is all there on my desk to deal with when I come back.  Waiting for me.  Hanging over me.  If my emotions are screwed and I can’t face being a grown up I am the one that has to rearrange things in advance and pick up the pieces afterwards.  Same if I have to go in and have a big needle up my ovaries with one day of notice when the clinic told you it would probably be another day.  There’s no PA or junior to call my clients and say ‘sorry she can’t make that important meeting today’ – I have to man up and do it myself.

Then there’s the forward planning.  Each time you do IVF you hope it will work.  So you wonder, should I be bidding for contracts that I won’t be able to deliver if I need to be in the hospital having a baby in nine months?  Since I have been doing IVF I have said no to contracts over six months in length just in case, because reputation is so important and letting clients down is not an option.  I’ve missed out on a lot of opportunities already, as it turns out unnecessarily because I’ve not got pregnant yet.  These are coming up now, I could have been working on them, but I’m not because I didn’t bid for them.

And then there’s the big one.  If I don’t work I don’t get paid.  Every time I am making a decision to take time out, or sit on a bus for two hours, or turn down opportunities in case they don’t fit around the IVF I am losing income.  I don’t have a salary, I don’t have an annual leave allowance, I don’t get sick pay.  There is a direct relationship between more time spent on IVF and less money in my pocket.  And I have bills to pay.

So how do I manage all this?  I have had to make trade offs.  I have to trade off my business against my desire to have a child.

And the trade off is quite straightforward the first time you do IVF.  The IVF is the most important thing in your life, you want to do it properly, you prioritise it and rearrange your whole life around it – work included.  End of.  It is inconvenient for yourself and others but it has to be done.  So if the IVF works first time, great, the equation linking inconvenience and outcome is balanced.  You made a good decision.

However, the more times you do IVF the less easy it is to conceptualise and manage the trade off.

As time is elapsing and you rack up the cycles the impact on your working life builds up.  The more time out you are taking, the more opportunities you are missing, the less flexible you are being, the more income you are failing to earn.  And yet, perhaps like me, there is still no baby.

And this could just go on and on and on.  I’ve done three IVFs this year and I have six frozen embryos.  I could potentially make some more embryos.  I could be doing this for a few years.

It is difficult to justify the inconvenience and the impact of this inconvenience for such a prolonged period.

And I know that even with all the effort and all the inconvenience IVF might never result in a baby for me.  I have become painfully aware that if I don’t get the balance right and prioritise my business as well as the IVF I could end up with no business AND no baby.

I have no idea how women manage all this, and more, when they are working full time for someone else.  Whether they tell their boss and their colleagues why they are taking extra medical appointments and need extra flexibility and keep having to make covert phone calls and might burst into tears at any moment.  Having to make ethical decisions about who should ‘fund’ this inconvenience – whether they take sick days or annual leave for the appointments that take place during the working day.  Whether they have to delay that second or third or fourth round because their employer isn’t sufficiently flexible or they have run out of annual leave allowance and just can’t take the time out.  The IVF clinic recommends that you take a couple of weeks off for the egg retrieval to pregnancy test component.  But how many times can you realistically do that?

I think it would be easy for an outsider to say ‘screw work, prioritise the IVF’ or even ‘if you’re so bothered about work you’re not really bothered about IVF’ or worse ‘you’re probably not getting pregnant because you are working too hard’.

But for me work is important.  I enjoy it, I chose it, I’ve set the whole thing up to suit my skills and interests and personal needs.  Work gives me routine, and a sense of purpose, and is a welcome distraction and something to keep me going when other things are hard.  I get a lot of satisfaction and a sense of achievement from a job well done and it is important to get that boost to your self esteem from somewhere when you are relentlessly failing to get pregnant over a prolonged period.

IVF is just one part of real life.

There’s work, there’s your relationship with your partner, there’s your health, there’s your social life.

It is important to me to keep all of the plates spinning.