How to Choose a Fertility Clinic

How to Choose a Fertility Clinic

Fertility treatment is an intensely personal process as well as a complex area of medicine, requiring deep emotional (and often financial) investment. You may have spent months or even years considering whether to seek fertility treatment. Once you’ve reached the pivotal decision to proceed with IVF or another therapy, the next important step is choosing which fertility clinic to use. This can be an overwhelming prospect for many patients. The clinic you choose will affect your experience at every stage, and can be a deciding factor in whether you achieve a successful outcome. With so many alternatives out there, how do you narrow down your choices? The most important thing you can do from the very beginning is to empower yourself with good information and a list of questions to ask any prospective clinic. This guide will walk you through what you need to know as you review your options.

What is a fertility clinic?

The term “fertility clinic” can refer to any medical practice which deals with reproductive medicine, from a single practitioner to a full-service clinic with its own labs and testing facilities. The highly trained staff of these clinics includes experts such as gynecologists, reproductive endocrinologists, embryologists, as well as specialist nurses and technicians such as sonographers. The exact list of Assisted Reproductive Technologies (ART) offered by a clinic can vary, but usually includes such treatments as Intrauterine Insemination (IUI) and In Vitro Fertilization (IVF)

Types of clinics

Different types of fertility clinics in delhi can offer very different patient experiences and levels of success. Factors such as size, direct access to doctors, and the resources available to you can vary depending on which type of clinic you choose.

Generally, fertility clinics can be split into three main categories:

• Private practice Under this umbrella you’ll find sole practitioners, smaller practices with just a few physicians, and larger, full-service practices which may have their own laboratory and other facilities. Private practices can also include fertility networks, which are groups of practices that have come together to share resources and may also offer different forms of financing.

• Hospital-based clinics Most successful clinics have moved away from the hospital system because hospitals are often focused primarily on caring for sick patients, not the complex conditions of infertility. Another thing to consider is that the reputation (for better or worse) of the hospital may not match the reality of care in the fertility clinic. Make sure that you ask all the same questions that you would in a private clinic.

• University-based clinics A fertility clinic associated with a university hospital might have some advantages, allowing you to proceed with experimental techniques, with the caveat – you might be working with younger doctors, or have students observing procedures. All kinds of fertility clinics can and do achieve wonderful results for their patients, so the type you choose will depend on your priorities, preferences and needs. Smaller clinics are often able to provide more handholding and personalized care, while larger clinics may offer better resources. Of course, the exact facilities and specialties offered by each individual clinic can vary hugely, and there may be crossover between types. No matter which type of clinic you are considering, thorough research is helpful.

Things to consider when choosing a fertility clinic

Having as much information as possible upfront is key to having a good experience, but with so many variables to consider, it’s easy to start feeling overwhelmed. You may be worried that you’ll miss something or leave out a crucial point. To help you through the process, a detailed checklist of areas to cover and questions to ask can help you stay focused and feel secure.

The experience and qualifications of staff

Knowing that you are in expert hands goes a long way towards peace of mind. Consider the training and years of experience of all members of staff. Where did they study? How long have they been in the field? Do they keep up with new advances through regular professional development, reading publications, and attending conferences? The quality of the laboratory A high-quality lab is absolutely crucial to success. This is where the most painstaking processes of fertility treatment take place. Whether your chosen fertility clinic operates its own embryology lab or outsources to a large hospital lab, they should be able to provide detailed information about how the lab is operated, including success rates. Some laboratory factors to consider:

• Qualifications/experience of doctors/staff: Just like clinical professionals, laboratory professionals such as embryologists and technicians should be highly trained, experienced, and certified.

 • Lab practices: How are the embryos handled, incubated, and stored? A lab which follows best practices and stays up to date on all the latest advances in embryology will offer you the best possible chance of success.

 • Quality of the supplies: The process of creating new human life is extraordinarily complex. Optimal embryo growth and development requires a complex and delicate set of environmental controls. It’s important to know what type of culture media/incubators/handling apparatus are used. How are they tested for their potential impact on developing embryos?

• Quality of the air filtration/purification system: Volatile organic compounds (VOCs), microbes, perfumes, and other contaminants are deadly to developing embryos. Specially designed Heating, Ventilating, and Air Conditioning (HVAC) units should be equipped with charcoal filters and high-efficiency particulate (HEPA) air filters, and should generate enough air pressure to completely change the air in the room 20 times per hour.

 • Quality of temperature/lighting: Both of these factors can have a profound effect on embryo development and should be carefully controlled.

Success rate

Understanding IVF clinic success rates can be a challenge. The way data and statistics are calculated and presented make a very real difference. Not all facts and figures are created equal, but you shouldn’t have to be a statistician or accountant to get the numbers you need. The truth is that the direct comparison of clinic success rates is not a good indicator on its own. Success rates differ between clinics largely because they are affected by the type of patient treated, the type of treatment used, and the clinic treatment protocols. However, there are some statistics which can help you decide if a particular clinic might be good for you and your needs.

• The clinic should provide data that shows number of treatments in a year and number of pregnancies and live births resulting from those treatments. Common breakdowns include statistics such as the implantation rate and live birth rate.

 • It should also be able to give you data such as age and diagnosis of its patients along with success rates broken down by treatment option, for example: IUI, IVF, ICSI (Intracytoplasmic Sperm Injection). The bottom line is this – you should choose a clinic which has a good match for your specific needs; that is, they should have a good success rate with patients who match your profile. Another rich source of clinic information is the website sart.org. This independent organization, the Society for Assisted Reproductive Technology (SART), provides searchable clinic-specific data.

