What should you ask your doctor during IVF?

Ask for the numbers at every stage, and write them down. After egg collection, ask how many eggs were retrieved and how many were mature, because only mature eggs can be fertilised. After fertilisation, ask how many fertilised normally and whether conventional IVF or ICSI was used. On the day of transfer, ask how many embryos developed, what stage and grade they reached, how many are suitable to freeze, and how thick the endometrium was. These figures are what make a cycle interpretable. If a cycle is unsuccessful, the decision about what to change next depends entirely on where the attrition happened: few eggs retrieved points somewhere quite different from good embryos that failed to implant. A clinic should provide these numbers without being pressed, and you are entitled to a written summary of your own cycle.

Watch: IVF Process Explained: What You MUST Ask Your Doctor

Dr. Vani Sundarapandian explains this on the Jananam Fertility Centre channel.

At each stage

• Stimulation — how are the follicles responding, and is the protocol being adjusted?
• Egg collection — how many eggs retrieved, and how many mature?
• Fertilisation — how many fertilised normally? Conventional IVF or ICSI, and why?
• Embryo development — how many embryos, at what stage and grade?
• Transfer — how many transferred and why that number? Endometrial thickness?
• Freezing — how many suitable to freeze, and on what terms?

Why the numbers matter

A cycle is a sequence, and each stage narrows the numbers. Knowing where attrition occurred is what determines whether to repeat the same approach or change it.

Also worth asking

What the quoted cost includes and excludes, particularly medication; whether any recommended add-on has evidence behind it; and who to contact between appointments.

Related: IVF at Jananam and how to compare fertility centres.

What should you ask at each stage of IVF?

What should I ask after egg collection?

How many eggs were retrieved and how many were mature. Only mature eggs can be fertilised, so these two numbers together tell you considerably more than the retrieval total on its own.

What should I ask after fertilisation?

How many fertilised normally, and whether conventional IVF or ICSI was used. Poor fertilisation points somewhere quite different from a cycle where fertilisation was fine but embryos arrested later.

What should I ask on transfer day?

How many embryos developed, what stage and grade they reached, how many are suitable to freeze, and how thick the endometrium was. These figures are what make the cycle interpretable afterwards.

Why do these numbers matter if the cycle fails?

Because what to change next depends entirely on where the attrition happened. Few eggs retrieved points to a different adjustment from good embryos that failed to implant.

Am I entitled to a written summary of my cycle?

Yes. A clinic should provide these numbers without being pressed, and a written summary of your own cycle is reasonable to request and genuinely useful if you ever seek a second opinion.

What should I ask before starting?

What the protocol is and why it was chosen for you, what response is realistic given your age and reserve, and how many cycles may be needed. Expectations set at the start make later decisions much easier.

What should I ask if the cycle is cancelled?

Why it was cancelled, what the scans and hormone levels showed, and what would be done differently next time. Cancellation before egg collection is disappointing but informative.

Should I ask about the embryology laboratory?

It is reasonable to ask who performs the procedures and how embryos are graded and cultured. Eggs and embryos spend their most vulnerable days there.

What if I do not understand the answers I am given?

Ask again, and ask for it in writing. Fertility medicine involves a great deal of unfamiliar terminology, and no reasonable clinician minds explaining twice. Bringing someone with you, or writing the numbers down during the consultation, both help. If explanations are consistently rushed or dismissive, that is useful information about the clinic in its own right.

Clinical references

Independent clinical guidance relevant to this topic:

• HFEA — In vitro fertilisation (IVF)
• NICE CG156 — Fertility problems: assessment and treatment
• ESHRE — Guidelines and legal documents

This page summarises guidance discussed by Dr. Vani Sundarapandian, MD, DGO, MRCOG (UK), founder and Medical Director of Jananam Fertility Centre, Neelankarai, Chennai. It is general information and not a substitute for consultation.