Write
questions down before every appointment
Specific
numbers — not 'normal' or 'fine'
Records
request copies of all results and reports
Second
opinion is always appropriate — not disloyal
Advocacy Principles
You are the expert on your own experience
Your symptoms, cycle patterns, and responses to treatment are data. Present them clearly and ask for them to be taken seriously.
Ask for specifics, not generalities
"Your results are fine" is not an answer. Ask: 'What is the specific number, and what does it mean for my situation?'
Write down your questions before appointments
Appointments are short and emotionally charged. A written list ensures you cover everything and gives you something to refer back to.
Request a copy of all results
You are entitled to your own medical records. Keep a folder of all test results, reports, and correspondence.
A second opinion is always appropriate
Seeking a second opinion is not disloyal — it is good medical practice. Any specialist who discourages it is a red flag.
Bring a support person
A second person in the room hears things you miss, helps you remember what was said, and provides emotional support.
Questions to Ask at Each Stage
Initial Consultation
- →What investigations have been done, and what are the results in detail?
- →What investigations haven't been done yet that you would recommend?
- →What is your interpretation of my AMH and AFC in the context of my age and history?
- →What treatment pathway do you recommend, and why?
- →What is the expected timeline from here?
- →What can I do in the next 90 days to optimise my preparation?
Before an IVF Cycle
- →What stimulation protocol are you recommending, and why for my specific profile?
- →What is your clinic's live birth rate per embryo transfer for my age group?
- →What is your policy on elective single embryo transfer (eSET)?
- →Do you offer preimplantation genetic testing (PGT-A)? Do you recommend it for me?
- →What triggers do you use for egg retrieval, and how is the decision made?
- →What is your OHSS prevention protocol?
After a Failed Cycle
- →What is your analysis of why this cycle did not succeed?
- →Were there any observations about egg quality, fertilisation, or embryo development that are relevant?
- →What would you change in the next cycle?
- →Should we investigate further before proceeding? What additional tests would you recommend?
- →Is ERA testing appropriate at this stage?
- →What is a realistic prognosis for future cycles based on what we know?
Lab Results Interpretation
- →What is the fertility-optimal range for this result — not just the lab reference range?
- →Is this result within the range associated with optimal IVF outcomes?
- →What would you recommend to optimise this result before treatment?
- →How does this result interact with my other results?
- →Should I retest this? If so, when and under what conditions?
Fertility-Optimal vs Lab Normal Ranges
Use these to ask more specific questions about your results.
| Marker | Lab Normal | Fertility Optimal | Why It Matters |
|---|---|---|---|
| TSH | 0.5–4.5 mIU/L | 0.5–2.5 mIU/L | Higher TSH associated with increased miscarriage risk even within lab normal range |
| Ferritin | 30–300 mcg/L | >70 mcg/L | Low ferritin impairs oocyte mitochondrial function and energy production |
| Vitamin D | >50 nmol/L | 100–150 nmol/L | Lab normal is the deficiency threshold — fertility optimal is significantly higher |
| HbA1c | <48 mmol/mol | <38 mmol/mol | Optimal glycaemic control supports oocyte quality and endometrial receptivity |
| Fasting insulin | <25 mIU/L | <8 mIU/L | Elevated insulin drives androgen excess and impairs follicular development |
| AMH | Varies by lab | Context-dependent | AMH measures quantity only — not quality. Low AMH does not equal infertility. |
Your Action Plan
Advocacy Checklist
0/15 completed
Before Your Next Appointment
Write down your top 5 questions before the appointment
Bring a support person if possible
Request a copy of all test results — keep a personal folder
Review your results against fertility-optimal ranges (see table above)
Prepare a brief summary of your cycle history and any symptoms
During the Appointment
Ask for specific numbers, not just 'normal' or 'fine'
Ask: 'What is the fertility-optimal range for this result?'
Ask: 'What investigations haven't been done yet?'
Take notes or ask permission to record the conversation
Ask for the next steps to be written down or emailed to you
After a Difficult Result or Failed Cycle
Allow yourself time to process before making decisions
Request a detailed debrief appointment — not just a phone call
Ask for a written summary of the cycle outcome and recommendations
Consider a second opinion before proceeding with the next cycle
Connect with peer support — others who have been through similar experiences