Navigating the IVF bonus scheme. 7 questions to ask when choosing an IVF doctor.

IVF is an epic undertaking.  Taking time to choose the right doctor is not only important for the end result, but your emotional, physical and financial well-being. 

That $180,000 incentive

A not secret-secret is that some IVF clinics pay their doctors bonuses based on how many rounds they perform.   One of Australia’s biggest IVF businesses outlines their bonus scheme in tiers and will pay a bonus of $180,000 to a doctor who averages 424 or more cycles per year over a four-year period.  To be clear, that goal has nothing to do with your goal – a baby.  That’s rounds of IVF and I’d say that’s a pretty attractive incentive.  It’s not top secret, you can read about their incentive program on their annual report. 

I’m not saying every IVF doctor is driven by this financial carrot.  There are doctors here in the Northern Beaches who I know will send patients away to try naturally if they’ve deemed it too soon or unnecessary.  I have also worked with a patient who was convinced against her better judgement to try just one more cycle, the same protocol as the previous three, which together had yielded just four eggs and no viable embryos.  I just don’t believe that every IVF doctor will have their patient’s best interest at heart all the time. 

How do you choose a doctor?

-        Recommendation from a friend:  Often women see a doctor a friend saw and loved.  This can be a good start, but what suits your friend, might not suit you, no matter how close you are. 

-        Online reviews:  Helpful to a point, but the IVF experience can be polarising depending on the outcome.  Women or couples who conceived tend to leave glowing reviews and those who don’t often leave negative reviews. 

-        Asking other health professionals: health professionals interact directly or indirectly through patients so have a wide scope of IVF doctors and patient experience.  Ask a few health professionals in the area who they like and importantly, why they like them. 

Ask ALL OF THE questions.

Go in to the interview loaded up with questions. 

The following are eight questions I suggest everybody ask in their consultation.  Many of the women I work with have more questions, specific to their own health and fertility. 

QUESTION:  What is your typical patient?

It’s best to work with a doctor who has experience working with women, men or couples who have a similar situation to your own. 

For example, if you’re dealing with unexplained infertility in your late 30’s or early 40’s, look for an IVF doctor with experience with older couples. 

QUESTION: What is our treatment approach likely to be?  What does this timeline look like?

Understanding as much about the process as possible can help make IVF less stressful and let you feel confident.  Often the timeline can be longer than people might first expect (note:  bring your tracking app or journal to your appointment).

QUESTION:  If this doesn’t work, what is the next step? Why are we not going straight to this step?

It is important to question your doctor.  It doesn’t mean you doubt them or their knowledge, but that you wish to further understand the thought process behind the plan and the way they work. 

QUESTION:  What are the chances of me conceiving through this plan, versus if we continued to try naturally, and why do you think that?

IVF isn’t a guarantee.  In some cases, it may be better or just as likely to happen if you continue trying naturally. 

QUESTION:  What are your success rates on a whole?  What do you consider success (frozen embryos? Pregnancy? Live birth?).  What are your success rates with patients like me/us?

“Success” is a bit of a grey area.  Asking what constitutes success is important for transparency, as different clinics have different markers. Of course, these rates are irrelevant if they don’t apply to cases similar to yours.  Dig deep ask for an honest and accurate an opinion as the doctor can give. 

QUESTION:  Who can I contact through this process?

Each clinic provides a different level of support.  You may pay more to have support on hand when you need it. Is this a priority for you or would you prefer to spend less?  

QUESTION:  Is it possible to transfer embryos to different clinics should I decide to leave at any point?

Sometimes things just don’t work out.  Maybe circumstances change, and a particular clinic is no longer a good fit.  It is important to understand how you can continue treatment should you wish to move to a different clinic.  This is particularly important if you are using a sperm donor through the clinic as ownership rights can be complicated. 

QUESTION:  What additional charges will I see?  What charges could I potentially be up for?

IVF can be expensive.  It is important to understand all the fees up front, this might have an impact on your decision.  I encourage patients to ask about any costs which they may not be expecting but might pop up along the way.  It does happen.  I saw a patient who was told mid-cycle she would need mandatory in-house counselling before the clinic would continue, which she was expected to pay for.

If you’re trying to keep costs down, there are some clinics who bulk bill and the cost difference is significant. 

I highly recommend patients see at least two doctors.  If it’s feasible, two different clinics.  If you have nothing to compare to, everything seems like the best option.  

We must be our own health advocates, and this applies to IVF and selecting the right team to work with. 

You can read about supporting your IVF naturally here.

All the best with your decision.

Jenna. xx