You're considering treatment
Treatment decisions are easier when you know what each option involves, what it's for, and what a reasonable number of attempts is before changing course. Under 35, there's usually room to start with simpler options, and it's fair to ask how many attempts are reasonable before stepping up.
The main options, roughly in order of intensity: ovulation medication (letrozole or clomiphene) with timed intercourse; intrauterine insemination (IUI), usually with medication; and IVF.
Which one depends on the cause. Blocked tubes or a significant sperm issue usually point to IVF. No ovulation starts with medication. Unexplained usually starts with medication plus IUI.
Costs vary widely. IUI is often hundreds to low thousands per cycle; IVF often $15,000–25,000 or more including medication. Coverage depends on your plan and state.
- Prepare both bodies for the three months before. No smoking for either of you, alcohol low, and a prenatal every day. How to prepare.
- Strong evidence If you have PCOS, ask whether letrozole comes first. It's the first-line treatment for ovulation in PCOS in the 2023 international guideline. Where inositol fits.
- Ask for the plan in writing. Including how many cycles before you'd change course.
- Moderate evidence Look after your head. Support groups and counselling help how you feel through treatment. What helps.
Why this option
What about my results makes this the right first step, and what would make you recommend something else?Success rates for people like me
Per cycle and cumulative, for my age and diagnosis, at this clinic. Clinic-specific IVF data is public.Number of attempts
How many cycles of this before we reassess or move to the next option?Side effects and risks
Including multiple pregnancy with ovulation medication and IUI, and ovarian hyperstimulation with IVF.The full cost
Medications, monitoring, procedures, anesthesia, freezing and storage, and what happens financially if a cycle is cancelled.Your actual coverage
Whether your plan is self-funded matters more than your state's mandate — state laws don't apply to self-funded employer plans, and most large employers are self-funded. How to find out, and what to ask →Alternatives
Is there anything less invasive, or more effective, worth discussing first?
- Based on my results, why are you recommending this option first, and what would you recommend if it doesn't work?
- What are the success rates for this treatment for someone my age with my diagnosis, per cycle and after several cycles?
- What is our timeline? At what point would you change the approach if this isn't working?
- What is the total cost of one cycle, including medication and monitoring, and what is and isn't refundable if it's cancelled?
Plus 5 more on your appointment checklist.
If you decide on medication or IUI, ask for the plan to be written down: which medication, what monitoring, how many cycles, and the point at which you'd reassess.
If you decide on IVF, move to I'm doing IVF for the step-by-step Path.
It's normal to take a cycle or two to decide. Time matters, but so does going in with a plan you understand.
Consider another opinion if you're recommended IVF without a basic evaluation being complete; if success rates for your situation aren't shared; if the cost isn't given clearly in advance; or if you feel rushed. Clinic-level IVF success rates are public through the CDC and SART, and comparing two clinics is a normal thing to do. See I want a second opinion.