Most people walk into a first fertility consultation without knowing what to ask, and walk out with a treatment quote instead of a diagnosis. These twelve questions change that.
For each one there is a version of the answer that tells you the clinic thinks clearly, and a version that tells you it does not. You do not need medical knowledge to hear the difference.
About your diagnosis
1. “What is my actual diagnosis?”
Good answer: names a specific finding, or says the workup is incomplete and lists what is still needed.
Poor answer: moves straight to recommending treatment without naming a cause.
2. “Have both of us been fully investigated?”
A male factor is involved in roughly half of infertility. The basics are ovarian reserve, a pelvic ultrasound, tubal assessment, thyroid and prolactin, and a semen analysis.
Poor answer: months of female testing before any semen analysis is ordered.
3. “Is there anything simpler we should try first?”
This is the most revealing question on the list, because an honest answer can cost the clinic an IVF cycle. Ovulatory problems from PCOS often respond to ovulation induction. A polyp can be removed at hysteroscopy. Selected tubal and endometriosis cases respond to fertility-preserving surgery.
Poor answer: “At your age IVF is the fastest route” — offered before tubes and sperm have been assessed.
About outcomes
4. “What is your live birth rate per cycle started, for my age group?”
Note every part of that. Live birth, not pregnancy. Per cycle started, not per transfer, which excludes everyone who never reached transfer. For my age group, not the clinic average.
Poor answer: a single headline percentage with no denominator, age band or year.
5. “How many cycles might I realistically need?”
Cumulative rates rise across the first three to four attempts for many patients. A clinic planning honestly will say so rather than implying one cycle will do it.
6. “What would make you change the plan?”
Good answer: describes specific findings — poor maturity, failed fertilisation, arrest at day three — and what each would trigger.
Poor answer: “We would try again.”
About the treatment itself
7. “Will I see the same doctor throughout?”
Fertility care is a sequence of judgement calls that build on one another. The clinician who watched your response in cycle one is best placed to design cycle two.
8. “Is the laboratory on site, and who handles my embryos?”
The embryology laboratory does more to determine outcomes than almost anything else. Ask whether it is in the same building and how many embryologists work there.
9. “Will you recommend ICSI, and on what grounds?”
ICSI is indicated for significant male-factor infertility, surgically retrieved sperm, and previous fertilisation failure. With normal semen parameters it has not been shown to improve live birth rates over conventional IVF, and it adds cost.
Poor answer: “We do ICSI for everyone.”
10. “How many embryos will you transfer?”
Single embryo transfer is the modern standard. Transferring two raises the twin rate, and twin pregnancy carries substantially higher risks of preterm birth and complications for mother and babies. Transferring one at a time across frozen cycles gives a comparable cumulative chance.
Poor answer: two embryos offered as a way to improve your odds, with no mention of twin risk.
11. “Which parts of this are established, uncertain, or experimental?”
Assisted hatching, embryo glue, endometrial scratch, time-lapse selection, immune therapies and PRP are all widely sold. For most, evidence of improved live births is limited or absent. The HFEA publishes independent ratings.
Good answer: the clinic sorts its own offerings into those three categories without being defensive.
About money and records
12. “What is the total cost in writing, and can I have my records?”
Total means consultation, medication, monitoring scans, retrieval, laboratory fees, freezing, annual storage, the later transfer, and any add-on. Medication is a large and variable share.
On records: your stimulation sheets, embryology reports and transfer notes are yours. A clinic should hand them over without friction. You will need them if you ever seek a second opinion, and reluctance here is one of the clearest warning signs there is.
A quick way to score the consultation
| Signal | What it suggests |
|---|---|
| Named a diagnosis before naming a treatment | Good |
| Ordered a semen analysis at the first visit | Good |
| Gave live birth per cycle started for your age | Good |
| Volunteered that something might be unnecessary | Very good |
| Quoted one headline success percentage | Caution |
| Recommended IVF before tubal and sperm assessment | Caution |
| Add-ons presented as standard | Caution |
| Pressure to decide today, or an expiring discount | Walk away |
One question to ask yourself
Did you leave able to explain, in your own words, what the problem is and why this treatment addresses it?
If not, that is not a failure of understanding on your part. It means it was not explained. Ask again, or ask someone else.
How we answer these
Our position is that IVF should follow a diagnosis rather than replace one, and we say so when a simpler or corrective route is realistic. Care is led by the same consultant throughout — Dr. Ramya Ramalingam or Dr. Jeya Nirmala R. We advocate single embryo transfer, and we label techniques as established, uncertain or experimental, including our own.
You can read more about how we approach fertility care, or browse our fertility education guides.
Frequently asked questions
What should I take to a first fertility consultation?
Previous test results, operation notes, and complete records from any earlier fertility treatment. Both partners should attend.
Is it rude to ask a clinic for its success rates?
No. It is a standard question and any clinic should answer it with a denominator and an age band.
Should my partner come to the first appointment?
Yes. A male factor is involved in roughly half of infertility, and evaluating both partners together saves months.
How do I know if ICSI is really needed?
Ask which specific indication applies — severe male-factor infertility, surgically retrieved sperm, or previous fertilisation failure.
Can I ask for my embryology records?
Yes. They are yours, and you will need them for any second opinion.
Does a first consultation commit me to IVF?
No. Many couples need only investigation, advice on timing, or treatment of one correctable problem.
Speak to a fertility specialist in Chennai
To discuss your situation, book a consultation. International patients can begin with a records review and online video consultation, and Bengali-language guidance is on our Bengali patients page.
Sources and further reading
- HFEA independent ratings for IVF add-ons
- NICE clinical guideline CG156 on fertility problems
- NHS guide to IVF
- ASRM Practice Committee documents
Medical review and disclaimer
This article is general patient education, not a diagnosis or a substitute for individualised medical advice. Treatment decisions must be made by a qualified clinician who has reviewed your history and test results.
Consultant — Reproductive Medicine
Dr. Jeya Nirmala R
MBBS, MD (OG) · Fellow in Advanced Obstetric & Gynaecological Ultrasound
Dr. R. Jeyanirmala, MBBS, MD (OG), is Consultant in Reproductive Medicine and Obstetrics at Jeevan Mithra Fertility & Women Care Centre, Chennai, and a Fellow in Advanced Obstetrics & Gynaecological Ultrasound. She graduated from Madras Medical College and completed her MD at the Institute of Social Obstetrics (KGH), Madras Medical College. She has managed complex referral obstetric cases…
Full profile and appointments →