What to ask at your first fertility consult

Arrive with your file, not just your story. That means: any prior fertility testing (bloodwork, semen analysis, ultrasound or HSG reports), records from previous cycles if you've done treatment elsewhere, your menstrual and medical history in dated notes, and a current medication list. If you have a referring physician, have the referral sent ahead — OFP-funded patients typically need one on file before joining a funded waitlist, even at clinics that accept self-referrals for the consult itself.

Write your questions down and bring the list on paper or your phone. Decide in advance the three you absolutely will not leave without asking — consults compress quickly once results and options come out.

Money questions first, because the answers frame everything else. Ask: What is your current OFP-funded IVF wait time, from this consult to cycle start? Am I eligible for OFP funding, and when exactly do I go on your waitlist? What does a private cycle cost here, itemized — base fee, ICSI, freezing, storage, and typical medication range? Which of those items are excluded from a funded cycle? What do add-ons like PGT-A cost, and when would you actually recommend them for my case?

Two follow-ups worth the awkwardness: Can I get the fee schedule in writing? And: If my funded cycle fails, what happens next and what would it cost? For context going in — private IVF in the GTA typically runs $9,000–$13,500 in base fees and $13,000–$20,000 all-in, and funded patients still pay for medications. A clinic that answers pricing questions crisply and in writing is telling you something about how it will treat you as a patient.

Now the medicine. Ask: What work-up do you recommend before any treatment, and what will it tell us? Based on what you see today, what treatment would you start with — and why that one rather than the step above or below it? What's your view on how many IUI cycles make sense before IVF for a case like mine? If IVF: what protocol would you likely use, and what would make you change it after a first cycle?

Then the questions that separate rehearsed answers from real engagement: What's the most likely reason treatment wouldn't work in my case? What would we learn from a failed cycle here? Who reviews my file between cycles — the physician I'm meeting now, or a team? You are listening for reasoning specific to your results, not a standard speech that any patient could have received.

Fertility treatment is logistically intense — cycle monitoring means frequent early-morning visits for bloodwork and ultrasound, often several per week during a cycle. Ask: What are your monitoring hours, and do you run weekends? Which location would I actually attend, and can monitoring happen at a satellite closer to me? How do I reach the clinical team with questions mid-cycle, and what's the typical response time? Do you offer virtual follow-ups? Who covers when my physician is away?

These sound mundane next to protocol questions, but they predict your day-to-day experience better than anything else. A clinic whose monitoring window fits your commute and whose messages get answered within a day is a materially different experience over six months than one where neither is true.

Ask about experience with cases like yours: How many patients with my diagnosis or age profile do you treat in a year? How does your lab report its results, and can you walk me through what your numbers mean for someone like me? Be appropriately skeptical of headline success rates — clinics differ in patient mix and in how they frame statistics, so a specific, caveated answer is more trustworthy than a confident big number. Ask too about the lab itself: accreditation, embryologist team size, and which technologies they consider standard versus optional paid add-ons.

Close with the comparison question: What would you say this clinic does better than the other clinics I'm considering? Then repeat the whole exercise at your second consult. Comparing two written sets of answers — not two vibes — is how the decision gets easy. Use the directory to shortlist which clinics get your consults.