This assumes two things about you already: you're over 40, and you're doing this without a partner. Neither is a special case here — they're the baseline the questions are built from.

Women often leave their first fertility consultation more confused than when they walked in.

I had two IVF cycles before I understood what questions to ask at a consultation. I was thorough. I just didn't know what I didn't know. And in fertility treatment, what you don't know in that first appointment can cost you thousands.

The consultation adds to the overwhelm. You're expected to take in clinical information, assess a doctor you've never met, and absorb decisions with long-term financial consequences — alone, with no one in the room to catch what you missed or sense-check your instincts. It's easy to leave and realise later that the most important questions weren't asked because you didn't know what the questions were.

You've likely paid for an hour. What you get is rarely the full hour — consultations run over, and when time is tight, what gets cut first is space for anything beyond what the clinic had already planned to tell you. If you don't already know what to ask, that already-short window gets shorter still. A doctor may not spontaneously fill in the gaps you didn't know you had.

This page gives you a framework rather than a flat list. Tell it where you are in the process and it will show you which questions apply to your situation.

Take these into your appointment

Print or save as PDF — all questions, formatted cleanly for paper.

Turn this into a checklist

Mark each question as you go — told, not told, or not asked yet.

Where are you right now?

Select your situation and the most relevant questions will be highlighted. You can select more than one.

Starting out First consultation — I haven't chosen a clinic yet Assessing whether this clinic is right for you
Returning I've had a cycle before — reviewing or starting again Using previous outcomes to inform next steps
Donor eggs I'm considering or being recommended donor eggs Understanding the decision before committing
Going abroad I'm considering treatment outside my home country Spain, Greece, Czech Republic and beyond

Select a situation and the page will scroll to your highlighted questions.

Clear filter — show all equally
Your situation Focus on Why it changes what you need to ask
First consultation Stage 1 (all) + Stage 2 (core) Your first job is to screen the clinic, not optimise a protocol. Most women skip this entirely.
Returning after a failed cycle Stage 2 (core + returning) The previous cycle is data. A good doctor uses it. One who doesn't is worth noting.
Considering donor eggs Stage 1 (Q5 + Q6) + Stage 2 (donor section) The donor egg conversation has a commercial dimension as well as a clinical one. Both matter.
Going abroad Stage 1 (all) + Stage 2 (abroad) Distance removes the informal cues you'd pick up in a UK clinic. Written clarity matters more.
1

Before you book

Pre-screening questions — to ask before you commit time or money to any clinic

Most women go into their first consultation in listening mode. The clinic asks the questions; you answer them. What rarely happens is the woman screening the clinic before she hands over any money. These questions do that. If a clinic is evasive on any of them, that's useful information — before you've paid a deposit.

