When to Seek a Second Opinion For Fertility Treatment
As a fertility doctor, I spend a significant part of my day reviewing IVF cycles from patients who have undergone treatment elsewhere but did not achieve the outcome they were hoping for. A common question I hear is, "Is it okay to get a second opinion?" Many patients feel nervous about seeking one, wondering how their current doctor might react.
I want to assure you—getting a second opinion is absolutely okay. In fact, it’s sometimes necessary to ensure you are receiving the best care possible. Not every IVF cycle is going to be successful, and that’s not always a reflection of poor treatment. However, there are times when a fresh perspective can provide new insights and improve your chances of success.
Understanding Your Expectations in IVF
Before deciding if you need another opinion, it’s important to understand your expectations based on factors like your age, ovarian reserve, medical history, and how IVF typically works. A good fertility team should walk you through these details, helping you understand what to expect from your cycle.
For example, when I guide a patient through IVF, we set clear expectations. We discuss how many eggs we anticipate retrieving, how many embryos we hope to create, and what we can expect based on age-related probabilities. If the cycle goes as expected but does not result in a successful pregnancy, it may simply mean you need another cycle. However, if something is not aligning with expectations—if the number of eggs retrieved, fertilized, or matured is significantly lower than predicted—that’s when we need to take a closer look.
When to Consider a Second Opinion
Here are some red flags that indicate it may be time for another opinion:
Lack of Personalized Adjustments – IVF should be tailored to you. If you’ve had multiple cycles and your clinic is repeating the same protocol without reviewing past results and making adjustments, it’s a problem. For instance, if your eggs are consistently immature, your doctor should evaluate your trigger timing and stimulation approach instead of using the same method over and over.
No Clear Plan or Communication – You should understand why your cycle turned out the way it did. If your doctor is not meeting with you after each cycle to review your results and explain next steps, you deserve better. I believe in what I call the WTF appointment—a deep dive into what happened and what changes (if any) should be made. If your clinic does not offer this level of transparency, that’s a red flag.
Ignoring Ovarian Reserve and Cycle Performance – Your IVF success depends largely on your ovarian reserve. If your clinic is refusing to proceed with IVF based solely on an AMH level, but you are still having regular periods and are under 38, seek another opinion.
Unjustified Recommendations for Donor Eggs or a Surrogate – If a doctor recommends donor eggs without fully exploring ways to improve egg quality, or if they suggest a gestational carrier without a clear medical reason, it’s worth asking why. These may be valid recommendations, but you should receive a thorough explanation before making such a big decision.
What You Should Expect From Your Clinic
A well-run fertility clinic should be proactive in helping you understand your treatment. They should:
Track Your Individual Response – The first IVF cycle is based on averages, but after that, your protocol should be adjusted based on how your body responded.
Discuss Your Options Openly – If a cycle doesn’t work, you should have a detailed discussion on why and whether changes need to be made.
Use Modern Lab Techniques – If your clinic is still transferring embryos on day two or three instead of waiting for blastocysts (day five or six), you should ask why. A good lab should be able to culture embryos to this stage.
Advocating for Yourself
Many patients don’t realize they can ask questions. They feel they have to trust whatever their doctor says without fully understanding their treatment. But fertility treatment is a partnership. You deserve answers, explanations, and a plan that makes sense for you. If something doesn’t feel right, trust your instincts.
If your clinic is unwilling to answer your questions, consider seeking another opinion. A fresh set of eyes may uncover changes that could improve your chances of success. At the end of the day, your fertility journey should be guided by informed decisions, compassionate care, and a team that prioritizes your individual needs.
