You might be surprised by this one, you might not have thought of this one when you were
taking a look at which clinic you might like to work with...
Hi, and welcome to the FertilitySpace channel. We help women take control of their fertility,
learn about reproductive health, and find the best fertility provider to suit their unique needs.
Today we're gonna be talking about the five steps for how to choose a fertility clinic.
So when is it time to seek out a fertility clinic? When should you even start looking
to work with a fertility specialist? It depends on what you'e looking to do at the fertility clinic.
If you have been struggling to conceive, the ASRM, the American Society for Reproductive Medicine,
actually has guidelines on how long you should try naturally based on your age
before reaching out to a specialist. So , the ASRM recommends that if you are
younger than 35 years of age, the female, is younger than 35 years of age, you should try to
conceive naturally for at least 12 months before reaching out to a clinic to get some testing done.
If you're older than 35, they recommend trying for 6 months before going in to get some testing done.
They recently updated their guidelines in February of 2020 to also include that women
that are 40 years or older should come in sooner for testing. They didn't state how many months of
trying you should do naturally but clinics generally recommend about
3 months if you're 40 years of age or older. So what is infertility? So, the ASRM
has a definition for this. Infertility is defined as "the failure to achieve
a successful pregnancy after 12 months or more of regular, unprotected, sexual intercourse or due to
an impairment of a person's capacity to reproduce either as an individual or with her/his partner."
For women that are just going in looking for egg freezing,
they're looking to preserve their fertility, they're not trying to get pregnant right now,
it's a little bit different. You don't have to wait until you're a specific
age. Fertility declines with age so egg quality actually declines with age as well so the sooner
you can go in for testing and speak to a physician about freezing your eggs, the better. So,
definitely do it while you're younger, you don't have to wait until you're 35.
Ok, so let's dive right in to the 5 steps. Step number 1 is to check with your insurance.
I know that not everyone has infertility coverage for treatment or sometimes even for testing
but if you do have insurance coverage for anything to do with infertility, it's a great place
to start just to check in with your insurance and see which clinics are in-network for you.
If you skip this step and you actually go working with whichever clinic you want
and you find out later that they're out-of-network, your insurance will definitely
pay for less but sometimes they won't pay for anything at all. So it's better just to check
with them ahead of time and make sure that you're working with one of their in-network providers.
If you don't have infertility coverage, that's totally fine. Skip this step,
the rest of the steps aren't dependent on having insurance coverage at all.
Step 2 is to compare success rates between different clinics.
So, annually clinics, fertility clinics, actually report their IVF success rates to either the CDC
or to SART, the Society for Assisted reproductive Technology. So you can find these stats online on
the CDC's website or on the SART website. Some clinics report to both, some clinics
just report to one, so if you're looking for a particular clinic, you might want to check
both websites but that's where you can find those and you can start to compare based on success
rates for your age range, they're stratified by age, which clinic might be preferable for you.
For those of you who are gonna be checking out the IVF success rates, I have a little tip when
you're looking at the metrics. There are a lot of numbers on there and sometimes it can be a
little bit difficult to figure out which ones actually might give you the most information.
So, a lot of you are gonna look on there and you might think you should be looking at the clinical
pregnancy rate. That's definitely a good place to start, always good to take a look at the clinical
pregnancy rate. Then some of you might have thought, "Oh, there's a live birth rate on there,
I should look at the live birth rate." Yes, definitely good, getting a little bit closer.
The best metric to look at is the Singleton Live Birth Rate. So that's definitely a good
metric to look at when you're evaluating which clinic you might be interested in working with.
It's important to keep in mind that, some of you might be thinking, "Oh you know I'm
just going in for testing or you know, maybe I wanna have an IUI don, I'm not
necessarily looking for IVF", totally get that. Clinics don't often report their IUI success
rates, they don't report them at least to SART or the CDC. That reporting is just for IVF.
You can always ask them about IUI success rates and what it would be most likely for your age and
your diagnosis. But it's always good just to take a look on SART and the CDC if you're just doing
an IUI or even if you're just looking into egg freezing. It will at least give you an idea of how
many cycles this clinic does annually and possibly give you an idea about the quality of the lab
and how many patients they see that are actually in your age range. So, that even might even help
you decide which clinic you might wanna work with even if you're not necessarily going for IVF.