The four things every clinic must be able to answer clearly
1. What are your live birth rates for women aged 40–43, using their own eggs — and how is that figure calculated?
The number on a clinic's website is typically the overall rate, dominated by younger patients. Your relevant figure is for your cohort specifically — per embryo transfer, for women in your age group, using a named metric, from a named year.
A specific percentage, per transfer, for women 40–43, with a data year. Ideally from the HFEA register or equivalent national body.
2. Can you provide a full itemised quote in writing — including medications, monitoring scans, sperm costs, and storage — before I sign anything?
Headline prices reflect the procedure only. The real total includes multiple additional line items that are rarely disclosed upfront. The women least surprised by their final bill are the ones who asked for a written breakdown before they committed.
Yes — and they provide it without being pressed further. A quote that separates each line item, with exclusions listed explicitly.
3. Are you independently owned, or are you part of a larger clinic group?
Ownership affects commercial incentives — which affects what gets recommended. This isn't automatically disqualifying, but it's information worth having when you're deciding who to trust.
A direct, clear answer. Most good clinics will tell you straightforwardly.
4. What add-ons do you typically recommend for women my age — and what's the evidence base for each?
Add-ons are a significant revenue stream for fertility clinics. Some have evidence for specific patient groups. Many are offered routinely, without evidence, because patients will pay when they are frightened. A clinic that presents them all as standard is telling you something.
Distinguishes clearly between evidenced and experimental. Explains what the evidence shows for women over 40 specifically. Lets you opt out without pressure.
5. If the cycle produces no viable embryos for transfer — what happens financially, and what would you recommend next?
This is a real outcome for women over 40 with low ovarian reserve, and many women discover the financial implications only after it happens. For some, the next recommendation will be donor eggs — a significant clinical, financial, and emotional shift that deserves more than a five-minute conversation after a failed cycle. A clinic that won't discuss any of this before you've paid is worth paying attention to.
A clear written policy, provided before deposit. Frank about both the financial terms and the clinical pathway — including whether donor eggs would be the likely next recommendation, what that process looks like at their clinic, and roughly what it costs. A clinic that handles this well will also mention fertility counselling as part of any donor egg pathway. They'll recognise it's a big decision that requires specialist support.
Also ask
6. How many single patients do you treat per year, and do you have experience supporting single women through the donor sperm process?
Not all clinics are experienced or comfortable with solo patients. A clinic that treats a significant number of single women is more likely to understand the practical and emotional differences — including that there is no partner in the waiting room, no one to debrief with after the consultation.
A specific, confident answer. Not "we treat everyone the same" — which is true in clinical terms but misses the point entirely.
7. What is your process for donor sperm — sourcing, selection, import if using a bank abroad — and what support do you provide for that decision?
Without a partner in the room, this decision lands entirely on you — and clinics vary significantly in how much guidance they offer. Some walk patients through sourcing, selection, and import logistics. Others treat it as your problem to solve independently.
A clear process, explained without being prompted. A named person or team who supports patients through the selection.
Alone in the room
8. I'll be attending appointments alone. What happens practically on egg retrieval day — sedation, recovery, and who I need with me?
Egg retrieval typically involves sedation, which means you can't drive yourself home. Without a partner, you need to know exactly what the clinic requires — whether a named companion must be present, whether they need to stay, and what the recovery protocol looks like before you leave the building. Some clinics have policies that aren't mentioned until late in the process.
A clear answer about who needs to be present, for how long, and what support the clinic can offer if you don't have someone available. If they haven't thought about this, that's worth knowing.
9. I'm funding this on one income. If the cycle produces no embryos for transfer, what am I charged — and what are the financial terms if I need to stop mid-cycle?
The financial exposure of a failed or cancelled cycle falls entirely on you. Some clinics charge the full cycle fee regardless of outcome; others have partial refund policies. Understanding this before you pay a deposit — not after a failed retrieval — is the difference between a manageable setback and a significant financial shock on a single income.
Specific written terms, provided before deposit. A clear breakdown of what you're charged if no eggs are retrieved, if fertilisation fails, or if you need to cancel mid-stimulation.

Answers that should make you pause

  • "Our success rates are excellent" — without a specific figure, denominator, or data year. A percentage with no context cannot be compared.
  • "We can go over costs when you're ready to proceed" — you are ready to proceed precisely when you have the full cost picture in writing.
  • "It depends" without a written follow-up or a specific offer to provide one. Vague answers don't help you compare clinics.
  • "That's not something we need to worry about yet" in response to the no-viable-embryos question. It is always something worth discussing before payment.
  • Reframing ownership questions as irrelevant to your care. They may not affect clinical quality — but you still deserve a direct answer.

Before you go further

These questions are the start. The strategy behind them is the work.

Knowing what to ask is one part of it. Understanding what the answers mean — and how to use them to compare clinics, read between the lines, and make decisions without a partner to sense-check them with — is a different kind of preparation. That's what the Briefing Room is for.

Find out about the Briefing Room →
2

In the consultation

Protocol and clinical questions — once you're in the room

By the time you're in the consultation itself, you've already screened the clinic. These questions are about whether the doctor in front of you understands your situation specifically — not just age as a general category.

