After months — or even years — of waiting to start a family to no avail, you may have decided to seek fertility treatment. For those embarking on a fertility journey, a good fertility clinic can be critical.
Fertility clinics can help people who are having difficulty conceiving a child. But as you start researching your options, it may quickly become clear that this process is more complex than you could’ve imagined. Finding the right clinic can be a challenging path to navigate, filled with high emotional and financial stakes and many unknowns.
Looking for the right fertility clinic for you? Here’s what to consider when you’re searching for a good fertility clinic.
[READ: IUI vs. IVF: What’s the Difference?]
What Is Reproductive Medicine?
Reproductive medicine is growing rapidly, providing options for people who face infertility challenges.
One of the most well-known fertility treatments is in vitro fertilization, where a woman’s eggs are fertilized with sperm cells in a lab setting to create embryos. Some of the embryos are then placed in the woman’s uterus to initiate pregnancy. During IVF, clinicians often retrieve and fertilize more than one egg to boost the chances of a successful pregnancy. Embryos not used in the initial transfer can be frozen and saved for future transfer attempts, if needed.
Each year, approximately 2.3% of all U.S.-born infants are conceived using assisted reproductive technology (ART). While IVF is the most common type of ART, others include frozen embryo transfer, intracytoplasmic sperm injection and gamete intrafallopian transfer.
In 2021, 453 fertility clinics reported performing 413,776 ART cycles in approximately 238,126 patients, which resulted in 91,906 live births, according to the Centers for Disease Control and Prevention’s Assisted Reproductive Technology National Summary Report. These numbers rose from 2019 data, where 330,773 ART cycles were reported by 448 clinics, according to the CDC. Those cycles resulted in 77,998 live births.
Despite the rising numbers, 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, a multidisciplinary organization dedicated to the advancement of the science and practice of reproductive medicine.
As a result, it’s essential for consumers to take an active role in evaluating fertility clinics when seeking care.
[Read: A Patient’s Guide to Infertility.]
What to Consider When Choosing a Fertility Clinic
When considering which fertility clinic is best for you, weigh several factors:
1. Cost
The IVF process is pricey, and not all health insurance plans cover it. In the U.S., the average cost for a complete IVF cycle can range anywhere from $15,000 to $30,000 or more. However, it often takes more than one cycle of IVF to successfully conceive, with the average number of IVF cycles needed to become pregnant falling around 2.5.
Many states have infertility coverage laws in place, meaning health insurance plans may be required to include coverage for certain fertility treatments. For more information on your state’s fertility insurance coverage laws, Resolve: The National Infertility Association — a patient advocacy organization — breaks down insurance coverage by state.
In addition to familiarizing yourself with your state’s fertility laws and the parameters of your individual coverage, you should understand the cost of treatment at clinics you’re considering, as well as if they accept your health insurance plan.
[READ: Male Infertility: Causes, Symptoms and Treatments]
2. Clinic success rates
Look at how many assisted reproductive procedures the facility does and what their success rates are.
“Volume can matter in IVF,” 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. “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.”
Ask about the number of procedures the facility performs each year. While there’s no specific standard regarding volume, Turek notes that a fertility clinic that does fewer than 100 procedures annually is generally considered low volume.
Tipton adds that to be a member of the Society for Assisted Reproductive Technology — an organization representing the majority of ART clinics in the U.S — a fertility clinic must conduct at least 20 follicular aspirations (egg retrievals from the follicles) and/or transfers annually.
Additionally, 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. However, results for fertility may depend highly on selection of patients and their fertility risk factors. If possible, ask about the success rates for others in your position.
[Early Signs of Pregnancy: Symptoms to Watch For]
3. Expertise and credential of providers
Look for well-trained providers at the fertility clinic you’re interested in. As with other fields of medicine, training experience matters in reproductive medicine, Turek says.
Reproductive endocrinologists will have a minimum of seven years of training after medical school; they typically complete four years of residency training in obstetrics and gynecology and an additional three years of training in reproductive endocrinology and infertility.
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.
4. Location
While it may be tempting to focus solely on clinic outcomes and provider expertise, convenience is still an important factor to weigh. Fertility treatments often require multiple visits over several weeks or months, so ensuring that the fertility clinic you choose is in a reasonably accessible location can help reduce stress and the burden of frequent appointments.
5. Overall clinic support and services
How were your initial interactions with the clinic? Was the phone answered — quickly, or at all — if you called, and if not, did staff return your call? Pay attention to interactions with staff: Notice if staff are attentive, responsive and generally create a positive environment where you feel your needs will be met.
