Being informed and asking the right questions helps you make the best decisions for your treatment.
Before Starting IVF
Success Rates
Ask about YOUR specific chances:
✓ What’s my expected success rate based on my age and diagnosis?
- Not the clinic’s overall rate
- Your specific situation
- Per cycle and cumulative
✓ How do you define success rate?
- Pregnancy rate or live birth rate? (Live birth is what matters)
- Per embryo transfer or per egg retrieval?
- Fresh or frozen embryos?
✓ What are your success rates with my specific condition?
- Endometriosis, PCOS, male factor, unexplained, etc.
- More relevant than overall clinic statistics
✓ How many cycles do most people in my situation need?
- Realistic expectations
- Financial planning
Treatment Protocol
✓ What IVF protocol do you recommend for me and why?
- Long protocol vs. short protocol
- Antagonist vs. agonist
- Medication types and doses
- Rationale for your case
✓ Could I be a candidate for mini-IVF or natural cycle IVF?
- Less medication, lower cost
- Appropriate for some cases
✓ How will you customize the protocol if I don’t respond as expected?
- Flexibility and adjustment
- Backup plans
✓ What medications will I need?
- Complete list with purposes
- How to take each
- Side effects to expect
- Cost estimates
Expected Outcomes
✓ How many eggs do you expect to retrieve?
- Based on your AMH and antral follicle count
- Realistic range
✓ What if I respond poorly or don’t respond to medications?
- Cycle cancellation criteria
- Next steps
- Financial implications
✓ How many embryos typically make it to blastocyst stage with my egg quality?
- Realistic expectations
- Prepares you emotionally
Embryo Transfer
✓ How many embryos will you transfer?
- One or two?
- Factors influencing decision
- Your input in decision
✓ Do you recommend single embryo transfer (SET)?
- For your age and situation
- Multiple pregnancy risks
- Success rates with SET
✓ What day do you typically transfer – Day 3 or Day 5?
- Preference and rationale
- Flexibility based on embryo development
✓ Who will perform my embryo transfer?
- Your doctor or another provider?
- Experience level
About Testing and Add-Ons
Genetic Testing
✓ Do you recommend PGT (preimplantation genetic testing) for me?
- Benefits vs. costs
- Who benefits most
- Types available (PGT-A for aneuploidy, PGT-M for specific conditions)
✓ What are the pros and cons of PGT in my situation?
- Improves success rates?
- Reduces miscarriage risk?
- Risks of embryo biopsy
✓ Will PGT increase my chance of taking a baby home?
- Evidence for your age group
- May help older women
- Less benefit for young women with good embryos
Additional Procedures
✓ Do you recommend assisted hatching?
- What is it and why?
- Does it improve my success?
- Additional cost
✓ Should I have an ERA test (endometrial receptivity analysis)?
- Tests optimal transfer timing
- Who benefits?
- Cost vs. benefit
✓ Do I need a hysteroscopy before starting?
- To check uterine cavity
- Remove polyps or fibroids
- Additional procedure and cost
✓ Do you recommend immune testing or treatment?
- Controversial area
- What evidence supports it?
- Costs
Be wary of expensive add-ons without strong evidence.
About the Clinic
Laboratory and Staff
✓ Tell me about your embryology lab and staff.
- Embryologist qualifications
- Lab accreditation
- Quality control measures
✓ What are your fertilization rates?
- With standard IVF vs. ICSI
- Blastocyst development rates
✓ What’s your embryo freezing and thawing survival rate?
- Should be 95%+ with vitrification
- Important for frozen embryo transfers
Clinic Practices
✓ Will I see the same doctor throughout?
- Continuity of care
- On-call system
✓ Who will perform my egg retrieval?
- Your doctor or whoever is on call?
- Does it matter?
✓ What are your monitoring hours?
- Early morning appointments?
- Weekend availability?
- Conflicts with work schedule
✓ How quickly do you return calls and messages?
- Communication system
- Nurse line availability
- After-hours support
✓ What support services do you offer?
- Counseling
- Support groups
- Financial counseling
- Coordination with insurance
If You’ve Had Previous Failed IVF
Learning from Past Cycles
✓ Why do you think my previous cycle(s) failed?
- Specific reasons if identifiable
- Egg quality, embryo quality, implantation, other
✓ What would you do differently?
- Protocol changes
- Additional testing
- Different approach
✓ Should I have additional testing before trying again?
- Hysteroscopy
- Immune testing
- Genetic testing
- Thrombophilia panel
- Mock cycle/ERA
Moving Forward
✓ What are my chances of success with another cycle?
- After one, two, or more failures
- When to consider other options
✓ How many IVF cycles should I try before considering alternatives?
- Realistic expectations
- Diminishing returns
- Emotional and financial considerations
✓ If this doesn’t work, what would be the next step?
- Donor eggs
- Donor embryos
- Surrogacy
- Other options
About Risks and Complications
Safety
✓ What are my specific risks?
- OHSS (ovarian hyperstimulation syndrome)
- Multiple pregnancy
- Procedural risks
- Based on your characteristics
✓ What are your OHSS rates?
- Prevention strategies
- How they manage if it occurs
✓ What’s your multiple pregnancy rate?
- With 1 vs. 2 embryos
- Triplet or higher rates
✓ What happens if I get pregnant with triplets or more?
- Selective reduction options
- Clinic policy and referrals
Monitoring
✓ What warning signs should I watch for?
