Questions to take with you
The questions you only know to ask the second time round
Your first consultation
You will be given a lot of information quickly. Take someone with you if you can, and write the answers down — nobody remembers this appointment properly afterwards.
- Based on our test results, what do you think is going on, and what is still unknown?
- Are there any further tests you would suggest before we decide anything?
- What treatment options are open to us, including the ones you are not recommending?
- Is IVF the only sensible route for us, or is something less invasive worth trying first?
- What would you expect our treatment to involve, week by week?
- How long is the wait to start, and what would we be doing in the meantime?
- Do you think we may be eligible for NHS funding, and who do we ask to find out?
- What is your live birth rate per embryo transfer for people in our age group and situation?
- How many cycles do people in our situation typically go through here?
- Who will we actually see at each appointment, and will it be the same person?
- Who do we ring when something goes wrong at 9pm on a Sunday?
- What would make you advise us to stop, or to change approach?
Before agreeing a treatment plan
You are allowed to take the plan away and think about it. A good clinic will expect you to.
- Which protocol are you suggesting for us, and why that one rather than the alternatives?
- What medication will I be on, at what doses, and what are the common side effects?
- How many scans and blood tests will there be, and are they included in the price?
- How many embryos would you suggest transferring, and what is your reasoning?
- Would you recommend a fresh transfer or freezing everything, and why?
- What are the chances this cycle is cancelled before egg collection, and what happens then?
- What are the signs of OHSS I should watch for, and exactly who do I call?
- How and when will we hear about how the embryos are developing?
- What happens to any embryos we don't use, and what do we need to decide about that?
- What consent forms are we signing, and what are we agreeing to in them?
- Can we have a copy of the plan in writing before we commit?
Before agreeing to any add-on
Extras are often offered in the same breath as the treatment plan, which makes them sound standard. Ask these each time.
- Is this part of standard treatment, or is it an optional extra?
- What is the specific reason you are suggesting it for us?
- What does the HFEA rate the evidence for this as?
- What difference would you expect it to make to our chance of a live birth?
- What are the risks or downsides, including to our embryos?
- What is the total cost, including anything it makes necessary later?
- What happens to our treatment if we say no?
- Can we have the information in writing and decide later this week?
Understanding your quote
Advertised prices routinely leave things out. This list is about making the real number visible before you commit.
- Can I have the full price list in writing, including everything charged separately?
- What exactly is included in the headline cycle price?
- What is your estimate for our medication, and can we buy it elsewhere?
- Are consultations, scans and blood tests during the cycle charged separately?
- Is the HFEA fee included?
- What is charged if the cycle is cancelled at each stage?
- What does freezing cost, when does storage billing start, and how do we stop it?
- What will a frozen transfer cost later, all in?
- Are there package or refund schemes, and what are the exclusions?
- Realistically, what have couples like us ended up paying in total here?
After a cycle that didn't work
Give yourselves time before this appointment if you can. It is reasonable to ask for the review in writing as well as in person.
- Looking back at this cycle, what went as expected and what didn't?
- How did I respond to the medication, and would you change the protocol next time?
- What did the embryology reports tell you about fertilisation and development?
- Is there anything in this cycle that suggests a further test would be useful?
- What, if anything, would you do differently next time, and why?
- Do we have frozen embryos, and what would a frozen transfer involve?
- Realistically, what do you think our chances are with another cycle?
- Is there a point at which you would advise us to consider other options?
- What counselling is available to us here, and is it included?
- How long should we wait before trying again, physically and practically?
For the supporting partner
You are half of this. These are the questions that often go unasked because everyone is looking at the other person.
- What do my results mean, in ordinary words, and how much do they matter here?
- Is there anything in my results that changes what treatment you'd suggest?
- Should my sample be repeated, and how much do results vary between samples?
- Is there anything I can usefully do or change, and is there evidence behind it?
- Should I be referred to anyone else, such as a urologist or an andrologist?
- What will my partner physically go through at each stage, and what will they need from me?
- What are the warning signs I should watch for after egg collection, and who do I call?
- What am I needed for on the day, and how long will I be there?
- What support is there for me, not just for us as a couple?
- If this doesn't work, what does the conversation afterwards look like?
Three things that help in the room
Go together if you possibly can. Two people hear roughly twice as much, and one of you can write while the other asks.
Ask them to slow down. “Can you explain that in ordinary words?” is a completely reasonable sentence, and a good clinician will not mind being asked it three times.
Ask for it in writing. Plans, prices and consent forms should all be available on paper. If something can only be explained verbally, that is worth noticing.
Once a month, one thing explained properly
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