23 IVF Questions to Ask a Fertility Doctor at Your First Appointment

Making the decision to find a fertility clinic and schedule your first appointment is a big step. But when you finally get to meet with your new doctor, it's easy to forget that long list of questions you wanted to ask. Here's what you may want to discuss at your initial IVF consult.

In this article:

• Step 1: Find the Right Fertility Clinic
• Questions to Ask Your IVF Doctor
• Understanding In Vitro Fertilization (IVF)
• Preparing for IVF Treatment
• Is there anything I can do to increase egg quality or quantity?
• Is there a specific diet you recommend for fertility?
• The IVF Treatment Plan
• If I want twins, will you transfer two embryos?
• Should I do a fresh or frozen embryo transfer?
• Potential Risks & Side Effects of IVF
• Next Steps If IVF is Unsuccessful
• Why didn't my IVF cycle work?
• When should I consider using donor eggs?
• Set Yourself Up for IVF Success

Step 1: Find the Right Fertility Clinic

If you're just beginning this process, you may still be on the hunt for a fertility doctor that suits your needs. Finding the best fertility practice for you - and one that will give you the best chance at a healthy pregnancy - will greatly increase your odds of IVF success.

A great place to start is the Society for Assisted Reproductive Technology (SART), the primary organization of professionals dedicated to the practice of assisted reproductive technologies (ART) in the United States. On SART's website, you can view success rates at different IVF clinics (and compare against national averages), giving you a clearer picture of what to expect.

Comparing IVF Success Rates

Interpreting the data can be challenging if you're not sure what to look for, so keep that in mind as you review each clinic. Additionally, it is not always possible to accurately compare success rates, since some IVF clinics take on more complex cases than others. 

That said, it is important to explore your options, and having background information about potential clinics is key as you move forward on your journey to parenthood.

Questions to Ask Your IVF Doctor

Stepping into a fertility clinic is like entering a whole new world, and there is a lot to learn as a new patient. If you are considering in vitro fertilization (IVF) treatment, you likely have a long list of questions you want to ask your reproductive endocrinologist - but limited time to get them answered.

In order to make the most of your first fertility consultation, take some time to prepare beforehand. Here are some possible questions about IVF you may want to add to your list:

Understanding In Vitro Fertilization (IVF) 

What can I expect from a typical IVF cycle?

Ask your doctor to break down the basics of IVF! While specific fertility clinic protocols may vary, the general treatment process usually remains the same: ovarian stimulation, egg retrieval, fertilization, embryo development, embryo transfer, and finally - bloodwork to confirm whether or not the IVF cycle has been successful. 

What are your clinic's IVF success rates?

Some fertility clinics prominently feature their success rate data, while others require a little more digging to find. While you may already have a sense of a clinic's stats before your first appointment, it's a great time to ask the doctor about success rates in relation to your age and diagnosis. 

Is IVF the right treatment pathway for me?

IVF can be used to overcome a variety of fertility issues, including blocked or damaged fallopian tubes, male factor infertility, ovulation disorders, and unexplained infertility, among others. It can also be used by LGBTQ+ couples or single individuals wishing to have a child.

Despite its wide application, IVF does not guarantee a pregnancy, and success rates vary depending on factors such as age, cause of infertility, and clinic protocols.

Not all people who struggle to conceive require the help of IVF. Your doctor should want to perform a comprehensive evaluation of your current fertility to rule out certain issues first, not simply recommend IVF as the only treatment option. 

You may also want to ask:

• What are some potential scenarios where IVF would not be recommended?
• What other fertility treatment options does your practice offer?
• Does your practice have genetic counselors on staff?

What fertility tests are necessary to determine IVF suitability?

Before beginning any kind of fertility treatment, you will typically undergo a series of diagnostic tests to assess your current ovarian reserve, the health of your fallopian tubes and uterus, hormone levels, and other things that may be impacting your fertility.

Common fertility tests include:

• Cycle Day 3 and Day 21 blood work
• Transvaginal ultrasound
• Hysterosalpingogram (HSG)
• Sonohysterogram (SHG or SIS)
• Anti-Mullerian hormone testing
• Semen analysis (for male partner)

Learn more about fertility testing by downloading our free guide.

Preparing for IVF Treatment

What lifestyle changes are recommended before starting IVF?

Making certain diet and lifestyle changes before beginning treatment can improve your chances of success. These adjustments aim to enhance overall health, optimize fertility, and ensure your body is in the best possible condition for an IVF cycle.

Both partners (if applicable) should consider these changes, as they can impact egg and sperm quality, as well as the ability to carry a pregnancy to term:

• Maintain a healthy weight
• Eat a balanced diet
• Limit or exclude alcohol
• Stop smoking or vaping
• Exercise regularly
• Manage your stress levels
• Review medications and supplements
• Consider environmental factors

Get our 90-Day Preconception Guide for a complete list of recommended changes.

What vitamins or supplements can I take to increase my success with IVF?

