Infertility: When to Seek a Second Opinion
This blog post was originally written for Southern California Reproductive Center in March 2018.
Infertility is such a difficult thing to go through. Disappointment, grief, frustration, fear: by the time you seek expert advice, your emotions have probably already been through the wringer. Somehow, you summoned the courage to ask for help, submit to testing, and undergo treatment, but it’s not working. When all of this emotion and effort is met with more disappointment, where do you turn next?
If you’ve been through treatment for infertility for months (or even years) without success, getting a second opinion can offer you new information, new possibilities, renewed hope, and a fresh sense of purpose. You don’t need to justify your desire to consult another doctor. Choosing your next steps for fertility treatment is a significant decision, and you have a right to all the information and reassurance you need.
When should I think about seeking a second opinion?
If you’re not sure whether it’s time to look further afield, here are some of the most common reasons you might consider seeking a second opinion about your fertility treatment.
You’ve been under the care of your primary care doctor or OB-GYN and want to explore more specialized help
Many patients struggling with fertility first seek help from their own doctor. Your primary physician or gynecologist may run preliminary tests, recommend lifestyle changes or complementary fertility therapies such as acupuncture, or even prescribe a fertility medication like Clomid. If you’ve explored some or all of these options and still haven’t gotten pregnant, you may be at the point where it makes sense to seek a second opinion from a fertility specialist. Reproductive endocrinologists (REs) have specialized training in infertility and can offer more advanced diagnostic tools and treatment options.
You suspect that there may be more to your infertility diagnosis
While many cases of infertility are due to unknown causes (the dreaded “unspecified” diagnosis), undergoing a thorough diagnostic process is essential. If you’re concerned that something has been missed or feel that more investigation is needed, seeking a second opinion may be helpful. A fertility expert with additional experience may review your test results with fresh eyes and identify something that was previously overlooked. They may recommend new or different tests. An RE who stays current with the latest research may also be able to suggest new avenues for you to explore.
You have had several unsuccessful IVF cycles with your current clinic
The hard truth is that some IVF cycles fail, even at the most prestigious clinics. The human reproductive system is complex, and each patient is unique, so every cycle involves an element of trial and error. Fertility treatment takes time. However, if you’ve undergone three or more unsuccessful IVF cycles and feel you’re not getting closer to an answer, it may be time to consider another clinic.
While the basic components of an IVF cycle are similar across clinics, many variables can influence outcomes. Failure at one clinic does not mean failure is inevitable. Each clinic and specialist brings a different background, education, and approach. Differences in medication dosing and timing, laboratory technology, culturing methods, air filtration systems, or embryo transfer strategies such as personalized embryo transfer (pET) timing could make a meaningful difference.
You want to try something new that your current clinic can’t offer
When you’re putting so much effort into trying to conceive, you want confidence that all reasonable options have been explored. Reproductive endocrinology is a rapidly evolving field, with new research, technology, and best practices emerging all the time. In your own research, you may come across a test or treatment you’d like to pursue. If your current clinic is resistant to change or lacks access to advanced laboratory capabilities, seeking care elsewhere may help ensure that no options are left unexplored.
You have concerns about your relationship with your team
The rapport you have with your doctor and treatment team matters. While they are the medical experts, you are an active participant in your care. You should feel informed about treatment decisions and comfortable asking questions or raising concerns. If you’re presented with only one treatment option, if your doctor does not fully explain the reasoning behind your plan, or if potential risks are not clearly discussed, it may be time to reconsider whether this is the right fit. This is a professional relationship, and you deserve respect at every stage.
Sometimes, it’s harder to pinpoint exactly what feels off. You don’t always need a clear red flag to know a clinic isn’t right for you. There may simply be a mismatch between the clinic’s culture and your needs. Fertility professionals are often busy, and appointments may be brief. While it’s not reasonable to expect your doctor or nurse to serve as your primary emotional support, you should never have to tolerate dismissive, insensitive, or rude behavior. Infertility is deeply personal, and your care team should recognize and respect that. If you feel unheard or unsupported, it may be time to move on.
Your doctor recommends that you seek a second opinion
In some cases, your doctor may be the one to suggest seeking a second opinion. This can be difficult to hear, but it does not mean your situation is hopeless or that you are a “difficult patient.” Reproductive endocrinology is a broad and complex field, and many REs have sub-specialties or areas of focused expertise. Your doctor may know that a colleague or another clinic has more experience with your specific diagnosis or a higher success rate for patients like you. A physician with integrity will prioritize your care and help connect you with the best possible resources, even if that means transferring your case.
How should I choose which clinic to visit next?
Finding the right fertility clinic can be challenging, even if you’ve been through the process before. While the idea of starting over may feel overwhelming, remember that you’re approaching this step with far more knowledge and experience than you had the first time.
Ask your doctor
If you have a positive relationship with your current physician, consider discussing your desire for a second opinion with them. You’ve already been through a great deal together, so it’s natural to feel apprehensive, but this conversation doesn’t need to be uncomfortable. Most fertility specialists enter this field because they genuinely want to help families grow. They’re unlikely to view your request as a rejection or betrayal. In fact, doctors frequently consult colleagues themselves. Ask for a recommendation. Your doctor knows your history and may be able to refer you to someone well suited to your needs.
If your doctor responds defensively or is unsupportive of your request, that’s a strong indicator this may not be the right fit.
Reach out to your network
You’re not alone in your experience with infertility or in wanting answers. If you haven’t already joined a support group or fertility community, this can be a helpful time to explore those spaces. Conversations with others who’ve worked with different clinics and doctors can provide valuable insight and recommendations.
Arrive prepared
There are several steps you can take to make the process of seeking a second opinion smoother:
Go over your insurance policy again to see what may be covered.
Have a thorough copy of your medical records and test results on hand before you visit a new clinic.
Bring any notes you’ve taken at your previous clinic visits.
Prepare a list of specific questions to ask in advance.
Be ready to discuss any tests or treatments you’re interested in exploring next
Doing this not only makes your first visit more productive, but also helps a new provider quickly understand your case if you choose to move forward.
There are many reasons you might seek a second opinion about infertility diagnosis or treatment, but only you can decide when it’s time. Whether you’re dissatisfied with your current care or simply want reassurance that every option has been considered, this is a proactive and empowering step. You’re advocating for your health and your future. Don’t hesitate to ask for more support when you need it. You’ve already overcome so much, and you deserve care that feels right for you and your family.