Undergoing fertility treatments can also be an incredibly emotionally taxing process. With that in mind, some fertility clinics have additional resources — like counseling and other mental health services — available to support you and/or a partner during this process. Inquire with clinics you’re exploring about what kinds of support and services are available while you’re receiving fertility treatments.
6. Patient satisfaction
Ask around — do you have any friends or family members who received fertility treatments at a particular clinic? If so, was their experience largely positive or negative? And did their reproductive medicine procedure result in a live birth?
Hearing firsthand from a trusted source is one of the best ways to ensure you get the experience you’re looking for.
Even if you don’t know anyone personally who has used a nearby clinic, thanks to online reviews, forums and social media groups, patient input is at your fingertips. Read patient reviews online or consider joining a local fertility Facebook group to hear about others’ experiences. However, take what you read online with a grain of salt — keyboard warriors can sometimes focus on and amplify isolated negative experiences.
Instead, look for common themes across multiple patient experiences or reviews to get a balanced perspective of the clinic.
How to Choose a Fertility Clinic
If you’re considering a fertility clinic to help you conceive, here’s how to evaluate factors that go into a decision:
1. Do your research
Not all fertility clinics are created equal.
“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 visiting SART’s website, whose mission is to establish and maintain standards for ART to promote the highest possible level of care. The federal government requires fertility clinics to report their IVF treatment cycle success rates, and you can find those statistics on SART’s site.
2. Weigh your options
Take several factors into account when weighing your options and avoid choosing a clinic based on a single factor. For example, don’t choose a clinic solely based on insurance coverage — if that’s a financial option for you.
“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.”
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.
3. Trust your instincts
When you’re considering a fertility clinic, keep in mind that 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,” Turek says, adding, “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.”
At the clinic, ask yourself: Is the care and communication personalized and professional enough so you feel comfortable?
[Read: Everything You Need to Know About Prenatal Vitamins.]
Questions to Ask When Choosing a Fertility Clinic
When weighing your options, consider asking fertility clinics questions about their services, such as:
— How many assisted reproductive procedures does the facility do? Although success rates can vary based on the age and individual health factors of patients, getting a sense of how many procedures the clinic conducts annually can help better contextualize their level of expertise and the clinic’s success rates.
— What are the clinic’s success rates like for patients of my age and health status? Understanding outcomes specific to your individual circumstances is important for evaluating the clinic’s success rates and assessing your likelihood of success.
— I have an underlying health condition, can I still receive care? Some underlying health conditions, such as polycystic ovary syndrome, may affect how providers approach your care, so you’ll want to check what your treatment path should be moving forward.
— Does the clinic serve LGBTQ+ patient populations? Many LGBTQ+ individuals and couples turn to fertility treatment to build their families, making it essential to receive care that is both inclusive and supportive.
— How much does a specific reproductive procedure cost? Fertility clinics should be able to communicate overall costs of fertility treatments so you know what to expect.
— Do you accept my health insurance plan? Not all fertility clinics accept insurance, or they may accept limited plans. Knowing their insurance policies will help you confirm upfront how much fertility treatments may cost you out of pocket.
— Is financial assistance available? The facility may have a financial advisor that can help you navigate your options. The clinic may also work with financing companies to help establish affordable payment plans.
— How does your clinic handle communications with patients? The clinic should be able to tell you the best way to get in touch if you have any questions or concerns. It’s also helpful to know the expected turnaround time for responding to requests.
— I’m ready to start my fertility journey; what’s next? Asking a fertility clinic about those first steps can help provide you with insight on what to expect — both when you’re getting started and throughout the process.
The Future of Fertility Treatments
As more women and couples delay starting families, the demand for fertility treatments continues to grow. However, an uncertain political landscape, both at the state and federal levels, leaves many questions about the future of fertility care.
Over the past year, a controversial ruling by the Alabama Supreme Court declared that frozen embryos created and stored during IVF are considered children in a wrongful death suit where embryos were destroyed. This decision led some IVF clinics and providers in the state to temporarily halt certain treatments. Not long after, the Alabama Legislature passed a bill granting civil and criminal immunity to IVF providers and clinics. Most recently, the Alabama fertility clinic involved in the wrongful death lawsuit made an unsuccessful attempt to appeal the ruling to the U.S. Supreme Court.
As the landscape continues to evolve, staying informed about legal developments and how they may impact you is important for those seeking reproductive care.
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How to Find a Good Fertility Clinic originally appeared on usnews.com
Update 11/19/24: This story was previously published at an earlier date and has been updated with new information.