- When to call
- Emergency symptoms
- After-hours contact
✓ How closely will I be monitored?
- Frequency of ultrasounds and blood work
- During stimulation
- After transfer
Financial Questions
Costs
✓ What exactly is included in your IVF package price?
- Medications included or separate?
- ICSI included?
- Monitoring visits?
- Embryo freezing?
- Storage fees?
✓ What additional costs should I expect?
- Itemized breakdown
- Hidden fees
- Optional add-ons
✓ What’s the cost if the cycle is canceled?
- Partial refund?
- Credit toward next cycle?
✓ How much are frozen embryo transfers?
- Future cycle costs
- Storage fees
Payment and Insurance
✓ Do you accept my insurance?
- What’s covered
- Pre-authorization process
- Out-of-network benefits
✓ Do you offer payment plans or financing?
- Monthly payments
- Interest rates
- Qualification requirements
✓ Do you offer any shared-risk or refund programs?
- Money-back guarantees
- Who qualifies
- Terms and conditions
✓ When is payment due?
- Upfront or in stages
- Medication payment separate
About Frozen Embryos
Freezing and Storage
✓ What’s your embryo freezing method?
- Vitrification (flash freezing) preferred
- Survival rates
✓ How long can embryos be stored?
- Legally and practically
- Degradation over time (minimal with vitrification)
✓ What are the storage fees?
- Annual costs
- Payment schedule
✓ What happens to embryos if something happens to me or my partner?
- Legal documentation required
- Disposition options
Using Frozen Embryos
✓ What’s the process for a frozen embryo transfer (FET)?
- Timeline
- Medications
- Monitoring
✓ Are success rates with frozen embryos different from fresh?
- Often similar or better
- Depends on embryo quality
✓ Can I transfer my embryos to another clinic?
- Process and costs
- Embryo shipping
Lifestyle and Preparation
Before Starting
✓ What should I do to prepare for IVF?
- Lifestyle changes
- Supplements
- Weight management
- Timeframe for optimization
✓ Should my partner do anything specific?
- Sperm quality optimization
- Lifestyle factors
- Supplements
✓ Any restrictions I should follow?
- Diet
- Exercise
- Sexual activity
- Work schedule
During Treatment
✓ Can I work during IVF?
- Time off needed
- Restrictions
- Frequent appointments
✓ Can I exercise during the cycle?
- Type and intensity
- When to stop
✓ Any foods or supplements to avoid?
- Alcohol
- Caffeine
- Medications
- Herbal supplements
✓ Can I have sex during treatment?
- When and when not
- Why restrictions exist
Emotional Support
Mental Health
✓ Do you have a counselor or therapist you recommend?
- Fertility counseling
- Support services
- Support groups
✓ How do you support patients emotionally through this process?
- Check-ins
- Resources
- Community
✓ What should I do if I feel overwhelmed?
- Mental health resources
- When to seek help
Special Circumstances
If Using Donor Sperm/Eggs
✓ How does using donor [sperm/eggs] change the process?
- Success rates
- Legal considerations
- Timing
✓ What are my options for donors?
- Known vs. anonymous
- Donor selection process
- Costs
If Considering PGT
✓ How does genetic testing affect the timeline?
- Freezing all embryos
- Waiting for results
- FET cycle
If You Have Frozen Eggs
✓ What’s the process for using my frozen eggs?
- Thaw survival rates
- Fertilization and development
- Compared to fresh cycle
Getting a Second Opinion
When to Seek Another Opinion
Consider second opinion if:
- Multiple failed cycles without clear explanation
- Significant disagreement about protocol
- Uncomfortable with recommendations
- Expensive add-ons pushed
- Not satisfied with communication
- Major decision ahead (donor eggs, etc.)
Questions for second opinion doctor:
✓ Here’s my history. What would you do differently?
✓ What do you think is preventing success?
✓ Do you recommend any tests or treatments my current doctor hasn’t mentioned?
✓ Would you do the same protocol or something different?
Second opinions are normal and appropriate. Good doctors support this.
Red Flags to Watch For
Warning Signs
Be cautious if doctor:
- Guarantees success
- Pushes expensive add-ons aggressively
- Dismisses your questions or concerns
- Recommends treatments without clear rationale
- Has unusually high success rate claims (too good to be true?)
- Poor communication or hard to reach
- Doesn’t customize treatment
- One-size-fits-all approach
Trust your instincts. You should feel heard and respected.
Taking Notes and Following Up
During Appointment
Bring:
- List of written questions
- Notebook or device
- Partner or support person (extra ears)
- Previous medical records
Ask permission to record – complex information, helps review later.
After Appointment
If you don’t understand:
- Call back and ask again
- Request nurse to explain
- Ask for written materials
- Research from reliable sources
Follow up in writing:
- Email summary of your understanding
- Confirms both on same page
- Creates documentation
Remember
You are the customer. This is your body, your money, your future family.
Good doctors welcome questions. They want informed patients.
No question is stupid. If you don’t understand, ask again.
You have the right to:
- Understand your treatment
- Question recommendations
- Seek second opinions
- Choose a different clinic
- Take time to decide
The right doctor will:
- Answer questions thoroughly
- Customize your care
- Communicate clearly
- Respect your concerns
- Partner with you in decisions
IVF is too important to proceed with doubt. Get your questions answered.