Questions to ask any IVF clinic

Choosing a fertility clinic is a large decision made at a point when most people know very little about fertility medicine, are anxious, and are inclined to defer to whoever is speaking confidently. That combination is not in your interest.

So here is the list we would want a member of our own family to take into any consultation. Ask it of us. Ask it of everyone else you see. How readily a clinic answers tells you more than the answers themselves.

About your diagnosis

• What exactly do you think is causing our difficulty conceiving?
• Which investigations led you to that, and is anything still unexplained?
• Is there any test that has not been done that would change the plan?
• What would you say the chances are if we simply kept trying naturally for another year?

About the recommended treatment

• Why this treatment rather than a simpler one?
• What would happen if we tried the simpler option first?
• What are the realistic prospects for us, at our age and with our findings?
• How many cycles would you suggest before we reassess?
• What are the risks, and how likely is each?

About add-ons

Fertility medicine has accumulated a long list of optional extras, and the evidence for many of them is weak. Some are genuinely useful in specific situations. The question is whether yours is one of those situations.

• Is this add-on necessary, or optional?
• What is the evidence that it improves live birth rates for someone like me?
• What happens if I decline it?
• What does it cost, and is that included in the quoted figure?

About cost

• Is this the full cost, or is medication billed separately?
• What is not included in the quoted figure?
• What happens to the cost if the cycle is cancelled before egg collection?
• What does a frozen embryo transfer cost separately?
• What are the annual storage charges, and when does the first fall due?
• Will I get all of this in writing before I commit?

About the laboratory

The laboratory is the part you never see and the part that most affects your outcome.

• Is the embryology laboratory on site, or are samples transported?
• Who will handle our eggs and embryos, and what are their qualifications?
• What identification checks are in place at each stage where samples are handled?
• How and when will we be told how the embryos are developing?

About continuity

• Will we see the same doctor throughout, or whoever is available?
• Who do we contact out of hours if something goes wrong?
• Who explains the results — the doctor, or an administrator?
• If this cycle does not work, will we get a proper review of what happened?

Questions about the law

These have single correct answers. A clinic that hedges on any of them should be left.

• Can you tell us the sex of the embryo or baby? The only lawful answer is no. Sex determination and selection are prohibited under the PCPNDT Act, 1994.
• Can you guarantee a pregnancy? No clinic can, and none may claim to.
• Are you registered under the ART (Regulation) Act, 2021?
• Will we be offered counselling, as the Act requires?

And ask this of us

If you take this list into a consultation here and we answer any of it poorly, tell us. We would rather know. The point of publishing it is that a centre confident in its practice has no reason to hope you never ask.