Questions to ask your fertility clinic

Choosing a fertility clinic is a big, expensive decision, and you often have to make it while you are anxious and short on time. A good list of questions is your best protection. The answers, and the way a clinic responds to being asked, tell you a great deal about whether it is right for you.

This page collects the questions worth asking, grouped by topic, with a note on what a clear, honest answer sounds like. Take the checklist at the end into your consultation.

How should I prepare before the appointment?

A little preparation makes the consultation more useful and can save you repeating tests you have already done.

Do I actually need IVF, and what are the alternatives?

IVF is not always the right first step. A careful clinic looks into why you are struggling before recommending the most intensive option. Ask:

• Why are you recommending IVF for me specifically, rather than a simpler option such as IUI or timed medication?
• Have we identified a cause for our difficulty conceiving, or is this "unexplained"? What tests would rule things in or out?
• What are the alternatives, what do they involve, and why are they less suitable for us?
• In what situations would you not recommend IVF?

A good answer connects the recommendation to your own test results and history, not a blanket claim that IVF is the best option for everyone.

How do you report your success rates?

This is where clinics most often mislead, usually not by lying but by choosing the most flattering way to present numbers. Independent studies of clinic websites have found success rates reported in many different ways, often without saying whether they refer to a pregnancy or a live birth, or to a cycle or a single embryo transfer. Ask precisely:

• Is that a live-birth rate (a baby born) or a pregnancy rate? A positive test is not the same as a baby.
• Is it per cycle started or per embryo transfer? Per-transfer numbers look higher because they leave out cycles that never reached transfer.
• What is the rate for my age group and my diagnosis, using my own eggs? Headline figures are often lifted by donor-egg or genetically-tested cycles.
• Over what time period, and how many cycles? A strong result from one good year on a handful of patients means little.

Who will actually perform my treatment, and how good is the lab?

In IVF, the embryology laboratory matters as much as the doctor. It is where eggs are fertilised and embryos are grown. Ask:

• Who performs the egg retrieval and the embryo transfer, a senior consultant or a trainee? Will I meet them beforehand?
• Who runs the embryology lab, and how experienced is the team?
• How many cycles does the clinic do each year? Very low numbers can mean a less practised team. This is not decisive on its own, but it is worth knowing.
• Is the clinic registered, and at what level? In India every clinic must be registered with the National ART & Surrogacy Registry, and Level 2 clinics are authorised for advanced procedures including IVF and ICSI. You can confirm a clinic's registration in our registered-clinics directory.
• Does the clinic hold any additional accreditation (for example NABH), and is the lab quality-certified?

What will it really cost, and can I have that in writing?

Package prices vary a lot, and the quoted figure often leaves out things you will almost certainly need. In India a standard IVF cycle is frequently quoted at around ₹1.5 to 2.5 lakh in larger cities, but medication, ICSI, anaesthesia, embryo freezing, and genetic testing are commonly charged separately and can add 30 to 50 percent or more to the final bill. Ask:

• Can I have a written, itemised cost estimate before I commit?
• What is included in the quoted price, and what is not? (Medications? ICSI? Monitoring scans? Anaesthesia? Freezing and annual storage?)
• Roughly what should I budget for medication, given my likely protocol?
• Can the cost change during treatment, and will you discuss any change with me first?
• If there are multi-cycle packages or refund schemes, what are the exact terms?

Are these add-ons and extra tests actually backed by evidence?

Many clinics offer optional "add-ons", which are extra procedures or tests promised to improve your chances. The problem is that most are not well supported by evidence. The UK regulator (the HFEA) rates common add-ons on a traffic-light system, and in its most recent review it rated none of them green, meaning none had clear evidence of improving the chance of a baby for a typical patient. The European society ESHRE recommends against the routine use of several, including endometrial receptivity testing (ERA) and reproductive immunology treatments. Common examples include assisted hatching, embryo glue, endometrial scratch, time-lapse imaging, PGT-A, ERA, IMSI, and various immunology tests and treatments.

