It’s your initial consultation for fertility treatment…..
You’ve just got over the shock that you will need fertility treatment to conceive. You are probably very emotional, naturally taking over your intellectual and rational thinking. Your mind is running with a million questions.
You may be under NHS fertility care or private treatment. Everyone I have spoken with, including myself, remember coming out of the first consultation confused and needing to get more answers.
Arming yourself with the proper knowledge going into your consultation will make it easier to ask the right questions and, more importantly, get all the answers needed to make the right choices. Your clinic will have frequently asked questions, and I strongly suggest researching IVF treatments and protocols before you head to your first appointment. The more knowledge you have prior, the better you can understand and ask pertinent questions regarding the process and exactly how it would work for you.
Remember to note down your questions and discuss them with your partner before attending the consultation. I have added links below for suggested websites to find more information.
Here are some questions to consider:
How much will the treatment cost (in full)?
IVF is notoriously expensive and with many hidden costs; therefore, what you see on the price list of your chosen clinic, may not be the overall cost. Some do not add the cost of medication, which can certainly bump up the price. The clinic may offer package deals; make sure you ask precisely what you will get in this package. It is worth asking to get a FULL breakdown of your treatment cost. The clinic may also offer payment plans; ensure you understand if it’s interest-free.
What can I expect from my IVF treatment?
Obvious, I know, but everyone who goes into their consultation will leave worrying about what was said to you unless you’ve conducted your research.
Make sure your consultant takes you through the entire process, exactly how the treatment would work for you and your partner. Have other questions ready for when they explain the process, for example: how will the drugs work? Will I have any side effects? How will this specific treatment benefit me? Is there an alternative treatment?
I consistently see other questions on support forums; you should consider asking: can I have sex during treatment? Can I still exercise? What should my diet consist of to help conception? Should I take supplements? The clinic would probably have prepared leaflets on these subjects.
There are practical questions, too; is there a waiting list? When will my treatment begin? Will I get a plan? Do I need to take time from work for my appointments, or can I work around my job?
You should be aware of any concerns; you should be asking your consultant to be straight-talking about the risks and realities of assisted reproductive treatment (ART).
I went into my first treatment thinking it would work straight away; whilst this can happen, the reality is that it takes on average two or three cycles, and I wished my consultant conveyed it initially.
What emotional support can I expect?
Fertility treatment can be an emotional rollercoaster; therefore, licensed IVF clinics should always offer the opportunity to speak with a counsellor. Some clinics charge (may include it in a package) whilst others offer free counselling.
The NHS also offers to counsel you but always ask if there is a waiting list. Even if you are feeling fine, it’s always worth attending, using the sessions to discuss your feelings around fertility, helping you clear the emotions you may be holding back.
Fertility treatment is complicated, and you don’t want to feel like you’re going through a sausage factory. It would help if you felt welcomed, valued, and had a supportive team who would listen to your worries, answering your questions with empathy and understanding. Listening to your gut instinct about the impression you get from the clinic should be included in your decision making.
Will the clinic work at weekends and be flexible for my needs?
This question may sound a little strange for a private clinic, but not if you are under NHS care. Unfortunately, with the NHS, they won’t conduct transfers over the weekends, which may dictate your treatment.
You may be juggling work and fertility treatment, and managing both can be stressful. You should consider if the clinic offers early or late appointments to be flexible around work.
What are your success rates?
Although success rates have increased in the last 20-years, when choosing a fertility clinic, you will naturally seek the success rate. However, this can be misleading and should be considered closely with other factors.
There are different ways of presenting success, typically births per embryo transferred, births per egg collection, and births per treatment cycle, and it’s crucial to ask about all of these, especially the ‘live birth’ rate. Ask about rates on fresh or frozen transfers and how many cycles on average it takes patients to become pregnant and go on to have a ‘live birth’.
I’d also advise asking about the information which specifically applies to you and your circumstances; age, male factor, egg quality, how does the clinic perform in those areas? You want as much transparency as possible from your clinic.
What tests will I need?
You may have already undergone basic testing that indicated a requirement for fertility treatment. Fertility clinics offer fertility assessment MOTs (basic blood tests, ultrasound scans and semen analysis) included in your fertility package.
You should enquire if there are other tests available, including the NHS. Most private clinics provide the option of more comprehensive and advanced fertility tests, such as; Endometrial biopsy for NK cells, histology and plasma cells or ERA (Endometrial Receptivity Array Test). These tests will be ‘add ons’ to the original price, so you ensure you ask and get a full explanation of the tests and how they could help with your treatment.
There are other ‘add ons’, including embryo glue or endometrial scratch.
Whether you are receiving fertility treatment through the NHS or self-funding, before using a treatment add-on, you must ensure you have the information you need about why this has been recommended to you and how much you will be charged for it.