If you’re looking for IVF support in San Francisco, understanding the physical, emotional, and financial demands of treatment is a place to start. In our Puzzle Exchange conversation, fertility nurse Katerina Jones and I discussed what patients wish they had known, how acupuncture fits into a wider care team, and how to find support that respects your goals.
“I wish I would have known.” Fertility nurse Katerina Jones heard this again and again from patients already in treatment. How many appointments they would need. What it would cost. That they would be giving themselves injections every day for two weeks.
When we spoke on Puzzle Exchange, we talked about what patients were trying to manage alongside treatment: uncertainty, shame, physical demands, and the strain on their relationships.
The questions start before the first fertility appointment
Katerina helps people prepare before they see a reproductive endocrinologist. What happens at the first consultation? Which diagnostic tests are commonly ordered, and why? During treatment, she explains the medications, why they were prescribed, and the side effects patients might experience.
As a clinic nurse, she managed 30 to 40 treatment cycles a month. She was coordinating each patient's care, but couldn't give everyone as much explanation and attention as they needed. That gap led her to offer additional education and support.
Everyone wants to know whether treatment will give them a baby
Katerina described patients becoming locked in on numbers during IVF. They want to know the likelihood of having a baby if they go through treatment.
Doctors may offer a range, but so many factors affect the outcome that a precise answer is difficult. Patients are making decisions about treatment while living with that uncertainty.
Infertility still gets treated as the woman's problem
Katerina said this was one of the most common misconceptions she heard. Even when the fertility problem is with the sperm, the partner providing eggs still undergoes the injections and egg retrieval.
She corrected her own language to “the partner with ovaries.” Queer, nonbinary, and trans people also go through fertility treatment. The person having the retrieval carries much of the physical load, alongside the emotional effects of the hormones.
Shame can make it harder to talk about infertility
Katerina described people keeping their struggles private. Sometimes, others only learn what infertility involves when someone close to them opens up.
The desire to have a child can carry cultural expectations as well as personal hopes. That makes an already difficult experience harder to discuss.
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“Just relax” can feel impossible
Patients asked Katerina whether they weren't getting pregnant because they were stressed. She pointed out that people do get pregnant while stressed. Stress isn't the single cause of infertility.
“Who's not stressed out in this society?” she asked.
When having a baby becomes the thing you think about all the time, the pressure can affect your relationship. Katerina had seen resentment, blame, and unresolved emotional pain surface during treatment. Couples were trying everything they could for something they wanted so badly.
Support can come from a team
Katerina described a team approach: a reproductive endocrinologist providing treatment, a nurse helping patients understand it, and a therapist helping them talk through the emotional strain.
Acupuncture was one part of that discussion. I talked about helping patients feel calmer, and Katerina said her clinic recommended acupuncture during IVF.
A Chinese herbal formula increased IVF live births from 19.0% to 23.3%
A trial at 12 hospitals in China studied Zishen Yutai Pill in 1,467 women aged 35 to 42 undergoing IVF with fresh embryo transfer. Live births occurred in 23.3% of the formula group and 19.0% of the placebo group. Li and colleagues, Nature Communications
Understanding your options doesn't mean you have to choose IVF
Katerina was clear: she wasn't pushing people toward IVF or a particular clinic. Her job was to give them information before they decided.
“We deserve to have information about our bodies,” she said.
Conclusion: Care should respect your body, your goals, and your limits
Infertility can test you physically, mentally, and financially. It can change the dynamics of your relationship, bring family expectations into focus, and unsettle the future you imagined. There are real reasons to feel worried, sad, angry, or overwhelmed. You do not have to feel calm about all of this.
Support may come from more than one practitioner or clinic. Fertility treatment, nursing education, therapy, and acupuncture can have different roles, and figuring out which combination works for you takes time. More appointments can also mean more expense and more information to carry. Your care team should help you weigh what each option adds and whether it fits your life.
With so much advice coming at you, make room to notice how your body feels and tell your clinicians what you are experiencing. Work with people you trust, who listen, coordinate with one another, and respect your body, your goals, and your limits. You deserve care that makes room for your budget, your energy, and what you are ready to do next.