IVF Consultation ?'s to ask

[demold]

Hi all-
I am a long time IF'er, but was always on the FT IUI boards. In 2003-2004 I did a total of 6 IUI's (with injectables) and have a DS from that- and then did another 4 IUI (again with the shots!) last year- but no luck.
I am 35, husband is 41- and I am annovulatory, with male factor starting to maybe be an issue (2 of the last 4 attempts had low count)
So- we have decided to give IVF a try, and I am going into the consult on Thursday-
I know the lingo and the protocol, but is there any specific questions I should ask?
Thanks Ladies-
Dana- Milwaukee, WI

[demold]

really....nothing? Come on, help a girl out.

[Tapey]

Hi Demold!
Sorry for your lack of replies. Are you using the same RE that you used for all of your IUIs? If so, then I am sure you won't have many questions about the clinic/staff. Here are the things that I was/am curious about while going through IVF:

Cost - I pay for everything out of pocket, so this was a big concern for me. In addition to the cost upfront for the procedure, there are many others that you will need to anticipate like the meds (which you should have an idea about since your IUIs were medicated) and anesthesia. My clinic offers an outcome based plan where you can pay a larger amount (but less than the cost of three cycles if you were to pay for them separately) and you have three full cycles (three retrievals plus as many fresh/frozen transfers until your embryos are gone) to have a baby. If you are still childless after the third attempt, they will refund a portion of your money. Also, my clinic has discounts for teachers and military. I don't know your profession, but maybe your clinic can offer some kind of discount.

Scheduling - Ask if your clinic batches cycles. This means that they will put you on the BCP so that every IVF patient they have will be on the same time line. If they do, they should be able to provide you with specific dates ahead of time. I know this was helpful to me, as I am a planner and already have my IVF dates on the calendar for Dec.

Meds - This is the overwhelming part. My clinic provided me with a list of the meds, how to administer them, and what they are for. I liked having this reference. It might be too early to ask during the consultation, but the meds are an inevitability. Ask where you will be purchasing the meds from. If you are paying out of pocket, you might be able to shop around ahead of time to get the best prices. Some clinics have samples that they can offer to help with the costs as well.

Retrieval - I don't know if you will care either way, but some clinics do the retrival under anesthesia and others will just sedate you to the point where you are still "awake" and "aware" of the retrieval. I would want to know!

Transfer - Ask if your clinic allows DH to be in the room for the transfer. Some do and others don't...I liked my DH in the room!

I hope this information was somewhat helpful. Good luck!

[Tapey]

I thought of another one:

ICSI - My clinic does this regardless of male factor. I remember someone a while back being really upset because her eggs were ICSId. She got pregnant, so I couldn't understand why she was so upset, but everyone has there opinions, so if it matters to you, then ask!

[demold]

thank you so much for the response. Good luck on your Dec cycle.

[1stN44]

I did a search on the web site (which I highly recommend) for questions you may have and complied some of the ones I found below. My favorite questions are the first two:

What are the chances for success at my age? (I just about died when the Dr. told me less than 1% - but I got a BFP)

Are there any age limitations especially in regards to using my own eggs?

What protocol will you put me on?

How much will drugs cost me? (You will probably have to call the pharmacy and get a quote from them once you get your prescriptions)

Are there any other tests to do prior?

Should we consider ICSI (this is when they put the sperm in the egg)?

Most recent success rates for women your age and your diagnosis ?

How long treating infertility ?

Diet suggestions other than eating a well balanced diet ?

His availability to answer questions as they come up ?

Will you have a nurse assigned to you ?

Bed rest after transfer - why, why not ?

Baby aspirin 81mg – if and when to start taking ?

Prenatal and other vitamins/supplements to be taking ?

Exercise - any limitations ?

3 day or 5 day transfer and why ?

How many embies for transfer ?

How much is IVF? (May need to cover this first with your insurance and then verify with the doctors office - meds and procedures may have seperate coverage)

How many doc appoints can I expect?

Hope that helps and best of luck!
Lauri

[maa3]

Here is the list of questions I used to meet with local REs this month.

What type of protocol do you recommend for me? What do you use to trigger?
Do I have to take OCP and do you group patients so they start stims at the same time?
Go through their statistics. What are their live birth rates per embryo transfer for women in your age group and IF factor?
Walk me though a cycle. How many visits apprx? How are results communicated to me /by what time?
Can I combine stimulation drugs into one injection?
How long do you have to wait before appointments? Is monitoring by appt or on a walk in basis and what times are available?
Will my doctor be doing all ultrasounds and procedures or is it a rotation/ whoever is in the office?
How many follicles/eggs do you like to see? When do you trigger (what size)?
When/how often do you cancel a cycle?
When do you do icsi?
How many embryos do you like to put back?
Do I have the option to transfer only one embryo/blastocyst?
What percentage of embryos make it to blastocyst? Do you do co-culture? Do you have an ivf "clean room"? What transfer do you prefer day 3 or day 5? Which one do you typically do/had most success with? (this tells you a lot about their lab quality)
What type of embryos do you freeze? Type/quality/stage?
What method do you use to freeze them? i.e vitrification.
What supplementation do you use after a ET? i.e. estadiol, progesterone in what form IM injection or vaginal? Baby aspirin?
Is there any b/w monitoring between ET and beta test?
After a failed cycle is there a meeting to review what went wrong? How do I have to wait between cycles? How do you go about trying something different and customizing the cycle to how my body responds?
Do I have the choice of an unmedicated/natural frozen cycle?
How do you freeze embryos? Do you use vitrification?
When do you do assisted hatching?
What tests etc. would I need to do before I can start a cycle here?
What are the costs per cycle/packages you offer? How are refunds handled if ER or ET is canceled?

Hope this helps!
Good Luck!

[maa3]

That should read: How long do I have to wait between cycles?

By the way after I was done with all these questions and more the RE laughed and told me she felt like she was taking her board exam all over again.

[demold]

ask and you shall receive- thank you all. I am feeling quite prepared for my consult tomorrow.