It is often hard to balance full time work and treatment for infertility. Across a wide range of jobs, including a teacher, doctor, nurse, nanny, local government manager, city lawyer and journalist, combining treatment and work was difficult. Managing the timing of treatment appointments during a working week was tricky, especially for those who preferred not to tell work colleagues.
Belinda found that while the treatment schedule worked out perfectly for her first cycle of IUI, for her second it was really hard to manage, even though the clinic tried to help. She also had to be careful about lifting, while trying to behave normally around colleagues.
Belinda is an intensive care nurse, living with her husband. Ethnic background' White British.
So in a two week period you would have five or six trips up to the clinic?
And how do you manage to juggle that with work and things like that?
It is very difficult [laughs]. The first time it worked out perfectly and I wasn’t working on the days that I needed to go, whereas this time, it has just been a complete nightmare. I was working every day that I was meant to go. And because I am a nurse as well, then it is not you can even say, “Oh I will come in a bit later.” Because it is just not possible. So it’s a case of having to swap shifts round which is always difficult because people have plans, and it depends what hours you are working as well. So I have found that really, really difficult at the time. But literally from the point of view of not being able to swap shifts rather than anything else. But luckily the clinic are really, really good and they do try and be flexible. So that does help.
Awful. I don’t know the problem is like they advise you to take it easy and to relax, but I am not very good at that. I like to be doing things and a lot of people that I have spoken to do take two weeks off work. But that is just not – I am just not able to do it, because I just can’t take leave at short notice and unless you take sick leave which I can’t do, because I am not sick. So, yes I just have to continue working around it. And that makes it difficult. Because at work I have to do lifting and things. So you have to be careful from that point of view and because a lot of my colleagues don’t know.
Catherine, a journalist, found it so difficult combining the demands of her job and treatment, that she took a long period of time off during her first cycle of IVF.
Catherine is a writer, married with two children. Ethnic background' White British.
One minute you’re overjoyed because you can see all these follicles developing, and the next minute they’re saying, “Oh, well, we might need to leave you on the drugs for an extra day” or whatever, and you’re sort of panic-stricken. And it, it really is immensely difficult. I tried to carry on going to work when we were doing that, and after about four days I just realised that I was going to have to take some time off. Because apart from anything else it was the amount of time I was having to spend at the clinic. And I hadn’t told anyone at work, and so I had to keep lying about where I was. And I’d said that I had this series of appointments and I’d be a bit late in for work some days. And then, you know, the next day they rang and said, “Oh, can you go to Belfast tomorrow?” I was meant to be at the clinic at 9. I said, “No, no, I can’t” you know. It was just impossible actually. So I ended up taking the whole of that time until the embryo transfer off. Which was actually a really good thing to have done, because it just made it so much easier to cope. And I know some people prefer to keep working and find it easy, but I just found it really difficult. I think maybe a lot depends on the nature of your work really.
Age at interview:
Phil is a nurse, and lives with his wife, Karen (Interview 32) and her four children. Ethnic background' White British.
Because of my work commitments. I used to be a mobile screening nurse, and so I was travelling a lot. Because I travelled a lot, I would be stuck in hotels throughout the week. So if I could be there, I would be there. If I could have said to my company, “I want to be there for the blood test, for the scan, for everything else.” I would. But I couldn’t. So because of work commitments this is what I tried to get through to the second centre we were with, because I knew it impacted the first time. I was there at critical stages. I was there. I took days off. Because the idea was, I have only got xx amount of annual leave, take the days when they are needed. So the that’s the other thing about knowing about paternity leave. I didn’t know anything about that. I have only just that about this company now, about paternity leave. But I wanted to save as much annual leave for the positive result. So I couldn’t take off here, here and the next day, because a blood test, it feels like it was insignificant. Embryo transfer is important. She needs support there. Blood it’s just a stick in the arm. So I wasn’t there some of the times for those. But the important things I always tried to be there.
