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What if I Am Unable to Conceive Naturally?

If you are unable to conceive naturally, there may be various options available to you, including
using a surrogate, adoption, or seeking the help of an infertility service.

Because this can be a very emotional and stressful time of your life, you may find it difficult to
make rational and reasoned choices, and it's sad to say, but some services may take advantage
of your vulnerability. If you are considering infertility treatment, you may wish to take this form
with you to your initial appointment to determine whether treatment by a particular service
provider is in your best interests.

How long have you been in business? __________________________

How many patients have you treated? __________________________

Are you/your doctors board-certified?

___________________________________________________________

___________________________________________________________

In what specialties and/or subspecialties?

___________________________________________________________

___________________________________________________________

What is your overall success rate?

___________________________________________________________

___________________________________________________________

How is your success rate calculated?

___________________________________________________________

___________________________________________________________

Do you have written materials about your practice and procedures that we can review?

___________________________________________________________

___________________________________________________________
___________________________________________________________

In view of our medical history, are there particular procedures that you recommend?

___________________________________________________________

___________________________________________________________

___________________________________________________________

___________________________________________________________

How much experience do you have performing these procedures?

___________________________________________________________

___________________________________________________________

How much do these procedures usually cost? ________________________

How much do the required drugs cost? _____________________________

What portion of these costs is generally covered by our insurance company?

___________________________________________________________

How must payment for any uncovered expenses be made?

___________________________________________________________

What is your success rate for couples experiencing the same problems as ours or undergoing
the same treatments?

___________________________________________________________

___________________________________________________________

What is our overall chance of conceiving a c

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