You’re at your initial consultation with your prospective reproductive endocrinologist. After the doctor gives you a brief overview of the clinic, he or she asks you if you have any questions.
You were so nervous about the appointment that you had no idea what to ask. Or maybe you were scared to ask questions, for fear of not sounding very intelligent.
I was really nervous at my first RE appointment. It took me a few weeks to work up the courage to call to schedule the appointment. Once I did, I did have a few basic questions ready. My doctor and I had a really fruitful and productive conversation that sowed the seeds of a positive working relationship.
Of course, later I thought of more questions. But, since we’d already established an open-door policy and a good level of comfort and rapport with one another, I found it easier to go back to him later with more questions.
Try not to feel shy about asking questions. After all, your doctor wants to make sure you understand your diagnosis and treatment options. That old adage about there being no dumb questions really holds true here.
Here are 10 good questions to ask your doctor. You can write these down and take them with you to your appointment so you don’t forget them. They’ll help keep the conversation going, and as you and your doctor continue to talk, more questions might come up.
The first 5 are questions to ask at the initial consult; question #s 6-9 are good to ask when determining your course of treatment, after you’ve had initial testing. #5 should actually be asked at both of those occasions. #10 is just fun!
Question #1: What is your rate of success and how is it calculated?
For this question you not only want to make sure that the clinic has a strong rate of success, but you also want to know if success rates are based on number of pregnancies or number of live births. These are two different things. Ask about live birth rates for different treatment options for a woman or couple with similar diagnosis, age and treatment plan. You’ll have a clearer idea of what you might be able to expect from treatment.
Question #2: What type of testing will you do to determine my fertility issue and how long will it take?
Your doctor should be able to clearly outline the tests he or she is planning to perform on both you and your partner and how long it will take. Then he should be able to recommend during a follow-up appointment to discuss your results and recommendations for treatment.
Question #3: Does the clinic provide any emotional counseling, mind-body connection resources, or other resources?
Fertility treatment is a journey and chances are if you’re undergoing treatment, you’ll have an entire team of professionals to help you get pregnant. It’s a good idea to have the option to include professionals on that team to help with your emotional support. This could be a counselor, social worker, fertility coach, nutritionist, acupuncturist, or other types of professionals, and many clinics do offer access to these types of services.
Question #4: How much do the different treatment options cost? Will the clinic help me work with my insurance company or work out other financial/payment options?
Cost is a very real concern with fertility treatment. As if the process weren’t stressful enough, including the stress of not being able to get pregnant that brought you to the clinic in the first place. The astronomical costs of treatment are overwhelming. Some clinics can work directly with your insurance company to make this part easier for you. The clinic may also be able to work with you if you’re paying for treatment procedures out-of-pocket. The doctor knows that the financials are a source of stress for many couples. Your doctor is usually expecting this question. He or she is ready to refer you to the clinic’s financial services department to help you.
Question #5: How will we communicate during this process?
Communication is key during fertility treatment. The relationship that you have with your fertility specialist is unique and requires a close partnership with outstanding communication. Most doctors aren’t going to give you their personal cell phone number, but you do want to make sure that you have access to him or her when you have questions about your care. Some doctors prefer that you direct all questions or concerns to your nurse, knowing that the nurse will involve the doctor when it’s necessary. Will communication be primarily by email or by phone? Do they have a policy to return your calls within a certain timeframe, for example, one business day? Whatever the communication practices are, you want to make sure that your team is responsive to you, that they get back to you in a timely manner, and that you’re comfortable with how communication will flow.
Question #6: Based on my test results, what are my options?
Your doctor should be ready to present to you not only what your test results are, but additional information on what those results mean. How do your test results influence his or her recommendations for your treatment. In my case, my FSH level was high and my AMH level was low. My doctor learned from this that my egg supply was low and he diagnosed me with Diminished Ovarian Reserve. Based on this diagnosis, he recommended that my best option for getting pregnant was through donor egg IVF.
Your doctor should be able to lay out your test results and resulting treatment options in a similar way.
Question #7: Which option do you recommend I try first and how many treatment cycles do you recommend before moving on to another option?
In addition to performing your procedures, your doctor is there to help you develop a plan for your care. I’ve written about the importance of this plan before. The plan will guide you all through treatment. A key component of the plan is which options you’re going to pursue, and at what point do you exhaust one option and move on to the next.
Question #8: Are the technologies offered here the ones I have the biggest need for?
Asking this question not only helps you determine if the doctor is right one for you, but if the clinic itself is the right place for you to pursue treatment. If you and your doctor decide that donor egg IVF is the best course of action for you, or if you need to use donor sperm, it makes sense to make sure that the clinic can offer you access to those options.
Question #9: What is my prognosis? In your opinion how likely is fertility treatment going to be successful for me?
This is a fair question to ask. Part of your doctor’s job is to manage your expectations. In order to do so you need to have a frank discussion with him or her about this question. If you had cancer, you’d certainly be asking your doctor how long you had to live. It’s the same here. You can decide what works best for you in terms of your doctor’s manner in communicating information to you. Do you prefer someone who’s more sensitive or more blunt and direct? Whatever you preference, you will want to have a doctor who can give you an honest professional opinion.
Question #10: Some more personal type of question, to build rapport!
This is just for fun. You’ll be working quite closely for some time, and he or she will come to know you (and your body) very well. If you can learn something interesting about your doctor to help make him or her a real person to you, it will go a long way to helping you feel comfortable and at ease with him or her. Think about if you were meeting your doctor at a social gathering, and he or she wasn’t your doctor. What would you make small talk about?
When I was getting ready to meet my doctor for the first time, I researched his qualifications online. I discovered that he attended medical school at the University of Texas. This is where I went to graduate school! I loved going to school in Austin, and loved living in Texas so I was really excited to see this! At our appointment I brought this up, and asked my doctor about his favorite things to do in Austin. It was a minor thing, but we both grinned from ear to ear while comparing notes about living in Texas. It started our working relationship off on a positive note.
Fertility treatment can be an overwhelming and exhausting process. Asking questions from the start and having an idea of what to expect during your treatment cycle (and why) can help you feel at ease. It can also facilitate an open relationship between you and your doctor. This is so critical for a strong working relationship.
[originally appeared at B Fit, B Fertile 4/6/17]