You've just been told you might need IVF

First, nothing needs deciding today

This is going to feel urgent. Almost none of it is urgent this week. Referrals take time, waiting lists take time, and clinics are open next month too. Deciding slowly is not the same as losing time, and any clinic that makes you feel otherwise is worth a second thought.

This is hard. There is no version of it that isn’t. We’ll say that once and then get on with being useful.

What IVF actually is, in one paragraph

IVF means eggs are collected from the ovaries and mixed with sperm in a lab dish. If an egg fertilises and starts dividing, it becomes an embryo, which is watched for a few days and then placed into the womb. One full go at that is called a cycle. It takes roughly four to six weeks from starting medication to finding out, and most of that time is scans, injections and waiting.

Roughly what happens, in order

1. Tests for both of you. Blood tests and scans for one partner, a sperm analysis for the other. Male factor is involved in around half of cases, so both of you get tested. If only one of you is being investigated, ask why.
2. A consultation where a plan is suggested. You are allowed to take that plan away and think about it.
3. Ovarian stimulation — around ten to fourteen days of daily injections, with scans every few days.
4. Egg collection — a short procedure under sedation. Home the same day, sore for a couple of days.
5. The lab — a few days of phone calls telling you how many eggs fertilised and how the embryos are developing. This part is out of your hands entirely and it is horrible.
6. Embryo transfer — quick, no sedation, feels like a smear test.
7. The two week wait, then a test.

The three things to sort out early

1. Whether the NHS might fund any of it. This depends enormously on where you live. Ask your GP before you pay for anything privately, because in some areas private treatment affects later eligibility. How NHS funding works.

2. What it actually costs. Not the headline price. The whole bill, including medication, tests and freezing. People budget £5,000 and spend £8,000. Build a realistic picture.

3. What you’ll be offered on top. Around three quarters of patients end up having at least one add-on, most of which do not have strong evidence behind them. Add-ons, explained honestly.

Both of you, not one of you

Almost everything written about IVF speaks to the person having the injections. That leaves the other partner standing in the corner of the room with nothing to do and nowhere to put any of it. There is a whole section for the supporting partner: For partners.

Before your first appointment

Take a list. Take each other. Write the answers down, because nobody remembers this appointment properly. Questions to take with you.