At FertilitySpace, on our clinic profiles, you'll see that for each clinic we look at, we highlight
the Singleton Live Birth Rate for the IVF success rates. We get our data from the CDC. The rest of
the metrics are on there as well for you to take a look at but we specifically highlight
the Singleton Live Birth Rate because that gives you the best indication of,
you know, not only which clinics are following best practices but
that's the ideal outcome when you're going through artificial insemination or Assisted
Reproductive Technology, it's just to get one healthy baby from a cycle. They try to avoid
twins and multiples of higher orders because that can always lead to adverse outcomes for
the mother and for the baby, so one baby. So definitely look at the Singleton Live Birth Rate.
And for those of you interested about IUI success rates, because I mentioned that clinics don't
usually report on that to the CDC or to SART, we are gonna be doing a video looking at the clinical
research to see what the general success rates are for IUI for different patient populations. So
keep that in mind. Look out for that video if you do want a general idea of what the success
rates are with intrauterine insemination. Ok, so we just talked a lot about success
rates and they're very important but just keep in mind, they're not the end-all-be-all
when you're comparing clinics that you're interested in working with.
There are a lot of reasons why success rates can differ between clinics sand
it might not always mean it will differ for you if you go to one clinic over the other.
One reason is the number of cycles between two clinics for one particular reporting year
could be vastly different. One clinic could be newer, one clinic could be outside of
the metro area so they have less number of cycles. So that's something to keep in mind
is you might be looking at a really large clinic that does a thousand cycles a year and looking at
one that only does three hundred cycles a year and that could possibly affect the data and it might
not be accurate for what would happen for your particular age range if you went to that clinic.
Patient population might also differ between two clinics. So a clinic might see,
the majority of the patients they see might be a different age group than you or have a different
diagnosis. So that's something to keep in mind as well that could skew the outcomes a little bit
one way or the other compared to how the outcomes at that clinic would be for you.
Some clinics also take on harder cases, sometimes they're referred a lot of
patients from other fertility clinics where they've had failures in the past.
And that can always affect their outcomes as well, so it's something just to look into, to try to
understand a little bit more about why each clinic has certain success rates. So definitely look at
the success rates and they're important and can be really informative but remember that you can't
control of the confounding factors. So let's take a look at the next steps as well to help
you have a more holistic view of a clinic when you're trying to decide which one to work with.
And for everything we mentioned in the video today, just so you know,
it's all gonna be linked below. So if you did want to check out the CDC for their success rates
or SART or FertilitySpace, or if you wanted to look at those ASRM guidelines for the
ages and when you should go in for infertility evaluation, that's all gonna be linked below.
So check out the description if you did wanna research into this further.
Step number 3 is to check clinic distance. So, you might think that choosing a clinic
that's a little farther away versus a closer one won't really make a difference cause you
only go in once or twice to check in with the doctor. But if you're gonna be going through
infertility treatments or egg freezing, keep in mind that there are actually a lot of early
morning appointments and there might be times during a treatment cycle where you have to go
in 3 or 4 times in a week for early morning monitoring and if you have to drive further
away that could eat into things you have to do for your personal life or getting back
in time to start work. So just keep that in mind that clinic distance is important.
It's also important to note that some clinics have several locations,
you need to figure out which one is the main location and which ones are satellite locations.
The reason being is that if you end up going to a clinic and you realize that the closest one
to you that you thought you would be going to all the time is a satellite location,
you might no be able to have everything done there and find yourself traveling more often
to the main location. So if that's further away, it's just something to be aware of.
Satellite locations often have limited hours, limited services, and not all doctors
part of a fertility clinic group will go to satellite locations. Sometimes, maybe only 2 out
of the 5 doctors go to that satellite location. If you're ok just going in for monitoring
and seeing another doctor or a different nurse than you're used to
at the satellite location then fine, do it, just to let you know that the doctor that you're gonna
be working with might not actually be the one who's available at satellite locations most often.
Step 4 is to review doctors. So once you have a couple of clinics that you're interested in,
it's also really important to take a look the physicians to see which
reproductive endocrinologist, that's a fertility specialist, which one you would like to work with.
A recent study and anecdotal evidence from online actually has found that the reason
that a lot of patients chose a specific clinic or even chose to stay with that clinic was due to the
quality of the relationship with their physician. So it's really important that when you're taking
a look at which physician you wanna work with, you check reviews online, you read their bio
perhaps to see if they have a subspecialty within reproductive medicine that they primarily focus
on that might match what your diagnosis would be. And then also to check for personality-fit.