A prenatal vitamin with folic acid is the most important supplement to take since it prevents certain birth defects. Other supplements may be helpful, especially antioxidants, so speak with your doctor, nurse, or nutritionist about what they recommend.

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Is there anything I can do to increase egg quality or quantity?

It depends! If you are what we call a "poor responder" to fertility medications and naturally make very few eggs, it may be difficult to increase production. Often, different stimulation medication protocols are tested to see if the numbers can be increased, but that is not always successful.

In patients with a good ovarian reserve (adequate numbers of eggs in the ovary), a change in protocol or an increase in the medication dosage can up the number of eggs retrieved if the numbers in the first IVF cycle were less than expected.

Some additional medications and treatments have been suggested to possibly help increase ovarian reserve and egg quality, like antioxidants (CoQ10, vitamin E, vitamin C) or acupuncture, but the data supporting this is somewhat limited.

Is there a specific diet you recommend for fertility?

Many believe that a healthy diet rich in fruits, vegetables, healthy fats, fish, and whole grains (the so-called "Mediterranean" diet) is most beneficial and would be considered a 'fertility diet.' Speaking with a fertility-savvy nutritionist can help guide you to the best diet when you are trying to conceive.

Should we freeze sperm prior to an egg retrieval?

If your male partner suspects there may be a problem producing a sperm sample on the day of the egg retrieval (it can be stressful), then freezing a sample beforehand as a backup is a reasonable option.

Note: Be sure to freeze a sperm sample if your male partner will be unavailable or out of town on egg retrieval day. Your Care Team will help to schedule this. 

The IVF Treatment Plan 

How often will I need to come in for appointments?

During your diagnostic testing and after your IVF cycle begins, you will likely be making frequent visits to your fertility clinic. Ask about the clinic's monitoring schedule and where procedures will be performed (as some practices have multiple locations with varying capabilities). 

Is it safe to exercise during an IVF cycle?

Absolutely, but once the ovaries are enlarged and uncomfortable, you should cut back as needed based on symptoms, and should limit intense physical activity right after your egg retrieval. If you have questions about specific types of exercise, always ask your doctor.

Do you advise transferring multiple embryos to increase the odds of success?

Transferring two or more embryos at a time does not result in a dramatic improvement in success rates, but it does result in a tremendous increase in twin pregnancies (and even triplets occasionally, as some embryos can split during development).

Note: Elective single embryo transfer (eSET) is now common practice at reputable fertility clinics. While transferring more than one embryo may be approved in certain circumstances, this usually requires additional counseling in order to understand the potential risks.

If I want twins, will you transfer two embryos?

It is recommended to transfer back a single embryo in most cases, especially in patients under age 38 or those who are transferring embryos that have undergone testing and been found to be normal.

Twin pregnancies are much higher risk and are often complicated by premature delivery. This can leave children with significant impairments, including lifelong challenges such as cerebral palsy or autism. It can also cause higher-risk pregnancies with a greater chance of hypertensive disorders and gestational diabetes. It is safest to have children one at a time.  

Note: IVF used to cause a high amount of twin pregnancies, but this is no longer true. As a result of a concerted effort to reduce multiple pregnancies with IVF by transferring a single embryo at a time, the twin rate has become very low (<6% nationally in 2021). 

Should I do a fresh or frozen embryo transfer?

If you are doing preimplantation genetic testing (PGT) of your embryos, you will have to freeze them and not do a fresh transfer since it takes a week or two to get the results. Also, if you are at risk for ovarian hyperstimulation syndrome (OHSS), it may be recommended that you freeze all of the embryos rather than do a fresh transfer since getting pregnant in that cycle can worsen hyperstimulation symptoms.  

Some doctors are recommending freeze-all cycles for many of their patients due to concerns about the lining of the uterus not being ideal in an IVF cycle due to the high levels of hormones that occur during the ovarian stimulation phase of IVF.

Doing a later transfer in a natural cycle or in a hormone preparation cycle can result in a more normal endometrial lining and possibly improve the chances of pregnancy.

Note: While some research points toward frozen embryo transfer success rates being slightly higher, the data isn't conclusive - and most doctors agree that both fresh and frozen embryo transfers work well in the majority of cases. 

Should I have my embryos genetically tested?

If the genetic parents of the embryos are carriers for a heritable disease, then you should absolutely consider testing the embryos to avoid having a baby with a serious or life-threatening condition.

If you simply want to screen your embryos for chromosomal abnormalities, the benefits of PGT increase with the age of the woman providing the egg. Chromosomal testing is most often recommended for women over 35 because it can help reduce the risk of miscarriages that result from reproductive aging.

A detailed discussion about this testing with your doctor, and possibly with a genetic counselor, can help you make this decision.

Should I stay in bed after my embryo transfer?

Evidence suggests no benefits to bed rest after an embryo transfer. You should always listen to your body during the IVF process, but it is fine to resume normal activity after transfer.

Potential Risks & Side Effects of IVF

Are there any risks associated with IVF?

