Orchid offers advanced genetic testing for couples who want their child to have the best shot of a healthy life. As part of our “Pregnancy and Fertility” series, we distill down your fertility treatment options and help you navigate the complex process.
In this article we cover:
- How should I choose a fertility clinic?
- Questions you should ask fertility clinics you’re considering
How should I choose a fertility clinic?
There are many factors to consider — though ultimately, it’s a personal decision. Here is a general framework as well as a quick list of questions you can ask clinics that you’re considering.
What you should look for:
You want to go with a fertility clinic with a sufficient amount of practice and expertise.
Length of clinic’s practice
Freezing and thawing both eggs and embryos require precision and high-quality clinical practices. As Cristina puts it, “the majority of clinics do egg freezing today, but that was not the case just a few years ago.” That’s because egg freezing used to be considered as an “experimental procedure” by the American Society of Reproductive Medicine (ASRM) until recently in 2012.
This means ideally, find a clinic that has a proven track record for egg freezing and thawing
2. Fertility Doctor
Fertility doctors are board-certified reproductive endocrinologists specialized in diagnosing and providing fertility treatments. Here are some factors you should consider when picking a fertility doctor.
They specialize in what you have or need
IVF is not a one-size-fits-all. There may be a variety of reasons why someone is seeking fertility treatment. It’s important the clinician you’re working with is experienced in treating your specific circumstance — including factors such as PCOS, endometriosis, diminished ovarian reserve, male factor infertility, or recurrent pregnancy loss.
You have a natural chemistry with the physician and support staff
As Cristina puts it, “there’s an X factor after meeting the right MD. Having that connection and comfort with the attending physician and support staff is very important. Fertility treatment could be a long journey — and you want to view this as you might with any relationship with someone.”
If you and your fertility doctor are aligned in your treatment approach, that means they’re more likely to start at the right level of treatment. And, even if an IVF cycle does not lead to success, they’re more likely to adapt treatment in subsequent cycles to improve your odds.
The lab is one of the most important pieces of your journey. The best IVF lab maintains the quality of the gametes and embryos and also employs highly qualified embryologists and lab professionals. A high quality lab can improve your chances of IVF success.
You can evaluate how good an IVF laboratory is by assessing whether they have:
- The latest technology and laboratory equipment
- A good number of annual cases
- Experience performing ICSI
- Great culture conditions and thawing techniques
A word about numbers and statistics
In general, clinics that do more than 200 IVF cycles per year tend to have higher rates of success. As for the embryology lab itself, find out the laboratory’s average fertilization rate (~70% is decent) and blastocyst conversion rate (the number of viable, transferable embryos by day 5-7; 40-50% is respectable).
A clinic’s overall live birth success rates are trickier to interpret. “Each person is different and pregnancy or live birth rates change significantly depending on the type [meaning, different causes of infertility] and age of patients the clinic treats. Some clinics accept older patients, patients with low chance of IVF success, or very difficult cases which means the stats will be lower overall,” explains Cristina, “in my opinion, I wouldn’t compare pregnancy rates to decide which clinic to go with.”
Bottomline on “success rates”: these numbers will vary based on the patient population and the difficulty of cases that clinics tend to work with.
Remember that the data does not reflect what your specific outcomes will look like. As Cristina puts it: “It’s not easy to assess successful attempts at building a family through these numbers alone. SART is an outcome registry to collect IVF outcomes but is not designed to compare IVF centers.”
If you do end up sifting through each clinic’s SART success rates data, one useful statistic is the number of embryos the clinic transfers per cycle. Generally the closer to one the better — it indicates greater confidence in embryo quality if the clinic usually transfers only one embryo at a time. Plus, singleton pregnancies are safer than twin or triplet pregnancies.
4. Personnel experience
IVF treatment takes a small village to coordinate care for patients. This goes beyond your fertility doctor to include embryologists, nurse and patient coordinators, and financial coordinators. A well-run, efficient and compassionate care team can elevate your overall patient experience to make you feel supported and cared for while a disorganized team can lead to costly clinical and clerical errors.
5. Size of Clinic
In a large practice, it is very common to have a group practice. This is when a group of physicians work as a collaborative team to assist the patients. They also ask each other for second opinions and have weekly discussions about difficult cases.
If you go with a clinic that runs as a group practice, you will have a main fertility doctor who is deciding the plan, calling the shots, and following your case throughout the treatment. However, during your fertility care journey, you will often see other physicians and supportive staff to ensure their high-volume clinic runs efficiently.
Larger clinics have more supportive staff including Nurse Practitioners, Registered Nurses, Ultrasonographers, Medical Assistants, Financial/Insurance specialists, etc. They also have Andrology and IVF labs on site with high-tech equipment and more connections and resources for speciality consultations and referrals.
Procedure rooms are on site and feature a wide range of services beyond just egg retrievals. These can include testicular sperm extraction or other specialized diagnostic procedures such as hysteroscopies and dilation and curettage.
Smaller clinics are more “high-touch” and personal because the team is smaller. If you go with a smaller clinic, you likely will have a relationship with every clinic provider and staff.
As Cristina says, “They tend to have a boutique style. It’s more intimate because you likely will work with the same physician throughout your fertility treatment. On the flipside, they have fewer cases, which means less clinic data.” Some small clinics also don’t have the Andrology/IVF Lab or procedure rooms on site. If services aren’t centralized, you may need to travel to different locations for care.
The bottom line
Selecting the best IVF clinic for you can be a stressful decision. Given all these factors, what most matters to you and what are your priorities?
Do your research, call the office, and schedule an initial visit to discuss your case. Cristina offers you some words of encouragement and advice: “it is about finding the X factor — exceptional patient care and treatment combined with how the clinic makes you feel. You need to feel comfortable and excited to start your journey with a group that’s well organized, has great communication, and the experience to offer you the best care.”
Questions to ask fertility clinics you’re considering
Treatment approach and expectations
- How many fertility doctors are part of your clinic?
- Will you be present at all my appointments? Will you perform the egg retrieval and embryo transfer?
- Will my labs and procedures be done in the same location?
- Which specific tests do you suggest for myself and/or my partner?
- What are our treatment options and what would you recommend?
- What clinical treatments and services does your clinic offer? What support services are available?
- How do you assess what’s the right level of treatment to start with and when to advance to a more intensive approach?
- How would you describe your approach to single vs multiple embryo transfer?
Clinic quality and level of experience
- How many cycles does your clinic perform each year?
- What are your embryology lab’s fertilization (ICSI and conventional) and blastocyst conversion rates?
- What kind of equipment does the embryology lab use to grow embryos? Is there laboratory staff coverage 7 days a week?
- How does the billing department typically work with patients?
- What insurance do you take?
- Is there any discount for self-pay patients?
- What are the financial estimates for my treatment?
- Find a fertility doctor through FertilityIQ’s provider and clinic reviews
- American Society of Reproductive Medicine (ASRM) Patient Resources
- Society of Assisted Reproductive Technology (SART)
- American College of Obstetricians and Gynecologists (ACOG)
Fertility treatment and reproductive medicine have come a long way since IVF was first introduced over 40 years ago. Today, advanced embryo testing is now available to couples who want their child to have the best shot of a healthy life. Explore how Orchid helps you conceive with confidence.