Starting IVF is terrifying; there is no other way to describe it. Realistically, there are many words to describe IVF but there are very few that are positive (other than scientifically and medically incredible). Attending your very first appointment can be a super daunting experience; you are faced with a consultant who is telling you a huge amount of information on how they intend to create your baby. From medication they are planning to put you on, the procedure itself and the entire protocol from start to finish, it isn’t unusual for you to leave that appointment feeling like your brain is a short time away from exploding. And so, to make it that little bit easier, I’ve put together an essential guide to questions to ask at your very first IVF consultation! I also think it would be super useful if you’re attending a consultation at a new clinic; in my opinion, there’s no such thing as a stupid question, never such a thing as too many questions, and no such thing as being over prepared!
So, get your notebook at the ready and here are my top questions to ask!
TOP QUESTIONS TO ASK AT YOUR IVF CONSULTATION
Are there any further tests you would recommend we do prior to starting?
The answer to this question will quite often vary depending on your clinic, your diagnosis, and your path to treatment. If you are embarking on private treatment, clinics are probably going to be more encouraging of further tests because they have the freedom to request them as you are paying for them. If you are undergoing NHS treatment, it might be a bit more difficult as the NHS will only fund so much. They may recommend further testing, but you would potentially have to pay for them separately, so do bear that in mind. It’s a great opportunity to discuss your actual diagnosis and why you are in the clinic at all, but also rule out anything further that may hinder your results. Personally, I think knowledge is power and the more information you have, the better. If they do recommend certain tests (especially if you are paying for them!) ask why – it’s important that you get to make informed decisions based on the facts before you put your hand in your pocket.
What protocol have you chosen to put us on, and why?
Your clinic should be telling you this at your appointment anyway, but this should cover what medication you will be put on, why they have chosen this medication, whether they intend on doing IVF or ICSI, and effectively, what you will be doing from start to finish!
Is this protocol standard for all your patients or is it personalised to us?
Some clinics do have a personalised approach to treatment and will tailor a protocol to you based on all the information that they have about you and your results. However, many clinics – particularly on your first cycle – do have a standardised approach where they have a standard protocol. That doesn’t mean it isn’t a good protocol, it just means they have a standard dose etc that they put you on unless they need to tweak it during the cycle, or they have anything to suggest it won’t be adequate for you! If a personalised approach is important to you, this is something to ask, as you can perhaps ask for reassurance as to why they feel their standard protocol would be suitable for you.
What side effects can I expect from the medication?
It’s important to know that everyone reacts differently, but the standard side effects include fatigue, bloating, and sometimes bruising at the injection site. It depends on your body and your medication, but the clinic should provide you with information about the risks and the side effects – it’s always good to know what to expect!
Who do I contact if I have any questions or in an emergency?
Sometimes, our brains run away with us, and we have random questions at a random hour about our treatment. We react a certain way to medication and want to check that all is normal, or our bleed starts earlier than anticipated. Sometimes, we just can’t quite remember what was said at certain appointments, or you need to change an appointment. Or you leave this consultation and remember that you forgot to ask a question that is now burning on your mind. Asking who to contact for your questions or to discuss anything to do with regards to your treatment is a sensible thing to ask. You should also be given an emergency number, for exactly that – if anything goes a bit skew-whiff.
Are you open at the weekend or are appointments only on weekdays?
I feel this is a really important question to ask. It’s absolutely personal choice how you feel about this one, but my first clinic only offered appointments (including egg collection and transfer) which meant that I felt slightly concerned about how things would pan out in terms of embryo development and transfer. I had concerns that perhaps I triggered earlier than I was ready to because they were closed over the weekend, or that transfer happened on a certain day when the embryo could have maybe been left a day longer. I am sure the professionals know what they are doing, and if you don’t trust them complicitly then I don’t think they are the clinic for you. For me, I wanted less stress, and so I wanted a clinic I knew I could contact 7 days a week.
Is everything under one roof or am I required to travel to different locations for certain procedures and/or blood tests?
This again may not be a requirement for everyone, but I always think it is handy to know! As I’m sure you’ve probably twigged, my questions are predominantly based on my experiences and things I liked/didn’t like about my initial clinic. I certainly found it more stressful having one clinic for scans, another for egg collection and transfer (and another if it was a certain day of the week!) and having to travel to a different clinic for a blood test. I much preferred having everything in one place and not needing to constantly remember where I’m heading and finding new places.
How much is this going to cost?
IVF is expensive, that’s no secret. It’s good to be totally upfront and have the cost of the treatment at hand so you know exactly how much you’re going to pay and exactly when you need to pay it.
Are there any unexpected costs that could crop up throughout our cycle?
This is a TOP TIP! Always, always ask this question. The clinic may tell you that the cost of treatment is x, y and z, but they may not tell you initially that you may incur costs for things such as extra medication if your treatment is prolonged, an admin fee/fee for medication delivery if it is under a certain amount, blood tests they request throughout and if you are egg sharing, the cost of the cycle if you don’t get enough eggs to share. There are so many potential costs it’s a good idea to be clear and transparent and ensure you have all the information possible.
How much does it cost to store frozen embryos if we have any?
Whether your cycle is (hopefully) successful, or whether it isn’t and you decide to have a break from treatment, usually after a year your clinic starts charging you to store your frozen embryos. You can make the decision to have them discarded at this point (I really hate the word discarded for your embryos), but if you want to keep them stored to potentially use them, then you will have a fee to incur. It’s great to know in advance how much that will be so you don’t have a shock in the post a year later!
What support do you offer emotionally if any at all?
A question that isn’t important for everyone, but IVF is hard. IVF is hard and any failures are even harder; it’s an emotional time and a stressful thing to go through. Finding some emotional support is really great to help navigate these times and some clinics do offer sessions with a counsellor to help you through this time. If this is important to you and you don’t necessarily want to pay for therapy privately, it could be a good thing to explore with your clinic.
Do you recommend any add-ons, and if so, why?
Some clinics are very encouraging and supportive of certain add on treatments, such as embryo glue, endometrial scratches, time-lapse or genetically testing embryos. Others will not touch them at all. It’s worth asking your clinic what their stance is on this, and if they do recommend any, asking exactly why they want to do this, why they recommend it and why they feel it will support your case. I also recommend looking at the HFEA website – they have a traffic light system that rates the amount of research into each of these add-ons which can help you to make an informed choice. You can find the traffic light system here.
When can we start?
And the question on all of our lips when we walk into these clinics… when can we start?! I remember feeling bitterly disappointed when the clinic told me I was too close to my cycle starting to start during my next cycle. I was able to start the cycle after, but it’s always great to have an idea. Sometimes, if they do want you to undergo any further testing, it can delay your treatment, so it’s great to have an idea of a start date. It really helps arranging work and such too!
I hope this list of questions has been helpful for you and helps you to navigate your first consultation! If you’ve been through this process before, what questions do you think are vital to ask?
Let me know!
Love, Amber x