Questions to Ask About IVF
Questions to take to a fertility clinic before starting IVF: what the diagnosis is, what the odds are for someone your age, what the treatment really costs, which optional extras are being recommended, and what happens if a cycle fails.
The questions
Open any question for the note
What do you think is causing our difficulty conceiving, and which tests told you that?
Why ask it
A treatment plan should follow a diagnosis. Ask which results led to it: semen analysis, ovarian reserve, tubal patency, ovulation tracking. Unexplained infertility is a legitimate finding, but it should be stated rather than implied.
Is IVF the right next step, or is there something less involved to try first?
Why ask it
Depending on the cause, ovulation induction, IUI or surgery may come first, and some couples are advised to keep trying for a defined period. A recommendation for IVF that skips this discussion is worth a second opinion.
What is the chance of a live birth per cycle for someone my age with this diagnosis?
Why ask it
A clinic-wide average is not your figure. Ask for your age band and diagnosis, and for how many cycles that number is based on, because small samples move a great deal.
Are the figures you quote per cycle started, per transfer, or per patient?
Why ask it
The denominator changes the number substantially. Per patient across three cycles looks far better than per cycle started, and both get described as a success rate.
Do you report your outcomes to a national register, and can I see them there?
Why ask it
Several countries publish clinic-level results. A clinic that points you to the register is easier to compare than one quoting statistics it has selected itself.
Which protocol would you use for me, and why that one?
Why ask it
Protocols differ in drug type, dose and length, and the choice should connect to your test results or a previous response. If everyone gets the same protocol, ask what would prompt a change.
What is the total cost, including drugs, scans, freezing and storage?
Why ask it
Quoted cycle prices commonly exclude medication, which is large and variable. Ask for a written total estimate covering drugs, monitoring, freezing and the first year of storage.
What is not included in that price?
Why ask it
The exclusions are where budgets break: extra monitoring, a cancelled cycle, sperm freezing, a later frozen transfer, annual storage fees. Ask specifically what you pay if the cycle is stopped partway.
Which optional extras are you recommending, and what evidence supports each one?
Why ask it
A number of add-ons are sold alongside IVF without clear evidence that they raise live birth rates. Ask what each is meant to do, what it costs, and treat declining them as a reasonable choice.
How many appointments will this involve, and how much time off work should I expect?
Why ask it
Monitoring is frequent, early in the morning, and hard to reschedule. A realistic count helps you plan work rather than explaining repeated absences under pressure.
What are the risks to me, including ovarian hyperstimulation?
Why ask it
The main ones to raise are hyperstimulation, the risks of egg collection, and multiple pregnancy. Ask which specific symptoms mean you should ring the clinic rather than wait for the next appointment.
How will you decide how many embryos to transfer?
Why ask it
Single embryo transfer is standard in many places because twin pregnancies carry higher risks for mother and babies. If more than one is suggested, ask why in your case specifically.
What happens to embryos we do not use, and what does storage cost each year?
Why ask it
These decisions otherwise arrive at an emotional moment, so it is easier to think about now. Ask about annual fees, the consent forms, the maximum storage period, and what your options are when it ends.
Would you recommend genetic testing of embryos for us, and what would it change?
Why ask it
Testing helps in particular situations rather than all of them. Ask what it would alter about your treatment, how many embryos you would need for it to be worth doing, and what happens if none passes.
Who will I see at each stage, and will it be the same doctor throughout?
Why ask it
Continuity varies widely. Ask who performs the scans, who does the transfer, and who answers questions between appointments, because being passed between staff makes a hard process harder.
Who do I call at night or at the weekend if something goes wrong?
Why ask it
You want a number and the hours it is staffed, not general reassurance. Symptoms after egg collection can develop out of hours, and it is worth knowing in advance who picks up.
What counselling or support is available, and is it included in the cost?
Why ask it
Counselling is offered or required at many clinics and frequently goes unused. Ask whether partners are included and whether it is available after treatment ends as well as during it.
If we needed donor eggs or sperm, what are the rules here and how long is the wait?
Why ask it
Donor rules differ by country on anonymity, payment, family limits, and what a child can later find out. Waiting times can be long, particularly for donors of specific backgrounds.
If this cycle does not work, what would you do differently next time?
Why ask it
Asking before the first attempt shows whether there is a plan or only repetition. It also gives you something concrete to come back to at a point when clear thinking is difficult.
What would lead you to advise us to change approach, or to stop?
Why ask it
Clinics vary in how directly they discuss stopping. An answer naming conditions, such as repeated poor response or a particular result, is more trustworthy than one that treats another cycle as always reasonable.
Preparing for the appointment
Practical guidance for the conversation itself
Practical preparation
Take someone with you, and take notes
A first consultation covers a great deal in a short time. A second person hears different parts of it, and most clinics will agree to the conversation being recorded if you ask.
Ask for the plan and the costs in writing
A written plan makes a second opinion possible and lets you compare clinics on the same terms. It also protects you from a verbal estimate that grows once treatment is under way.
Set your limits before you start
Number of cycles, total spend, and the point at which you would pause are far easier to decide now than mid-treatment. Write them down so that any change is a decision rather than drift.
Which questions belong where
First consultation
- 1What do you think is causing this, and which tests showed it?
- 2Is IVF the right next step, or is there something to try first?
- 3What is the live birth rate per cycle for someone my age with this diagnosis?
- 4Which protocol would you use for me, and why?
Before you pay anything
- 1What is the total cost including drugs?
- 2What is excluded, and what do we pay if the cycle is cancelled?
- 3Which add-ons are you recommending, and what is the evidence?
- 4What does embryo storage cost each year?
Before the cycle begins
- 1Which symptoms mean I should call you straight away?
- 2Who do I reach out of hours?
- 3How many embryos will be transferred, and how is that decided?
- 4If this does not work, what would change next time?
What goes wrong
Do not compare clinics on headline rates
Which patients a clinic accepts affects its numbers, so a clinic taking fewer complex cases reports better results. Compare figures for your own age band and diagnosis, from a national register where one exists.
Do not decide on add-ons under time pressure
Optional extras are often raised close to the start of a cycle, when declining feels like reducing your chances. Ask for the evidence and the price in writing, and take a day to think.
Do not leave the emotional side unplanned
The schedule is demanding and the waiting is harder than the appointments. Arrange support before you need it, and agree with your partner in advance how you want to handle a negative result.
After a cycle that does not work
Ask for a review appointment that goes through the specifics: how you responded to the drugs, how many eggs were collected, what happened at fertilisation, and the quality of any embryos. Those details are what should decide whether the next attempt is the same or different, and they are easier to take in a few weeks later than on the day.