Finding a good fertility clinic can be a challenging experience, with high emotional and financial stakes.
Fertility clinics can help people who are having difficulty conceiving a child. In vitro fertilization is a process in which a woman’s eggs are fertilized with sperm cells to create embryos in a lab setting. Some of the embryos are then placed in the woman’s uterus to initiate pregnancy. Clinicians can retrieve and fertilize more than one egg, to boost the chances of a successful pregnancy. Embryos not used in the original transfer can be frozen and transferred into the uterus later if needed.
The process is pricey, and not all health insurance plans cover it. In the U.S., the average cost for a complete IVF cycle is about $23,000, according to the Coalition to Help Families Struggling with Infertility.
[Read: A Patient’s Guide to Infertility.]
Reproductive Medicine Is on the Rise
Reproductive medicine is growing rapidly, providing options for people who face infertility challenges.
In 2015, 464 fertility clinics reported performing 231,936 assisted reproductive technology cycles, which resulted in 60,778 live births, according to the Centers for Disease Control and Prevention’s Assisted Reproductive Technology National Summary Report. In 2019, the number jumped to 330,000 ART cycles reported by 448 clinics, according to the CDC. Those cycles resulted in 77,998 live births.
Reproductive medicine is regulated by “a complex patchwork of federal and state licensing and self-regulating by the clinics themselves,” says Sean Tipton, chief advocacy and policy officer at the American Society for Reproductive Medicine. ASRM is a multidisciplinary organization dedicated to the advancement of the science and practice of reproductive medicine.
[Read: How Does Surrogacy Work?]
Strategies to Improve Fertility Outcome
If you’re considering a fertility clinic to help you conceive, experts suggest these eight strategies to improve your odds of a good outcome:
1. Do some research.
Not all fertility clinics are alike. “Your local fertility center may not be the best center around, and it’s worth doing your homework,” says Dr. Thomas A. Molinaro, a reproductive endocrinologist at Reproductive Medicine Associates of New Jersey in Eatontown, New Jersey.
He recommends logging onto the website of the Society for Assisted Reproductive Technology. The federal government requires fertility clinics to report their IVF treatment cycle success rate, and you can find those statistics on the site. SART says it is “the primary organization of professionals dedicated to the practice of IVF, or assisted reproductive technology.” The organization represents the majority of ART clinics in the U.S., and its mission is to establish and maintain standards for ART to promote the highest possible level of care.
Another good resource is Resolve: The National Infertility Association, a nonprofit nationwide network that promotes reproductive health and works to ensure equal access to all family-building options for men and women experiencing infertility or other reproductive disorders.
2. Find out what precautions the clinic is taking regarding COVID-19.
If you’re considering a fertility clinic, ask what protocols it has in place to prevent transmission of the virus that causes COVID-19. The approaches of clinics will likely vary, depending on the level of transmission in their region.
RMA of New Jersey screens all patients for COVID-19 symptoms, including conducting temperature checks, before they come into the office. “We perform COVID-19 testing on patients prior to procedures if they are not vaccinated, and we have universal masking in the office to limit the possible spread of infection,” Molinaro says. The clinic also offers telehealth options and tries to maintain social distancing. RMA has clinics in four states, and they all follow their respective state’s COVID-19 safety guidelines for ambulatory care and patient care.
3. Trust your instincts.
When you’re considering a fertility clinic, keep in mind it provides a service, and evaluate it the way you would other providers you might hire.
“I think patients’ gut feelings are usually pretty good,” says Dr. Paul Turek, a board-certified urologist and microsurgeon. He’s also founder and director of the Turek Clinic, which has offices in San Francisco and Beverly Hills in California.
“Your gametes are one of life’s most precious commodities. You use a lot of different factors to decide who’s going to handle your retirement or keepsake your jewelry. Use the same sorts of input for this precious resource. Consider how the clinic’s staff talk to you, what they say — how professional does the care feel? Is the care personalized and professional enough so you feel comfortable?”
[Read: Everything You Need to Know About Prenatal Vitamins.]
4. Don’t choose a clinic based solely on insurance coverage.
Currently, 19 states have laws that mandate at least some coverage for infertility treatments, according to healthinsurance.org. “Although it’s tempting, it’s not necessarily the best idea to pick a clinic based on your insurance coverage,” Turek says. “The best thing to do is to base your decision on the performance of the individual clinic, which is knowable.”
5. Be wary of programs that aren’t transparent about their results on their website.
Most programs are proud of their results and will list them on their website, Turek says. If a facility doesn’t list its outcomes or doesn’t appear to be fully transparent, consider it a red flag. It may mean the facility doesn’t have good results.
6. Ask how many assisted reproductive procedures the facility does.
“Volume can matter in IVF,” Turek says. “In many areas of surgery, volume is a sign of expertise. It’s not a hard-and-fast rule, but it is a consideration when evaluating program quality.”
Inquire about how many procedures the facility does each year. There’s no standard regarding volume, he says. However, he adds that a fertility clinic that does fewer than 100 procedures annually to be a low-volume clinic. Tipton notes that to be a member of SART, a fertility clinic must conduct at least 20 follicular aspirations (egg retrievals from the follicles) and/or transfers annually.
7. Look for well-trained providers.
As with other fields of medicine, training experience matters in reproductive medicine, Turek says.
Any reproductive endocrinologist will have a minimum of seven years of training after medical school, says Dr. Lora Shahine, a clinical associate professor of fertility at the University of Washington. She also practices at Pacific NW Fertility and IVF Specialists in Seattle.
Seeing fertility doctors who are fellowship trained and board-certified in both the fields of obstetrics and gynecology as well as reproductive endocrinology and infertility “provides a reassurance that you’re in the hands of specialists who are well-trained in and dedicated to the field of fertility,” she says.
8. Consider what you’re getting for your money.
Price is always a consideration, but you should also weigh what you get for your money. “It’s not about the cheapest program. It’s about what you’re getting for your money, and that’s a value proposition,” Turek says. “If you spend 25% more for a 50% higher pregnancy rate, that could be a better deal for you.”
Good clinics with high success rates may cost more up front, but may get you pregnant faster and at a lower cost in the long run instead of paying for multiple treatments.
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How to Find a Good Fertility Clinic originally appeared on usnews.com
Update 01/11/22: This story was previously published at an earlier date and has been updated with new information.