Like any medical procedure, IVF comes with its own set of risks and potential side effects. Your doctor should always be transparent and upfront with you about any potential issues to help you make the most informed decision. They may bring up possible risks such as:

• Ovarian Hyperstimulation Syndrome (OHSS)
• Multiple pregnancies (twins, triplets, or higher order multiples)
• Emotional and psychological stress

Note: You may also want to ask how their clinic handles potential complications,  whether they have 24-hour access to medical staff in case of emergency, or if they offer a Patient Advocate or mental health counseling to manage the stress of treatment.

Is there a high risk for cancer if I do multiple IVF cycles?

There has been some concern that fertility medications can cause breast, ovarian, or uterine cancer. These cancers are more common with infertility, so it is difficult to know whether the reason for the cancer is the infertility itself or use of the medication.

In current studies that take into consideration the increased risk of cancer due to infertility, there does not seem to be an increased risk of cancer due to fertility medications alone.

Next Steps If IVF is Unsuccessful

What if fewer eggs are retrieved than expected?

During morning monitoring appointments, your Care Team will perform ultrasounds and bloodwork to estimate the amount of follicles present in your ovaries. However, not every follicle has a retrievable, mature egg.

Smaller follicles often have eggs that are immature and may not be released from their attachments to the follicle wall. Your doctor will do their best to estimate the number of eggs they will get during your egg retrieval, but won't know the final count until after your procedure.

When should I consider using donor eggs?

This is a difficult question, and a very personal, emotional decision. It is important to weigh the chances of success doing IVF with your own eggs versus IVF with donor eggs, the costs involved, and your views on using a donor.

Donor conception is not for everyone. Some patients feel certain they would never use donor eggs, whereas others are more open to the idea. When the chance of success with your own eggs gets to be so low that you and your doctor decide you are best served by using donor eggs, that is the time to consider them.

Why didn't my IVF cycle work?

Not every IVF cycle or transfer results in a successful pregnancy, not even with genetically tested, "normal" embryos. Sometimes it just takes multiple attempts to achieve success.

If your IVF cycle is unsuccessful, you will likely be scheduled for a follow-up visit, which can be very beneficial. This conversation allows you and your doctor to review the stimulation protocol and embryology to see if there are any identifiable factors that may have led to the lack of success.

While incredibly frustrating, a "failed" IVF cycle can reveal helpful information that can be used to improve outcomes for your next cycle. For example, adjusting stimulation medications or changing laboratory procedures, like trying intracytoplasmic sperm injection (ICSI) if fertilization was poor in the first cycle.

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How long do I have to wait before starting another IVF cycle?

It is usually recommended to wait one month in between IVF cycles to allow your body time to "reset" and recover, but there may be some exceptions made depending on your situation. 

How many IVF cycles should I do?

The answer depends on many factors, including how your IVF cycles have been going, what the prognosis is for success in subsequent cycles, and how many children you wish to have. There is no absolute limit, but additional IVF cycles may be beneficial if your prognosis for getting healthy embryos is still good, but pregnancy just hasn’t happened yet.

Note: If you are planning on having more than one child, you may want to consider doing more than one IVF cycle to store additional embryos for future use.

Set Yourself Up for IVF Success

While IVF is a complex process affected by many different factors, there are a few important things you can do to give yourself the best odds of success. Here are our top tips:

Evaluate Your Insurance Coverage

Look into your fertility coverage prior to starting IVF and ask if there are limitations on your coverage or if your insurer requires a specific order for treatments that you can do. For example, some insurers require you to undergo a certain amount of IUI cycles before moving on to IVF.

Others won’t allow you to do additional IVF cycles if you already have frozen embryos in storage. Understanding the details of your coverage will help you make informed decisions about which treatment pathway to choose.

Understand the Biological Clock

With IVF, age is the most important predictor of success. Reproductive aging includes a decline in the quantity and quality of eggs. This means that it is more difficult to stimulate the ovaries to get eggs and that the embryos created are more likely to be abnormal, especially in women over 40.

Build a Support Network

Make sure you have support from your partner, family, or friends, or try joining a peer support group. While this process can feel incredibly isolating, remember - you are not alone.

Make a Self-Care Plan

Learning how to manage stress during fertility treatment is crucial. Options for stress reduction include yoga, meditation, acupuncture, and exercise. Some people choose to work with a counselor to help navigate the mental toll of infertility.

Be sure to speak with your personal Care Team about these and other options.

Stay Organized

Make sure you write things down and follow instructions carefully. Some instructions must be followed exactly (like timing of the trigger shot prior to egg retrieval) or the cycle can be adversely affected. If you're unsure about an aspect of your protocol or have questions about an upcoming procedure or appointment, always reach out to your fertility clinic team.

Moving Forward with IVF

It's no secret that the fertility treatment process can be overwhelming. Never be afraid to ask your doctor and team detailed questions and ask for support and resources. Being an informed participant on your IVF journey will help you feel more empowered, prepared, and confident as you take these next steps.

Always maintain open lines of communication with your Care Team, and remember that they are there to help guide you through this entire process. Your experience and outcomes matter to them, and they want to see you succeed.