We hear a lot about in-vitro fertilization (IVF) these days. It may be a celebrity who shares their family building journey using IVF, a plotline on our favorite television show or simply, a friend who knows another friend who did it. However, if you’re considering IVF, it can be incredibly helpful to fully understand the procedure and options that go along with it so you can feel like an empowered patient!
When your reproductive endocrinologist meets with you about IVF, don’t hesitate to ask questions. This is your time and your body. The doctor is there to support and educate you so now is not the time to be shy! Grab your notebook, and write down what you want to know. Here are some suggestions:
1. How long does the IVF process typically take?
Everyone’s situation will be different, but be sure to ask their estimated time frame from the start of the IVF cycle to the end. It might be helpful to bring a calendar to the appointment to check for any important dates, work travel, or other things that may need to be scheduled around your cycle dates.
2. Are any additional tests needed before starting?
Make sure to ask about all medical records and previous tests on file so you can be sure no further testing is needed before starting IVF.
3. What medications will you recommend for our situation?
Different medications are typically recommended for each unique case. Make sure you understand why the doctor has selected those in particular and you are aware of any side effects.
4. If you have a diagnosis like PCOS, ask the doctor how the protocol he/she is recommending will ensure you don’t have Ovarian Hyperstimulation Syndrome (OHSS).
Ask if there’s anything you should be aware of (symptoms of OHSS) to be on the lookout for to make them aware.
5. Are there additional procedures they recommend? What are the risks?
Additional procedures such as ICSI (intracytoplasmic sperm injection) or PGT-A (preimplantation genetic testing) and/or a variety of other steps may be suggested for your IVF cycle. Make sure to ask for explanations to determine if they are the right options for you and your partner.
6. What are the typical costs associated with IVF? Do we pay all upfront, in monthly installments, or will insurance cover any related costs?
Every clinic will have a system in place for payment. While some ask for a large deposit at the beginning, others may have a guarantee in place, where you pay a large amount for multiple IVF cycles until you get pregnant. Additionally, medications are typically ordered separately through specialty pharmacies and may not be included in the IVF costs from your clinic. Call your insurance to see if there are any fertility-related benefits.
7. Will training be available for injections?
Most IVF protocol includes some type of injection. If you are not used to handling needles and/or administering medications, be sure to clarify the training process. Many times, the nurses at the clinic are more than happy to help. They may also have online videos to assist you.
8. How many doctors will I see?
You may have a main doctor, but when you come in for routine appointments during your IVF cycle, it’s not uncommon that you might see others in the practice, especially for ultrasounds. This isn’t an essential question but it can help with expectations as you’ll know how many people you’ll be dealing with (or not).
9. What is the method for selecting embryos for transfer? Would you recommend a day 3 or day 5 transfer, and why?
There is a grading system available for selecting embryos that have the highest chance of survival. Ask what their system is, how many they recommend to transfer at a time, and what their process is for cryopreservation if any embryos remain. Be sure to ask for clarification on the difference between a day 3 and day 5 transfer and what the benefits are for each.
10. Does the doctor recommend a freeze all cycle?
A ‘Freeze All’ cycle is similar to the in vitro fertilization (IVF) process but all of the embryos are immediately frozen for future transfer to the woman’s uterus. There are some potential advantages to doing a Freeze All cycle. Some studies have indicated a higher chance of pregnancy when freezing the embryos first as opposed to transferring a fresh embryo into a woman’s uterus.
11. What can be expected on the transfer day?
For many, this is one of the most exciting times in the IVF journey – transfer day! Your doctor should walk you through what can be expected and how to prepare.
12. How many embryos are you recommending we transfer?
To be clear: more and more clinics and doctors lean towards eSET, which is elective single embryo transfer. This is to reduce the amount of pregnancy complications you could have with a multiples pregnancy PLUS quite often, twins and triplets end up in the NICU. Therefore, they usually recommend one but for one reason or another, your doctor may suggest otherwise.
13. What do I do/who can I call if I have additional questions?
If at any time you have questions, whether prior to starting your cycle, in the middle, or even during your 2-week wait, make sure you have the name of someone available at the clinic who can answer your questions – day or night.
We highly recommend taking notes at the appointment. Much of the information you hear will be new to you, so give yourself some grace. It’s ok to not remember every single thing they say – that’s what follow-ups are for!
Also, while some appointments don’t require both that partners attend, if it’s possible, it can be helpful having someone with you. If for no other reason than you have someone to turn to and ask, “What did the doctor say again about exercising while getting hormone injections?”
Lastly, if for any reason something doesn’t feel right or you’re concerned about the IVF protocol being recommended, don’t be afraid to advocate for yourself. You can ask the doctor to meet with you again or even get a second opinion to gain additional insight. Going through infertility treatment can be an undertaking and you should feel both comfortable and confident pursuing it.
I’m a freelance writer and an avid women’s health advocate. I am a Forbes Women Contributor and have had pieces in Time magazine, Parents Magazine, Huffington Post, and ScaryMommy. As an infertility subject matter expert, I’ve been interviewed on news outlets such as CNN, NPR, FOX, NBC, and BBC America, plus, I was featured in the documentary, “Vegas Baby”. My blog, “The 2 Week Wait” was awarded the Hope Award for Best Blog from Resolve: The National Infertility Association and was also named the “Best IVF Blog” by Egg Donation Friends. You can follow me on Twitter or Instagram.