Top 10 Things to ask at an IVF Follow-Up Appointment

I have decided to call this the WTF appointment.

As in What the f***? and Why the f*** did this fertility treatment not work?

When IVF fails it is a real kick in the gut. Although you never really had a pregnancy, you had a whispered promise for a fortnight or so of a baby. Your baby. The one you always wanted and just assumed that when the time was right, would come to be.

So it’s only natural to project the mind forward to that baby (it was always a boy in my dreams) – what will he look like? Like mum or dad? How will he respond to the world that we have made for him? Will he play football with dad on the green outside our home? Thoughts of decorating his nursery sneak in spontaneously.

Even though you don’t quite want to go there, some part of your mind does.

I just assumed our first IVF would work. Yep my eggs were a bit fried (bordering on hard-boiled, in fact) but I thought this was our golden ticket to us becoming a family.

Until my period arrived 2 days before I was due to test. Devastation.

I was not all that happy with some aspects of the clinic we were attending at the time. Not the failure of the treatment as I know the chances are slim of pregnancy. Mainly the fact that I felt like just a number in a queue (and not someone who is going through an extremely difficult and painful process).  Nevertheless, I comforted myself with the fact that we would have a chance to analyse with our fertility doctor where things might have gone wrong, what other approaches might be useful, maybe some further testing for me etc. I since understand that a first IVF can be a little of a test drive (expensive one) to see how your body responds to a protocol of drugs.

Our WTF appointment lasted approximately 8 minutes.

We would do the same protocol again, see how it goes and not one of my questions answered. You are politely dismissed, thank you! See you in 3 months.

No you certainly will not, my friend!

Now it was a different WTF. What the f*** do we do now?

I have my amazing acupuncturist to thank for sending us in a completely different direction – where we were finally heard and really listened to (ironically even though English was not our doctor’s first language). I felt nurtured and considered as a woman and although our next IVF was not a success either (and of course that was really tough) – the support and empathy we received was priceless.

Here are my top 10 tips for what you should ask at your follow-up appointment:

1. Why do you think this treatment failed?
2. Can you discuss the quality of my eggs at egg collection and how was my endometrium lining for implantation?
3. What other protocol would you recommend moving to the next cycle to suit mine and my partner’s specific issues, and can we talk about the dosages and whether they should be increased or decreased next time?
4. What was the quality of the sperm like? Is there anything that can be done to improve this?
5. What did the embryologist think about our fertilization rate? What was the quality of the embryos? Is there anything we can do to improve embryo quality? Should we transfer more than one embryo next time (if advanced maternal age)?
6. Are there any further tests or treatments you would recommend before our next cycle? e.g. immune/blood clot testing, genetic testing of eggs/sperm/embryos.
7. Can you give me an estimated chance of our success moving into the next cycle (taking into consideration my specific age, health issues and that of my partner)?
8. What other additional treatments do you think might help us? Intralipids, endometrial scratch, assisted hatching, embryo glue, oestrogen, low aspirin dose etc?
9. Does the clinic have an egg donation scheme (if this is something you’re considering or is being recommended to you)?
10. What is the clinic procedure for IVF cycles (how many recommended) and breaks in between etc.

Please don’t leave until you get your questions answered. It really is the very least you deserve. And if you are not happy, feeling dis-empowered and ignored like I felt, be brave and take action. There are other options. There really are. If doesn’t feel right in your gut, it usually is not right. Trust your gut.

This journey is a tough one. However when emotional support and kindness is available to you when going through fertility treatment, grab it with both hands. It makes all the difference.

Need some emotional support on your treatment journey from someone who’s been through it all? Here’s how I can help.