Your treatment history & protocol
8. What is your experience treating women over 40, and how do you approach this age group differently?
Over 40, egg quality takes priority over egg quantity. The stimulation approach changes. A doctor without specific experience in this cohort may apply a protocol designed for younger patients — producing a different result than intended.
Specific examples of how their approach to women over 40 differs from the standard protocol. Confidence without over-promising.
9. Will you create a personalised protocol for me — and if I've had a previous cycle, how will those outcomes inform what you'd do differently?
Too many doctors apply a favourite protocol without examining what might suit each patient. If you've already been through a cycle, that data is valuable — and a doctor who doesn't factor it in is not learning from your history.
A protocol discussion that references your specific test results and — if applicable — your previous cycle data. Not a generic description of what they usually do.
10. Do you prime before stimulation, and what might that look like in my case?
Some doctors undertake pre-stimulation preparation — HGH, progesterone, Progynova — that can support follicle development before the main stimulation begins. This is not universal, and it's worth understanding what the doctor's view is and why.
A considered view on whether priming is appropriate for your situation, with a rationale — not just "we'll see how you respond."
11. How closely will you monitor me during stimulation — and will you adjust my protocol based on how I respond?
Every woman responds differently to stimulation drugs. Monitoring matters — not as a baseline scan and then nothing, but as a genuine read on how your body is responding, with adjustments made accordingly. Some clinics do daily blood tests and team reviews during stimulation. Others don't.
A specific answer about monitoring frequency, who reviews the results, and how protocol adjustments are made during stimulation.
Expectations & outcomes
12. What are your honest expectations for this cycle — eggs retrieved, fertilised, and potential blastocysts?
Having an estimate from the doctor stops you relying on Google and forum posts, which will almost always be either more alarming or more optimistic than your specific situation warrants. A doctor who won't give an estimate is either being overcautious or hasn't thought about your case carefully enough.
Specific, honest estimates — with an acknowledgement that they are estimates, not guarantees.
13. What are the realistic chances of this working for someone in my situation — and how are you defining "working"?
The right doctor is positive but honest. Manufactured optimism is one of the oldest tools in the fertility sales process — a patient who feels reassured stops asking difficult questions. Equally, a doctor who leads with pessimism before a cycle begins isn't serving you well either.
A frank, case-specific answer. References your age, your results, your history. Doesn't promise; doesn't catastrophise.
The lab & embryology
14. Do you recommend a fresh or frozen transfer — and day 3 or day 5 — for my situation, and why?
Views on this vary, and both approaches have legitimate rationales. What you want is a doctor who can explain their recommendation for your specific case, not a default position applied to everyone.
A recommendation specific to your situation, with a clear rationale — not just "it depends" or "we prefer frozen."
15. Can I have a conversation with your embryologist about lab procedures, grading criteria, and their approach to embryo selection?
The outcome of a cycle depends as much on what happens in the lab as in the clinic. A clinic that supports patient access to their embryologist is one that's confident in their lab. Questions worth covering: whether they cultivate to day 7, their approach to PGT-A for your situation, how they communicate during the fertilisation window.
Yes — and they facilitate it. Access to the embryologist is a sign of confidence, not an unusual request.
If it doesn't work
16. If this cycle fails, what will you explore — and is there anything you'd investigate before starting a second attempt?
Too often, failure prompts no follow-up. Money paid, doctor moves on. Or the response is to recommend donor eggs without exploring whether a different protocol, different timing, or additional investigation might change the outcome. The right doctor has a plan for failure before you've even started.
A specific protocol review process. Named investigations they'd consider. Not "we'd look at all options."
17. What would an experimental or more aggressive protocol look like for my situation — and what are the evidence and the risks?
Some doctors won't raise experimental options unless asked. Others will raise them as standard without explaining that the evidence base is limited. Asking directly, and asking for both sides of the argument, gives you a clearer picture of whether you're being offered something genuinely tailored or something standard with a different name.
A balanced explanation of options — including what the evidence does and doesn't support — and a clear view on whether it's appropriate for you specifically.
If you've had a previous cycle Returning
18. Looking at the notes from my previous cycle — what specifically would you do differently, and why?
A previous cycle is data. A doctor who can look at your cycle notes and describe a specific different approach is demonstrating genuine analysis of your case. One who speaks in generalities is not.
19. Is there any investigation of the previous failure you'd recommend before we start again?
Depending on your history — number of failures, quality of embryos, uterine environment — there may be specific investigations worth doing before another cycle. ERA testing, endometrial biopsy, immunological screening. These are not always appropriate, but a doctor who doesn't consider them isn't working from your full picture.
If you're considering donor eggs Donor eggs
20. At what point do you recommend moving to donor eggs — and what specific evidence, from my case, is driving that recommendation now?
This is one of the most significant decisions in this process. It deserves a specific, evidence-based answer — not a recommendation based on age alone. A doctor who can cite your test results, your cycle history, and the clinical reasoning is doing their job. One who says "at your age, donor eggs give you the best chance" without further analysis is presenting a commercial recommendation as a clinical one.
Specific reference to your results and history. A clear statement of what they'd need to see to recommend continuing with your own eggs. Not age alone as the determining factor.
21. What information would I receive about a donor — and who makes the final selection?
Clinics use different matching models. In Spain and Czech Republic, the clinic selects based on your criteria. In some UK and Danish clinics, you may review profiles yourself. Neither model is objectively better — but knowing which model a clinic uses, and what information you'll receive, lets you make a decision that fits how you want to approach it.
A clear description of the matching process, what information recipients receive before confirmation, and any wait times for specific criteria (ethnicity, identifiable donor).
22. What are your live birth rates for donor egg cycles specifically — and how does that break down for your donor pool and patient age group?
Donor egg success rates are generally higher than own-egg rates. But they vary by clinic, by donor pool quality, and by how the clinic defines and reports success. You need the donor-egg-specific figure, not the clinic's overall headline.
If you're going abroad Abroad
23. How many visits will I need for a typical cycle — and what happens if I need to travel at short notice?
Fresh cycles typically require more trips than frozen. Going abroad alone means no partner managing logistics with you. Understanding the exact travel requirements — and what happens if stimulation moves faster or slower than expected — matters more when you're doing this without a support structure nearby.
24. What monitoring can be done in my home country — and how do you coordinate with local clinics?
Some abroad clinics have established networks with local monitoring clinics; others leave patients to arrange this themselves. Knowing this before you commit determines whether treating abroad is genuinely logistically manageable for you.
25. What is your communication process for solo patients — and who is my single point of contact throughout?
Distance amplifies the communication issues that exist in any clinic relationship. When there's no partner to relay information, no local nurse to call in, and a time zone difference, having a named coordinator matters significantly.
A named patient coordinator. A clear communication process. A response time commitment.