Others described difficulties around being able to take time off work at critical stages during treatment. Some said they felt guilty about their treatment. Sometimes women felt that they were put in the uncomfortable position of having to lie to their colleagues. However it was important to many couples to do everything they could to give themselves the best possible chance of success.
Carol is a marketing manager living with her husband. Ethic background' White British.
It is very, very difficult. Because naturally you want to share with everybody in your social network that you are having treatment but employers will automatically assume that you are going to get pregnant and then take time off for maternity and if you work for a small company then that would cause great inconvenience to them. So it has very often been a question of juggling and saying, “Well I have got a medical appointment.” And not necessarily lying but not telling the truth either. And fortunately I have had, in some weird way, I have had an ovarian cyst because of the treatment, now ovarian cysts occur naturally so I have been able to say, look I have got to go and treatment because I have got an ovarian cyst, which has not been a lie, I just hasn’t told them what the cause of the ovarian cyst was. And I did tell one employer, about a year ago, and he was very understanding but it didn’t work and the reason I told was that his wife was a midwife and I thought if he can’t understand nobody will and unfortunately it didn’t work, but they were very understanding, but most of the time it is very difficult to go into work if you have had a negative and everybody does know, so sometimes it is better not to be truthful.
Have you worked in different places?
Okay so you have moved and had sort of different environments in which to sort of manage it?
Yes, yes. I was a UK sales manager and then I have moved into marketing to try and stop doing all the travel in order to be able to get to the appointments more easily.
Age at interview:
Age at diagnosis:
Sarah is a hospital consultant and lives with her husband. Ethnic background' White British.
And it is very hard to know what to do and you feel bad having time off work because you are not poorly and then you are worried that people are going to see you if you go out shopping and think well she looks all right to me. And all that kind of thing. You don’t want to tell everybody your business but then similarly, you feel a bit conspicuous being off work. But I the longer term I don’t regret having that time off work, because I think you have got so many regrets after at least the one regret you have not got is, if only I had taken better care of myself. If only I hadn’t been lifting at work or breathing in gases or whatever it might have worked. So I think it were the right thing to do to take that time off work.
But anyway before the two weeks were up anyway, I knew it hadn’t worked because I started having, you know, period pain and a bit of spotting and stuff like that, and I thought well that is that it has not worked.
Fiona, a teacher, was conscious of the disruption it caused to school management but her colleagues knew what she was going through and were kind and supportive.
Fiona is a part-time teacher. She lives with her husband and three adopted daughters. Ethnic background' White British.
From where we were living then, it was about ten minutes. We lived very close and so that wasn’t a problem. It was a problem in terms of work. I was very at work, I had a very sympathetic personnel woman. I mean being a teacher it is quite hard, because you are missing lessons, you know, you are causing a lot of disruption and teaching is hard work. So when you are feeling really yucky, and they just said to me, “Take whatever time you need.” And they actually gave me, because our staff time tabling person was a man, this woman actually assigned another member of staff to me, who I could phone if things weren’t going right, and she would relay the message back so I didn’t have to deal directly with this bloke, he was the most sympathetic. So I would say my work were very supportive. I do know of other people where work haven’t been as supportive and people who have tried to go through it without telling anybody, whereas my work excellent, and really, really supportive when things didn’t work out. They were very good. Which was nice. Really nice. They just said to me if you need to go home at any point. If you need this, or you need that just say.
But I remember that deputy head, she was a very scary woman, she took me in her office one day and I was telling her that I was going through all of this and I think we had had one failed attempted. And she just looked at me and she said, “You will have your children.” She didn’t say where they would come from or whatever, she said, you will have your children and I often think about that, because I think she was right. I just didn’t have them the way that I originally thought I was going to have them. And I have never forgotten her saying that. I just thought wow you knew didn’t you. You know she was a very strong woman and she was right.
