What To Ask Before Starting IVF
I know IVF can feel overwhelming. Sometimes we just want to trust the process and proceed—but I truly believe IVF is like running a marathon: the more prepared you are, the better you train, the easier it will be. Because while we can't control the entire outcome, we can control your experience, your knowledge, and your understanding of what’s happening. And that matters.
Let’s start with a quick overview of IVF, and then I’ll share the top questions you should be asking your care team before you begin.
IVF in a Nutshell: What’s Actually Happening?
When we do IVF, the goal is to get one month’s group of eggs to grow, not to tap into your entire supply.
I like to explain it like this: Think of your ovary as a vault. Every month, a group of eggs is released from that vault. The size of that group depends on your age and your ovarian reserve—things like AMH levels and antral follicle count. What we’re doing in IVF is trying to grow that specific month's group—not the entire vault.
If you're 30, you might have around 20 eggs in that month’s batch. But your body isn’t designed to grow all of those at once—so IVF protocols override the natural selection system, allowing us to grow more than just the “biggest bird.”
Suppression + Stimulation = Your IVF Protocol
I break IVF protocols down into suppression and stimulation:
Suppression helps reset the system by leveling the playing field. This might include medications like estrogen, progesterone, testosterone, birth control pills, or Lupron.
Stimulation is typically about two weeks of hormone shots, mostly FSH (follicle stimulating hormone), to help multiple eggs grow.
During this process, you’ll come in for monitoring (ultrasounds, blood work) every few days. Once your follicles are ready, you’ll have an egg retrieval under anesthesia. After that, eggs are fertilized, embryos grow in the lab, and then:
Embryos may be frozen and genetically tested
You may go straight into a fresh transfer (less common)
Or prepare for a frozen embryo transfer (FET) in a future cycle
Why Most People Need More Than One IVF Cycle
Here's the truth: not every egg becomes a baby.
Let’s say we get 20 mature eggs:
About 75–80% fertilize
Half of those may grow into embryos
And only a percentage of those will be genetically normal (varies with age—about 50% if you're in your early 30s)
So if you’re hoping to have three kids, you likely need more than one egg retrieval to make enough embryos. That’s called embryo banking, and it’s something we need to plan for.
The Top Questions to Ask Before You Start IVF
Here are the essential questions you should ask your doctor before you begin. These are game-changers for setting expectations, making confident choices, and feeling in control.
1. What Is My Expected Egg Count?
You should know how many eggs we expect to grow in a cycle based on your ultrasound and hormone levels. It’s not a guarantee, but it’s a baseline to help plan your journey.
2. Based on My Family Goals, Will I Need More Than One Cycle?
Tell your doctor how many children you want. Then ask:
“If everything goes average, do you think I’ll need more than one egg retrieval?”
This helps you mentally and financially prepare.
3. Why Did You Choose This Protocol for Me?
You deserve a personalized protocol—not a one-size-fits-all plan. Your doctor should be able to explain why this protocol works best for your diagnosis, egg count, and goals.
4. What Will My Monitoring Look Like?
Ask:
Who does the ultrasounds—doctor, nurse, tech?
Will I get a calendar in advance?
Will I need to go to multiple locations for monitoring?
These details impact your daily life during IVF and how much time you’ll need to take off work or adjust your schedule.
5. How Will I Get Instructions and Updates During the Cycle?
Make sure you know:
Who’s communicating with you (nurse, doctor)
How updates will be delivered (phone, portal, email)
How quickly you can expect responses
This is critical for feeling supported and avoiding unnecessary stress during your cycle.
6. What Happens After the Embryos Are Created?
So many patients get stuck here. They finish egg retrieval and then… wait.
Ask:
How will I get results?
Will someone reach out to me?
How do I schedule my FET?
What’s the timeline?
You should never be left wondering what’s next. IVF is already a waiting game—let’s not make it worse.
Bonus: How Can I Ask Questions Along the Way?
You need to know how to ask questions if something comes up. Is there a direct line? A nurse line? A messaging portal?
You cannot advocate for yourself if you don’t know how to communicate with your team.
Final Thoughts
IVF can feel like a lot. And it is. But it’s also an incredible tool that helps many people grow their families. You can’t control every step, but you can control your preparation, your understanding, and your ability to ask questions.
