13 Oct 10 Questions to Ask at Your Initial IVF Consultation

In vitro fertilization (IVF) is a commitment, and patients form a close relationship with both their fertility physician and the center’s staff. Whether IVF is the last stop on your fertility treatment journey or you’re starting there due to your infertility diagnosis, your initial IVF consultation offers the opportunity to ask any questions you have, as well as any concerns.

10 Things to Ask Before Embarking on IVF

Use this opportunity to ask as much as you want. The clearer you are, and the more you understand the IVF process and the expected outcomes based on your reproductive and fertility treatment history, the more prepared you will be for what lies ahead.

Here is a list of 10 questions to help guide the conversation at your upcoming IVF consultation.

1. What does my IVF timeline look like?

Your IVF timeline will depend on many different factors.  Whether or not you are planning to do a cycle using embryos which will be created and then frozen, whether or not you are planning to do genetic testing on the embryos, and the type of embryo transfer protocol that is recommended will all impact the IVF timeline.  In general, from the start of an IVF cycle until the time that you know you are pregnant, it takes between 8 to 12 weeks from start the finish.  You will talk to the IVF nurse coordinator at a time after your IVF consultation with your physician, and the IVF nurse coordinator will want to know your personal work obligations, holiday travel plans, and vacation schedule, all of which are important as you are looking at the overall timeline.

2. How does billing work? Is there financing available?

IVF cycles are expensive, but there are plenty of ways to reduce those costs if you plan ahead of time. Examples include:

• Your personal health insurance coverage
• Special discounts for active military and veterans
• Potential coverage from fertility-specific insurance carriers (such as Prodigy)
• A variety of IVF packages are typically offered at most infertility clinics, allowing you to have flexibility in the number of IVF cycles you plan to do or your goals related to egg or embryo banking

If you decide to do IVF at Virginia Fertility & IVF, one of the financial coordinators or insurance coordinators will contact you after you have your initial IVF consultation visit with your doctor in order to give you the information about the costs of the different packages / options for IVF.

3. What types of testing do you recommend

Some patients may need to participate in a fresh round of infertility testing. This is the case when you are a new patient or transferred from a different clinic. Insurance companies also often require ovarian reserve (egg supply) testing to be updated every 6 months or so.  While we respect the work of our colleagues at other fertility centers, we only trust accurate testing, results, and diagnoses that we control from start to finish. We may also want to perform additional testing if your male partner hasn’t undergone a complete round of male factor infertility tests.  We will ask him to complete a semen analysis at our clinic even if he has done one before, in order for the embryologists and andrologists to make determinations about insemination plans for IVF.

If this is your first infertility consultation and you’ve never had infertility tests before, odds are the specialist will want:

• Blood tests for a general panel, as well as hormone level testing
• Various imaging tests to see if you have anatomical features making conception or pregnancy more difficult (blocked tubes, scarring, fibroids, endometriosis, symptoms of PCOS that were overlooked in the past, etc.)
• Male factor fertility tests
• Genetic screening testing for autosomal recessive conditions to determine if you or your partner carries any of the most common genetic conditions in the population

And any other tests required to complete a comprehensive analysis of your reproductive health.

4. Do you have an age limit for IVF?

Most, if not all, clinics set a cap on female patient age for IVF. There are varying reasons for this, the most common being that even with ART, fertility rates drop drastically after 40. Most infertility clinics limit IVF with your own eggs to an age less than 45 years, but you should ask your clinic the upper age limit at which IVF with your eggs is offered.  This age limit will be different for IVF with your eggs compared to IVF with donor eggs, so make sure to clarify with the clinic what the age cut-off is for your planned treatment.

5. Do you recommend I/we consider egg or sperm donation?

If IVF is the last stop after multiple failed IUI attempts or you’re embarking on a new series of IVF cycles, it may be time to determine whether donor eggs or sperm would increase your chances. Egg and sperm quality are essential to conception and healthy full-term pregnancy.

If we suspect that age, chromosomal, or genetic abnormalities are part of the problem, this is a good time to discuss the benefits of using donor egg or sperm to increase your chances of success. Keep in mind that a healthy woman in her early to mid-40s using donor eggs has the same IVF success rates as a woman in the donor’s age bracket.

6. Which medications will I be taking?

Again, we vary injectable fertility medication types and dosage depending on the patient’s reproductive history to optimize the results and minimize potential medication side effects. So don’t assume you’ll be taking the same medications as a friend or co-worker who’s had IVF.

7. Do you provide training for administering injectable IVF medications?

We understand that most patients are not comfortable with self-administered injections. That’s especially true for those with needle phobias. Our nurses walk you through the process and provide detailed training, so you become more comfortable with the process. We also share tips and tricks to minimize pain or discomfort associated with fertility injections.

8. Do you recommend any additional lifestyle changes?

By now, we’d bet you’ve changed your diet and cut out unhealthy lifestyle choices to prepare your body for a healthy pregnancy and improve fertility changes. The most important lifestyle change to make if you are considering IVF is for both partners to stop smoking or using other tobacco products.  Smoking dramatically decreases the success of IVF, and most clinics require that both partners stop smoking or using tobacco at least 6 weeks before the start of the IVF cycle.  You want to have the best chances of pregnancy possible with IVF, given the significant physical, emotional, and financial costs, so make sure to do your part and stop smoking as soon as possible.  The other lifestyle change that many individuals or couples find useful as they are facing IVF is finding a way to get the emotional support you need as you embark on IVF, which is known to have its share of roller coaster moments. Virginia Fertility & IVF has partnered with MotherTree Wellness to offer group counseling sessions to all of our patients, provided free of charge to our patients.  Alternately, you could seek individual counseling through this wonderful organization or other groups if needed.

9. Are there add-on services you recommend in our case?

Odds are your physician already shared recommendations for additional testing or procedures s/he feels would optimize your IVF outcome. However, it’s still worth checking in. It may be that sperm analysis reveals a need for ICSI (intracytoplasmic sperm injection) or PGT (preimplantation genetic testing) to give the sperm and resulting embryos an extra boost.

10. Do you recommend fresh or frozen IVF transfers?

In most cases, fertility doctors recommend using frozen IVF transfers due to the higher success rates.  Frozen embryo transfer is also necessary if you are planning to do preimplantation genetic testing (PGT-A) on your embryos.

Virginia Fertility & IVF Is Here to Answer All of Your IVF Questions

There’s no such thing as a silly or irritating question. The physicians, nurses, and staff at Virginia Fertility & IVF understand IVF feels overwhelming until you’ve received the answers you need and are in your cycle groove. Contact us to schedule an initial consultation or to ask any questions that emerged since seeing you last.