Managing appointments and work was easier for those who worked part-time or on flexible hours. Sandra said she had been lucky with her employers and that now she was working part-time she could make up her hours if she needed to. Saskia, a teacher, was able to manage her full time work and treatment because her clinic was open at 7am and was just ten minutes drive from home.
Saskia is a teacher. She is in a civil partnership with her lesbian partner, and they have two daughters. Ethnic background' White British.
Well they were great, because the unit opened at seven and the doctor [name] was brilliant at seeing, I would see her, because I think if you didn’t ask for a doctor you just had whoever was on scanning duty that morning. And she was just lovely and it was just really nice to always have the same… anyway, so you’d go at seven and you could be out by quarter past seven.
I worked ten minutes away from it so I’d drive there do it, drive to work. All done and dusted. I had to get up a bit earlier but apart from that it couldn’t have been easier, and then the actually procedure, the insemination would only be one afternoon every couple of months. So… I could just say I had a medical appointment or, that wasn’t a big deal. So that’s pretty easy to manage.
Another difficulty of balancing work and treatment was feeling up to the job while coping with the side effects of treatment and drugs. Belinda, who had been through a couple of cycles of IUI at the time of the interview felt exhausted from her treatment and struggled with her 14 hour days as a nurse. Mary was a lawyer in the City of London when she went through her first IVF treatment. She bled frequently through her pregnancy and although she tried to keep working, it was very stressful. Her boss was very supportive and she was eventually given the rest of her pregnancy off work. Mike and his partner had anticipated how difficult it would be to combine work and treatment and his wife had quit work while she went through treatment.
Belinda is an intensive care nurse, living with her husband. Ethnic background' White British.
Very surprised. I didn’t realise how hard it was going to be physically. Like the side effects of the drugs. The fact that they make you feel so emotional and tired and like with the first cycle of treatment I am just about absolutely exhausted and I just really put it down to having to go over the clinic sort of like one day I would be doing like a fourteen hour day at work and the next morning I would be having to get up early then to go the clinic and then I would be doing another fourteen hour day. And I was doing that for about a week and so I really put it down to that. Whereas this time I sort of like had a slightly easy work schedules but even still I have been absolutely exhausted. And it is actually one of the side effects of the drugs. You have to make yourself do things. Like you have to think I really need to be doing something, but all you want to do is lie down and go to sleep. Like in the evenings, like, I am just fast asleep on the settee and then go off to bed and sleep and yes, like the side effects aren’t particularly pleasant and they do make you emotional. And like I have been quite lucky in that because I am on a lower dose of the drugs because of the treatment then in some ways that makes it easy whereas I know for IVF then you have a much higher dose. So I hate to think what the side effects are going to be like if I ever have to go that far.
Age at interview:
Age at diagnosis:
Mary is married with three children. Ethnic background' White British.
And what was the next twelve weeks, must have been quite an anxious time.
It was really dreadful. I was very lucky that I had had an amazing boss at work who had been very supportive. I had to tell him at this stage where I had to take time off for this, that and the other. And he was fantastic. He just said, “Whatever time you need, just take it, take it in the middle huge trials and everything.” He was fantastic. But I went back to work, whereupon I started having bleeds and fainted outside the office. We had three ambulances came, I was collapsed in the foyer, they had brought me in off the street. And then I had huge bleed when I was in the High Court. I rushed around and tried to get a Court Order or something out and rushed back to the office. Anyway and then I had a huge bleed and I had to go straight to the clinic, where they scanned and said, “The baby is still there, the baby is still there.” I think that was about, I must have been about two weeks, two weeks or three weeks then and then I just kept having bleeds for the whole time. And they were very good at the clinic because although you normally… it was a private clinic and you had to pay for scans, they waived that and they scanned me every week free of charge, just so I would know, but I did have about, in the first twelve weeks I had about five bleeds or so, or even more. And you can imagine I was like, beyond hysterical. And when I think after the big bleed my boss called me in and said, “There is nothing more important than bringing this child into the world. You are to go home. We will pay you your full salary but you have got to go home for this pregnancy because I can’t send you off to the High Court and worrying about you when you are off and out.” So I stopped work, which I think was… well physically I was very, very drained. Physically I was weak. I had had the whole IVF thing, all the emotional trauma and it was probably the right decision but emotionally it was very, very difficult then because I was entirely focused on this pregnancy and I kept thinking this is my one chance. If I screw this up, this is one my chance. And everything is resting on it. And so then I became paralysed with fear and didn’t do … I didn’t move and watched Richard and Judy virtually the entire eight months and I was so frightened and I did have bleeds and scares and the whole time and even at five months I was being rushed to hospital with cramps and pains. So it was an ordeal all the way through really.
