Top 7 things to consider when choosing a fertility clinic

Dr. Martha Noel outlines the most important factors that distinguish the right fertility clinic for you.

1. How much you like it: Before beginning any treatment it’s a good idea to check out a few different clinics in your area to get a feel for each because you’re going to be spending a lot of time at the clinic office and lab, and doing a lot of intense, hard work with its team.  There are lots of different styles of clinic to choose from, so be sure to think about which one right for you as an individual, not just as a patient.

Dr. Noel’s advice

Fertility specialists see patients in a wide variety of clinic settings, ranging from private practice to large academic hospital centers.  There are benefits to both–for example, academic practitioners are often involved in cutting-edge research, while private practitioners are more likely to devote 100 percent of their time to their clinical practice–and the decision is very personal.

Ask your general OB/GYN for recommendations, or look up fertility clinics in your area at www.sart.org.  Many of these clinics will have meet-and-greet events or info nights for you to attend as you make your choice.

2. Clinic success rates: Clinics are required by law to report their success rates to the Centers for Disease Control and Prevention (these can be found on the CDC website), but what do these rates mean to you?  Depending on your specific case and what course of treatment you pursue, you may want to look at different data.

Dr. Noel’s advice

Be careful when choosing a clinic based on the pregnancy rates it reports to the CDC.  These statistics can be ‘doctored’ (pun intended) by the clinic—by controlling the patients a clinic accepts (e.g., taking patients based on their age or other success factor), by the way in which patients are selected for fresh embryo transfer, and by the embryology lab procedures a clinic recommends.  Choose a clinic where you feel most comfortable with the physicians and the teams who will be providing your care.

3. The fertility doctor: How much does bedside manner matter to you?  Do you want a doctor who is very straight-forward?  Or more warm and fuzzy?  How much time do you expect to spend with your doctor?

Dr. Noel’s advice

Fertility clinics vary in the number of physicians that make up the practice.  Having a solo practitioner means you’ll see the same doctor for all of your visits, but keep in mind that because there is no back-up person, there may not be as much flexibility in scheduling.  In a group practice, you may not see your own physician as frequently, but oftentimes these clinics are open 365 days a year, and perform IVF cycles during almost all of that time.

4. Location, location, location: While you’re “in cycle” you’ll be going to this place every day.  Consider picking a clinic and lab that’s close by and investigate what your commute will be like to each place

Dr. Noel’s advice

When you are undergoing an IVF cycle, you’ll likely be asked to come in to the clinic for monitoring 5 or 6 times over a 2-week period before you have your egg retrieval.  Often these visits will be early in the morning.  Even for patients who are not doing an IVF cycle, most fertility treatment requires at least 1 to 2 visits for ultrasounds and/or procedures.  Keep this in mind when trying to decide how much you are willing to travel.

If you have your heart set on a particular clinic or doctor but live far away, ask them about “outside monitoring”–can you have all your ultrasounds and blood tests at another center but keep all treatment decisions with your doctor and procedures at your clinic.

5. Dolla dolla bills y'all: No doubt about it, fertility treatments are expensive.  It’s worth a call to your insurance company to get a statement of benefits and find out if any clinics in your area are in their network.

Dr. Noel’s advice

Insurance companies vary a LOT in the amount of fertility coverage they offer–some provide no coverage, some have a cap (for example, they will cover up to $20,000 but no more), and some cover certain procedures/medications/visits but not others.

This becomes very important as you think about your treatment strategy.  Most clinics have a patient liaison who can help you navigate the insurance world, so it’s a good idea to get in touch with them as soon as you can in the process.

6. Credentials: Does it matter where your doctor went to residency and did their fellowship?  Do all doctors specialize in the same area, or should you find a doctor who specializes in your particular cause for infertility?

Dr. Noel’s advice

In order to be credentialed as a fertility specialist (technically a “reproductive endocrinologist”), your doctor will have completed 4 years of medical school, 4 years of a residency in OB/GYN, and 3 years of a fellowship specifically in reproductive endocrinology and infertility.  What this means for you is that your doctor has been very highly trained, so it probably doesn’t matter quite so much where she did that training (particularly because there are only about 40 fellowship programs in the entire country).  Things like location, insurance networks and the general vibe of the practice are probably going to be more important to you than the diplomas hanging on the wall.

7. Clinic support team: Fertility treatments are a team effort.  Your fertility doctor is obviously an extremely important part of this whole process, but there are lots of others involved as well.  Nurses, cycle coordinators, medical assistants, billing staff, et. al. are all a part of your clinic experience.

Dr. Noel’s advice

The nursing staff is the front line of the clinic.  They help scheduling visits, ordering medication, answering questions and providing general TLC.  You may spend more time over email and on the phone with your nurse than you do with your doctor, and depending on the scope of the practice, many doctors have more than 1 nurse helping to care for their patients.  When you come for your initial visit, ask if you can meet the nurse who’ll be coordinating your care (and make him or her your new best friend!).