Financial considerations

 In comparison to all the other medical procedures that families may encounter, such as appendectomy or hernia repair, IVF is actually considerably less expensive. Unfortunately, IVF may not be covered by insurance, which passes the burden of payment directly onto the patient. This makes understanding the value of the services you are purchasing more important. Getting a clear picture of what a prospective clinic will charge can sometimes help you make a decision about whether it is the right choice for you. Some clinics advertise one-size-fits all packages and upfront estimates which look attractive but may end up costing patients more in the long run. Because each case is unique, generalized quotes given before the clinic has a full picture of your particular situation can be misleading. Careful investigation is required to avoid the physical, emotional, and financial cost of unnecessary failed cycles. Finding ways to limit the number of cycles required to become pregnant is the best way to limit the overall cost of IVF. At SCRC, we take a highly customized approach to treatment planning. We concentrate our process on comprehensive diagnostic testing to identify the cause of infertility. We then work as a team to design a final personalized plan around the issues we have uncovered. Isolating the diagnosis allows for more effective treatment and better outcomes.

 • Cost Most fertility clinics will charge a base fee for each IVF cycle. This single fee encompasses most major costs, but your clinic should be upfront about which treatments and procedures are and are not included in that fee. You can usually expect this fee to include costs such as lab tests, ultrasounds, egg retrieval, sperm prep, and embryo culturing and transfer. There may be other associated costs to consider throughout the cycle, including medications, anesthesia, genetic screening tests, additional advanced treatments such as Intracytoplasmic Sperm Injection (ICSI) and embryo freezing. If you will be using donor eggs or sperm or a surrogate, there are separate costs involved.

• Insurance accepted Coverage for infertility treatment varies greatly by state and employer, but if your insurance program covers your cycle in part or full, it is almost always worth your while to find a clinic who will accept your plan. While many fertility clinics accept a wide range of insurance plans, others may be limited or not accept insurance at all.

• Financing available If you are paying for some or all of your treatment out of pocket, financing may be necessary. Some IVF clinics in delhi, especially larger practices and networks, sometimes offer special financing plans which will allow you to spread the cost of treatment into smaller payments, and may offer options to finance the high cost of fertility prescriptions. Other plans can work in tandem with any insurance coverage you do have, to ensure that any gaps are filled. If this is an option you would like to consider, be sure that the clinic offers comprehensive and responsible financial counselling. Convenience of location and hours Because IVF is a process and not a single procedure, multiple visits are required, often in quick succession. You are going to be attending the clinic several times a week at certain points in your cycle, and it should be easy for you to access. Racing back and forth to appointments can be very stressful, which is the last thing you need at such an intense and emotional time. If you are traveling some distance to attend a specific clinic and will be taking time off work for your treatment, make sure that you can find comfortable accommodation nearby. Clinics should be able to assist you with finding accommodations, particularly if you are out-of-state or out of the country

Questions to ask when visiting a clinic

Having a “script” in place when you go to meet with a clinic can help settle your nerves and ensure that you get the information you need.

How long has the clinic been established? The longer a clinic has been working with patients, the more experience and data they will have to share with you. Are the doctors and embryologists board-certified? Your family’s future is in their hands – make sure the professionals you are working with have demonstrated an ongoing commitment to excellence in their field. All doctors need a medical license to practice, but not all are board-certified. According to the American Board of Medical Specialties, “Board Certification demonstrates a physician’s exceptional expertise in a particular specialty and/or sub specialty of medical practice.” Board-certified physicians must meet stringent standards to prove their excellence in their specialty, and are committed to a program of ongoing review and professional growth. Extremely experienced doctors may hold multiple board certifications. For example, you may meet a physician who is board-certified in both Obstetrics and Gynecology as well as Reproductive Endocrinology and Infertility. For embryologists, most certifications are issued by the American Board of Bio analysis, and the process and demands of certification are similar: strict qualification requirements and ongoing training to ensure that these professionals remain at the top of their specialty. Treatment-related questions:

• How soon can treatment start? Is there a waiting list? If so, how is it managed and what are the average waiting times?

 • Will I see the same doctor throughout the course of treatment?

• What procedures are offered? Are they the ones for which you have the biggest need? Clinics should have wide range of treatments available to increase chances of success: if it turns out that I need a different approach at some point in my care, will they be able to help me?

• Do they offer genetic screening? What types? PGS, preimplantation genetic screening, examines embryos for additional or missing chromosomes, while PGD, preimplantation genetic diagnosis can check for chromosomal translocations or single gene disorders.

What are the clinic’s office and lab hours?

 If you have to plan around work or other commitments, will they have flexibility? Is there after-hours phone or email consultation available?

What kind of emotional and psychological support is available?

 Does the clinic provide counseling? Is there a patient support group? Or can they refer you to a counselor who deals with fertility problems? What financial considerations should you take into account? Does the clinic have a financial coordinator who can help with cost breakdown, insurance coverage, and financing options? Beware of clinics offering money-back guarantee: while this sounds generous, it may actually lead to a clinic charging much more for successful results. In essence, how money-back guarantees work is that the center has set up a mini-insurance company, in which those who are successful pay for those who fail treatment. Success rate-related questions

• What is the live birth rate per treatment cycle? Per egg collection? Per embryo transfer?

• What is the percentage of fresh embryo transfer vs. frozen embryo transfer?

• What is your success rate for patients of my age and with my diagnosis?

 • What is your success rate compared to other clinics?

 • Do you report to SART?

 • Do you follow SART protocol for best practices?