In addition to the practical difficulties of combining work and treatment, it was also sometimes difficult to perform as normal at work because of the emotional side effects (see ‘IVF & ICSI’ and ‘Difficult parts of IVF & ICSI treatment’). Even without the side effects of hormonal treatment the whole process could be very draining emotionally. As Belinda said, “It is just so draining. But it just takes everything out of you”.
People understandably worried about whether their employers would think they were less committed to their work and some concluded that it was better to tell their boss, at least, what was going on. Carol decided to tell one employer, thinking he might be sympathetic because his wife was a midwife, and he was very understanding.
Many people preferred not to tell colleagues about their treatment but this could, in turn, increase their sense of isolation,
Brian is a manager in a local council and is married to Michelle (Interview 21). Ethnic background' White British.
I don’t think I shut it out. I think more hardened because I found it. I don’t think I found it difficult to talk to people. I don’t think there is anyone I could actually talk to about. I talked to my parents and we talked to [wife]’s parents and my sisters and you know brother-in-law. So I did talk to people but 90% of the time I’m at work or with work friends. I didn’t talk about it with them. No one knew anything about what was happening until the very end of our treatment at work. And I think that’s more because I was embarrassed because you put on a persona at work don’t you? Well men do anyway.
[Laugh] So what prompted you to tell people?
Physically because I had to have time off and if I hadn’t had to have time off for which. Local government are very good. You get time off for lots of different things if it’s needed. And I looked through our handbook at work actually just on the off chance and I saw that it said for IVF treatment, you’re allowed compassionate time off for that because with IVF treatment it can take, you know, you might need to be off three or four days, individual, just to be going back for different blood tests and whatever and medication. So I thought it was going to be very awkward for me to have to take it off as leave if they asked questions. So that, that’s when I went and told my immediate superior. It was actually useless I have to say and a woman which surprised me. I’d thought I was actually, get lot of sympathy and she didn’t know how to handle it amazingly.
Yet the friend who’s the same level as me at work my friend [name] was brilliant and I still talk to him about it now. And that surprised me because I thought it would have been the opposite.
So what did she do that wasn’t what you expected? What did she say of it?
I don’t know. I expected to go to her and not to be a shoulder to cry on but I thought she’d be a lot more sympathetic and would have given the opportunity to talk about it. And she just didn’t. She didn’t. She really didn’t know how to handle it. She just said to me, ‘Ok well if you need the time that’s fine. Don’t worry.’ End of conversation. Not if you want to talk about it come and talk about it or if you, you know, if you just want someone to chat about anything to come to me which is what I would do with my staff. Maybe it’s two ways of management or maybe she just thought, well that’s a man with a man’s problem. He needs a man to talk to. I don’t know.
And your friend, how did he react?
He was brilliant yeah. It’s amazing you talk to one person and he turned around and said, ‘Oh yeah well so and so and so and so are going through the same problem. My friends are doing this and my sister’s had to adopt because they’ve been through the same problem.’ And you start realising that you’re not isolated. You’re not the only person who has this problem. But it makes you feel like it doesn’t it? Well it does yeah. He was brilliant really helped. I couldn’t have a cry with him but yeah he was really good.