So schedule if you can, a couple of consultations with different physicians just to make sure that
there's a good personality-fit and that your style of communication
actually matches. When you're going through infertility treatment, it's not unheard of
to be working with a clinic for several months. So you really wanna make sure that the person
that is guiding you through the process and giving you all your protocols is someone that
you can easily communicate with and that you trust to guide you throughout the process.
Step 5 is clinic size. You might be surprised by this one, you might not have thought of
this one when you were taking a look at which clinic you might like to work with.
But the size of the clinic can actually affect whether you have a good experience there,
depending on what sort of experience you're expecting for yourself and your personality.
So this is one of those things where you really have to know yourself
and know if you're the type of person that would prefer working with a larger clinic
or a smaller clinic. So we're gonna compare the two really quickly just to
see reasons why you would wanna go for one or for the other and what the pros and cons are.
So generally, larger clinics are know to have more appointment availability,
so that's good. They're also known to have a less personal feel. When you go in,
some patients say they feel a little bit more like a number and less like a person when they go into
a larger clinic because they're a lot busier and you get in and out and you might not see the same
nurse or work with the same care team every time that you go in.
And another reason, another difference, is that when you're going to a larger fertility clinic,
your specific physician, your reproductive endocrinologist,
might not do all of your procedures himself or herself. So a lot of times, the physicians switch
daily who's doing IUI that day, who's gonna do the egg retrievals, who's gonna do embryo transfers.
SO just keep in mind that, if you're ok with that, you might be working with a different physician
for some of your procedures. But for counseling and when you have to go in for consultations,
you'll definitely be seeing your physician but that's juts something to keep in mind.
Smaller clinics are generally know to have less appointment availability. They might have more
limited hours than a larger clinic. Sometimes they're not open on the weekend or they have
more limited weekend hours than a larger clinic would have. So that's something to keep in mind.
But smaller clinics also are known to have a more personal feel. Every time you go in,
you're likely to see the same nurse and always see your physician, so you know you're working with
the same care team. There are a lot of patients that like that. They like going in and knowing
it's the same people they're gonna be talking to every single time and when they call they almost
always talk to the same people. That can be really comforting when you're going through the process.
Something that can be less favorable about some smaller clinics, this doesn't happen at all small
clinics, but when it comes to IVF cycles, some clinics batch their IVF cycles. Because they do
less rounds of IVF when it comes to their patients population,
they sometimes need their cohorts of patients to wait like a month so they
can sync everyone up and start a certain number of patients at the same time.
So if you don't feel constrained for time when you're going through IVF and you can
give yourself a month or so of leeway, then that probably won't affect you or bother you at all.
But just check with those clinics to see if they do batch their IVF cycles and and know if that's
something that's gonna work for you or if that's something that's not gonna work for you. It's
all about how it works out for you. It's kind of a unique, personal preference thing.
This is more of a general rule of what patients usually say about larger and smaller clinics,
so it might not be the case for the clinic that you're interested in. But these are just general
characteristics to be aware of so that when you do start looking at fertility clinics and reaching
out, you can take these things into account and maybe ask some of these questions. Just
to see what to expect when you're getting started going through the process. It's better not to be
blind-sided and just to know these things ahead of time going in so that you're prepared and you
know that you're ok with these possible limitations of larger and smaller clinics.
Neither is better, they're just different.
So these are our top 5 tips for how to choose a fertility clinic but I would be
interested to now what is most important to you when looking for a fertility clinic.
We didn't mention price and one of the reasons why, if you're curious, is because
clinics aren't very transparent on their website with their price. That's something
where you'd have to talk to them directly, so I would definitely say that that's kind
of later on in the steps when you've narrowed down which clinic you're most interested in,
is to give them a call, maybe speak with their financial counselor
and go over pricing. SO I would say that's one of the reasons that is further down the line
but I recognize that, that might be further to the top of the list for some of you for
how to choose a clinic. So I'd be interested to hear what you think is your #1 metric.
Ok, so with these 5 steps, you're equipped to start looking for the fertility clinic
that is best for you. So if you don't know
where to start or even how to start looking up clinics, you can head to FertilitySpace.
I'll leave the link down below to the Search. You can search hundreds of fertility clinics
across the United States there with us. And each clinic profile is going to have the
CDC Success Rates, Locations, Services Offered, Doctors Available, and Contact Info as well.
So that's where you can get started. I wish you luck.
If you have any questions, please leave them below or you can shoot us an email, I'll include that.
And then, happy hunting. I hope you find a clinic that works well for you.