This does not mean every add-on is useless. A few may help specific patients. But you deserve to know the evidence before you pay extra. Ask:

• What is the evidence that this add-on will improve my chance of a live birth?
• Is it recommended for someone in my situation, or offered to everyone?
• What does it cost, and what happens if I decline it?
• Will you, or anyone at this clinic, benefit financially from me choosing this add-on?

The same caution applies to extra tests sometimes sold as essential, such as sperm DNA fragmentation or endometrial receptivity assays, where routine use is not well supported.

What about consent, support, and what happens if a cycle fails?

How a clinic treats you across a cycle matters for both your outcome and your wellbeing. Ask:

• How and when will you explain the consent forms, and can I withdraw consent later?
• Who is my point of contact during the cycle, and how quickly can I reach someone with an urgent question?
• What counselling or emotional support do you offer? (This is part of good fertility care, not an extra.)
• If this cycle does not work, what happens next? Will you review what we learned and discuss whether to change the approach?
• What are the risks and possible side effects of the medications and procedures for me?

What are my rights as a patient in India?

India's ART (Regulation) Act, 2021 gives you specific protections. Knowing them helps you recognise a clinic that is doing things properly:

• Registration is mandatory. Every ART clinic must be registered with the National Registry. An unregistered clinic cannot legally provide IVF.
• Written informed consent is required before any procedure, and a couple may withdraw consent before the embryo is transferred.
• You are entitled to counselling about your chances of success and the procedure's costs, benefits, risks and disadvantages, so you can make an informed decision.
• There must be a way to raise a grievance. Clinics are required to keep your information confidential and to have a complaints process.

We explain what registration does and does not tell you on the how we evaluate clinics page.

A checklist to take with you

• Why IVF for me specifically, and what simpler alternatives were considered?
• Have we identified a cause, or run the tests to rule things out?
• Is your success rate a live-birth rate, per embryo transfer, for my age, and using my own eggs?
• Over what time period and how many cycles is that rate based on?
• Who performs the retrieval and transfer, consultant or trainee?
• Is the clinic registered (and at what level), and is the lab quality-certified?
• Can I have a written, itemised cost estimate, including medication, ICSI, freezing and add-ons?
• Can the price change during treatment, and will you tell me first?
• For any add-on or extra test: what is the evidence for me, and does anyone here benefit financially?
• Who is my contact during the cycle, and what support is there if it fails?
• How do you handle consent, and can I withdraw it?

Frequently asked questions

Is it rude to ask a fertility clinic about its success rates?▾

No. You have every right to ask, and a good clinic will answer clearly. Ask for the live-birth rate per embryo transfer, for your age group, using your own eggs. The way a clinic responds to the question also tells you a lot.

What counts as a 'good' IVF success rate?▾

There is no single number, because success depends heavily on age, diagnosis, and whether your own or donor eggs are used. Instead of chasing a headline figure, compare like for like: live births per embryo transfer for patients similar to you. Be wary of any single blended rate shown without an age breakdown.

Should I get an IVF cost estimate in writing?▾

Yes. Ask for a written, itemised estimate that separates the base procedure, medications, ICSI, monitoring, anaesthesia, freezing and storage, and any likely add-ons. Quoted package prices often leave out items you will need, and hidden charges can add 30 to 50 percent or more. A transparent clinic provides this without hesitation.

Are IVF add-ons worth paying for?▾

Usually the evidence is weak. In its latest review the UK regulator (HFEA) rated none of the common add-ons green for improving the chance of a baby, and ESHRE recommends against routine use of several. Some may help specific patients, so ask what the evidence is for your situation, what it costs, and whether anyone at the clinic benefits financially from the recommendation.

How do I check that an IVF clinic in India is legitimate?▾

Under the ART (Regulation) Act 2021 every clinic must be registered with the National ART & Surrogacy Registry, and only Level 2 clinics are authorised for IVF and ICSI. Ask for the clinic's registration, and confirm it in the registered-clinics directory before you commit.

Next: learn the warning signs of a clinic to avoid, or start from the registered-clinics directory.