Answers that should make you pause

  • No specific plan for your previous cycle notes — a doctor who responds to your history in generalities hasn't analysed your case.
  • "Donor eggs give you the best chance at your age" without referencing your specific results — this conflates a population statistic with an individual recommendation.
  • Manufactured optimism before stimulation — a doctor who tells you "this will definitely work" before seeing any results is telling you what you want to hear.
  • No clear monitoring protocol — or "we'll see how you respond" as the full answer to monitoring frequency.
  • Presenting all add-ons as necessary for women over 40, without distinguishing evidenced from experimental.
3

Before you pay anything

Get these five things in writing before any deposit leaves your account

A good consultation is necessary but not sufficient. The things that protect you — financially and clinically — are the things you have in writing. These five items should be confirmed before any deposit is paid. If a clinic won't provide them, that is the information.

  • 1
    Success rates for your age group — in writing, with the metric defined Which measure (live birth, clinical pregnancy, positive beta-hCG), which denominator (per transfer, per cycle started), which patient cohort (your age and treatment type), and what year the data covers.
  • 2
    A full itemised cost breakdown with all exclusions listed explicitly Not a headline figure. Every line item: medications, monitoring, sperm purchase and import, storage, any add-ons discussed, anaesthetist if applicable. And what is explicitly not included.
  • 3
    Cancellation and refund terms — especially if no viable embryos result The financial terms if the cycle produces nothing to transfer. This is a real outcome for some women over 40. You need to understand it in writing before it happens, not after.
  • 4
    Any add-ons discussed — which are recommended, which are optional, and what the evidence reference is A written record of what was recommended and why. Specifically whether the evidence cited is for your age group and diagnosis, or for a different patient population.
  • 5
    Your named point of contact throughout treatment Who you contact when something changes during stimulation. Who calls you with results. Who is available when the doctor isn't. As a solo patient, this is not an administrative detail — it's a clinical one.

If the questions open up more questions

That's the process working. The questions on this page get you further than most — but the full picture sits around them: the costs, the decisions, the options you haven't thought to ask about yet, and the weight of navigating all of it alone. That's what the Briefing Room is there for.

About the Briefing Room

This resource is not medical advice. It is based on lived experience, research, and the questions that women going through this process have found most useful. For clinical decisions, speak to your doctor.

Part of the Navigating the System cluster. Independent — not funded by any clinics.