I Got My First Fertility Consultation Totally Wrong. Here’s 3 Key Things I’m Doing Differently.
Make the most of your fertility consultations
Instagram: @solofertility40s
I was really nervous!
And in panic mode since getting my AMH results. 0.31ng/ml sounded horribly low.
Then I scared myself further reading about ‘Diminished Ovarian Reserve’ and the dreaded graph showing the steep cliff as the number of healthy eggs declines in your 40s.
So I didn’t prepare many questions.
Overwhelmed with worry, I headed straight for my friend’s clinic in Spain, without researching any others. (Big mistake.)
I paid 120 euros for a consult via Zoom - a call that lasted about 40 minutes and in hindsight, only scratched the surface of the IVF process.
I talked about wanting to do everything possible to have a healthy baby. The doctor talked about my test results being “above average” and selected the 8.5k euro PGTA IVF package.
PGTA (a type of genetic testing to detect chromosonal abnormaltiesi) apparently, due to my age.
(But vital information was withheld - he never explained that PGTA is optional, nor that the clinic refuses to transfer aneuploids, and rather, discards them.)
It still makes me shudder to recall how poorly I managed that consultation.
But I didn’t know there was any need to ‘manange’ the consult. I assumed the doctor would tell me everything I needed to know. I assumed the clinic wanted the best for me.
Well, we know what assumptions are….
Let’s examine my biggest mistakes.
Misunderstood the context
I thought that I had to be a “good candidate” to become a patient.
That as an older woman (I was about to turn 43) and with a low AMH, I would have to get a doctor’s ‘stamp of approval’ to become a solo mother.
Oh dear.
But no one had told me what to expect; or how to prepare; or explained that no doctor or clinic is created equal.
Also, I assumed the context for the interaction would feel similar to my friendly local neighbourhood General Practitioner. Typically well meaning, empathic and keen to support.
Wrong!
The fertility world is big business. Every clinic is hungry for your cash and the service you might receive in return varies wildly. Ask any woman who, like me, has had to move clinics three times. There would be no need to move, if your first clinic was doing a great job.
The context for the consult is essentially a sales pitch - the doctor trying to convince you to part with your cash. The client, you, attempting to discern who to invest in.
It’s as transactional as spending £10k on a kitchen, or a car.
But the exchange with a fertility business involves life-changing decisions and potentially eye-watering amounts of money.
So get the context clear in your mind from the outset.
Learning: The consultation is the clinic’s opportunity to sell you, the prospective customer, their services. It’s your opportunity to establish what they are going to do in return for your money. To determine this, it’s crucial to ask good questions - but at the start, you don’t know what you don’t know.
Related read: 10 Red Flags (And Green Flags) To Look Out For When Choosing Your IVF Clinic
Too passive and redundant
“Doctor is King”!
They’re the ‘expert’ and the patient should be totally guided by the doctor’s feedback. This is the attitude I adopted in both my fertility consultations.
It’s a power imbalance that underpins most interactions with the medical world, whereby the patient is fully dependent on (and controlled by) the doctor.
In fertility world, I find this imbalance even more pronounced because the treatment is so specialist. This makes advocating for yourself even harder.
There are also so many unknowns. The first cycle is widely regarded as an experiment, to see how you respond to the stimulation medication. (And this is part of the reason why it can take many women +3 cycles to achieve a live birth.)
The interaction feels fraught when it comes to fertility because of the Big Money at stake. Thousands of pounds transferred to fertility clinics.
“The global infertility treatment market size is calculated at USD 1.70 billion in 2024 and is expected to be worth USD 3.65 billion by 2034.” [Towards Healthcare]
This means navigating dirty tricks to get your cash.
Like being told your stats are “above average” (doctor at my Spanish clinic, puffing up my hopes). Filled with false optimism, I was more inclined to give my cash to this clinic rather than another whose feedback was gloomier but realistic.
Yet I think a balance can be found - acknowledging the doctor's expertise while being proactive about your fertility journey by, for example:
preparing and asking good questions;
checking online for reviews about your prospective doctor/clinic - both on fertility sites and in forums (source feedback from other women);
seeking clarity rather than making assumptions (applies to the whole process);
reading research papers on sites like PubMed and sharing with your doctor for discussion (if they’re not open to this, you might look for another doctor).
Learning: Taking a more active role in your fertility treatment from the outset will make clear that you want a doctor / medical team who will collaborate with you, potentially across +3 cycles.
Unclear about the priority questions
Two cycles down, and now I’ve finally got a solid list.
But it shouldn’t take failed cycles to get clearer on what you need to know. Obviously it would be better to know what you need to know at the very beginning.
Some clinics provide lists of questions, such as this.
I’ve created my own list tailored to women +40. No more guesswork as you head into your consultation! I’ve included a “why“ against each question to explain the rationale for asking it.
Download them here.
What I’m doing differently
Now I realise: Customer is King (or Queen!).
Until you part with your cash, you are in the driving seat. The clinic should be trying to impress. Every exchange you have with your prospective clinic is an indication of the service you might receive.
Are they getting your name right? Have they acknowledged you’re solo or do they keep mentioning your partner? Is their pricing clear? Do they respond promptly?
Or does it feel more like you’re booking a hair appointment, rather than parting with thousands for a potentially life-changing outcome?
Pay attention to everything.
It helps me to acknowledge the transactional format of the exchange. You, the customer, are seeking a service from a fertility business, the service provider.
A business that provides a service in exchange for payment is called a service provider. The service provider performs a task for a customer, who pays for the service.
You may need to pay for a consultation to clarify the service you will receive.
Consultations in the UK are +£200 yet I’ve had plenty of free consultations in Spain, Greece, Cyprus and Albania.
(I spoke with Eugin Clinic in Spain twice. They were impressive, empathic and thorough - yet more expensive than Greece, so I didn’t move forward. I’m not getting any comission for referencing them!)
Here are three ways I’ve improved my approach to consultations:
I select the doctor I want to connect with
I prioritise medical professionals with experience of working with women +40.
And I choose who I want, rather than waiting to be assigned.
Do they have the right accreditation? Are there positive online reviews? If you want feedback from other women about a doctor or clinic, ask in a relevant forum. There are Facebook groups for the UK plus European countries.
This is one of my favourite for Europe, run by Fertility Clinics Abroad.
I try to get the doctor’s email address in advance, and send questions
If possible, I email with the consultant before paying, to confirm their experience of working with women +40.
Else I ask someone else at the clinic to confirm their expertise.
I am most interested to understand live births a doctor has achieved for women +40, and their total number of patients. This data might only be available for the clinic rather than each doctor.
Note: Many doctors seem to claim they’ve experience with women +40; that’s different to being experienced - where it is a specialism.
After the consultation
Follow up by email if anything is still unclear.
It’s your money, and as the service provider, they should want you to be completely confident and comfortable about every stage of your fertility journey. I’m not looking for nice words and vague assurances - I want to see verified data, feedback from other women and evidence of their expertise, such as contributions to research papers.
Good service providers will respond to all questions, and promptly.
(Eugin was outstanding regards willingness to inform and their level of organisation. You are given a profile on their patient portal; they uploaded your medical records and add information about the clinic.)
Coming up: Knowing when to move on if you’re not getting a positive vibe from your doctor or clinic.
If you have any questions about preparing for your consultation, email me: fertility40s@gmail.com
NEW: Resources page on Solo Fertility 40s with my favourite webinars, articles, forums and podcasts. I’m adding to this all the time so keep checking back.
NEW: 10 Important Questions for Your Consultation
Sarah x
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