Questions for pre-IVF and post-IVF consultations

[agesandages11]

Hi there

Just wanted to share this list of questions I was sent from the Fertility Network and some other resources that might help you if you are either considering IVF, or are going into a consultation after an IVF cycle.

I'll try and make a few posts in this thread to split things up, and encourage people to add anything else they think might be useful.

Questions to ask at a pre-IVF appointment

• What are the benefits of the treatment you've recommended and why do you think it's the best option for me?
• How many patients at your clinic have had this treatment in the last two years and how many of them have become pregnant/had a baby?
• Are there alternative treatments? If so, what do they involve, and why do you think they are less suitable for me?
• What other options are available to me if this treatment doesn't work?
• How does my age affect the choice of fertility treatment?
• What drugs will I have to take, and what are the usual side effects they might have?
• Are there any alternatives to the drugs you have mentioned or already had?
• Do I have to buy them from you, or can I purchase them from elsewhere?
• Can you break down all the costs involved in this treatment? Are there any other costs that might arise?
• Is there any way these costs can be reduced?
• Do I/we get reimbursed if any part of the treatment cycle has to be

abandoned?

• What freezing facilities do you have and what is the cost of storage of embryos/sperm and for how long?
• What lifestyle changes can I make to boost my chance of success (e.g. diet, exercise, stopping smoking, etc)? How will these help?
• What kind of counselling or advice service do you provide? Is there a cost for this, or how many free sessions can I have?
• Does this clinic have a patient support group I can join, or are there other groups you would recommend?
• Could you tell me more about the assessment process you will need to carry out before giving me the go-ahead for treatment (this is sometimes known as the “welfare of the child” assessment)?
• Are there any arrangements that can be made to have scans/blood tests done at a clinic/hospital more local to us to cut down travel?
• Why do I/we need to have the blood tests you have advised?
• What provisions do you have to cover weekends and Bank Holidays?
• Do you do a “dummy” embryo transfer, or are you happy that my cervix will be OK?
• What happens next? Do I (and/or my partner) need to do anything now?
• Will we see the same doctor/ team members throughout the treatment?
• What is the cost of treatment? Cost of drugs? Cost of tests? What payment methods do you accept?
• How often will we be billed?
• How soon can I start treatment/again?
• How many times will I need to visit the clinic? Daily? Twice a day? Take time off work?
• Will there be any side effects from the treatment?
• What will happen if we don’t achieve a pregnancy?
• How long before we can try again?
• What sort of implantation failure testing can be done?
• Might DHEA help my egg/embryo quality?
• What about treatment to boost my immune system?
• Would using low dose soluble aspirin and/or heparin be beneficial in my case?
• Will you tell me how many follicles were aspirated from each ovary when I have my egg collection?
• Do you perform antagonist cycles?
• Do you do egg collection at the weekend?
• Would I benefit from having an endometrial scratch?
• What about the use of embryo glue – would I need that and do I have to pay?
• Do you offer chromosome testing/immune system testing?
• If there is an inherited disease in either of our families, would PGD (pre-implantation genetic diagnosis) be available?

Questions to ask at a post-IVF consultation
Some example queries that will need to be tailored to each individual included

1. We didn’t have an optimal cycle this time (no pregnancy and none to freeze again). What do you think is the problem? What causes the poor embryo quality is it egg, sperm or something else? What can be done to improve it?
2. Can we have the embryologist report for the quality of the eggs, sperm analysis and embryos? Was embryo transfer easy or difficult?
3. Should we change protocol? I’ve always done a long protocol with no success, should we try a short protocol (or vice-versa)?
4. Stimulation meds. I seem to be a poor responder to meds because without stims I have at least 5-6 follicles on each ovary but this always decreases when I’m on stims. Should we try natural IVF (without stim meds and taking only 1 or 2 naturally releasing eggs)? OR change the stim meds? I have done a mix of FSH ‘gonal F’ and a mix of ‘FSH & LH’ Menopur and had poor response.
5. We don’t think growth hormone made a difference do you think we should ditch this?
6. Oestrogen pills didn’t seem to make a difference either – should we ditch?
7. Is it a good idea to take a break? How long for?
8. Immunity – Can we explore the possibility I may have high natural killer cells? Or at least take immune meds (steroids) that help reduce problems like anti-ovarian antibodies?
9. What are my FSH levels? AMH levels/egg reserve?
10. Is my lining ok?
11. Am I insulin resistant?
12. Do I have Homocystein or Antiphospholipid syndrome? Blood clotting disorders that can cause miscarriage or complications.
13. Do I have thyroid issues and perhaps test for Test for TSH, FT4 and antithyroid antibodies.
14. Would the use of embryo glue be beneficial and at what cost?
15. Should I try the endometrial scratch 2-4 weeks before embryo transfer? For unexplained implantation failure.

Lots more info/guidance in these posts around failed cycles as well:

• Why did my fresh embryo transfer or FET fail?
• A guide to learn from your failed IVF cycle