Choosing the right fertility clinic is one of the most important decisions you will make on your IVF journey. And it is not an easy one: everyone is different and the right clinic for one couple may not be right for another.
The critical thing is to find the best IVF clinic that is right for YOU.
How do you do that? Most fertility clinics will have shiny websites, glossy brochures and emotive advertising but, whilst these can be helpful, it is important to look behind the marketing and get the facts.
By having all the facts you can make better decisions about your care.
When my wife and I came to choose a clinic we did a lot of research. We drew up a list and visited 4 in total. For clinics that offer the same treatment there were some significant differences.
And that’s the point of this post. We’ll go through the factors to consider when making your decision.
There are lots of things to think about so to help you I have put together a free comparison tool you can download.
The tool allows you to choose which factors are most important to you and rate several fertility clinics on 15 factors to give an overall score.
By doing this you can take emotion out of the equation and come to an objective and better decision.
Free Comparison Tool: Choose the Best IVF Clinic That is Right for You.
Don’t get sucked in by glossy adverts.
Choose the top IVF clinic to give YOU the best chance of success. Download the tool and rate multiple clinics on 15 key criteria.
Success rates
We talked about success rates in detail in the post Real IVF Success Rates (What Your Clinic Isn’t Telling You). If you have not already read it I suggest that you do. The message is that it is important to look behind the “success rates” used in marketing to understand exactly what they mean.
You may be surprised.
We go through IVF to have a baby but clinics often use a different measure of “success” to give themselves higher percentages to use in adverts. It’s good for business but not necessarily good for us.
There are, of course, clinics that genuinely are better than others and have higher success rates. It would be wise, however, to be particularly cautious about taking at face value success rates that significantly higher than average (21-22% per embryo and 26-28% per cycle according to the latest Government stats).
In the Real IVF Success Rates post there is a free checklist that you can download to help you go beyond the adverts and get the real success rates.
Of course, genuine success rates are a very important consideration when choosing a clinic. A little research can help you get to the real numbers.
Patient ratings & reviews
Getting insights from others who have used a fertility clinic can be extremely helpful. Personal experiences can reveal things that you would not be able to uncover by looking at stats, going to open days, etc.
To help give a reasonable perspective it is important to listen to several opinions rather than just one or two. By doing this you reduce the chance of a single experience unfairly swaying opinion. It will also reduce the risk of, shall we say, “influenced” reviews being given too much credibility.
In some countries Government websites allow patients to rate their clinic. As an example, in the UK the Human Fertilisation & Embryology Authority (HFEA) website contains patient reviews on each clinic page.
If there is no equivalent in your country the best option is a simple online search for the name(s) of the clinics you are considering. There are many forums where patients share their experiences and people are generally happy to answer any questions you may have. We were very grateful for the help we were given.
Inspection ratings
Whilst patient ratings and reviews are extremely helpful they are unlikely to reveal any “behind the scenes” issues. That’s to be expected. Most patients are not medical professionals and would not have access anyway.
This is where official inspections come in.
In the US the Society for Assisted Reproductive Techniques (SART) sets certain clinical and ethical standards that fertility clinics must meet to ensure high quality care. One of the requirements for membership is that clinics pass regular inspections. Most of the top IVF clinics in the US (around 80%) are members of SART and this is an important factor to take into account.
In the UK the HFEA performs a similar function. It also gives each clinic an inspection rating and publishes the reports on its website. You can find them on each clinic page.
For other countries, regulation of fertility clinics is mixed. Some have stringent requirements but in others clinics are largely unregulated. If you live in a country where inspections are conducted by independent bodies it would be wise to ensure your clinic has passed successfully.
Trust
Trust is one of the most important factors in choosing a clinic. You should have complete faith that the clinic’s primary focus is helping you to have a baby. With low success rates and hormone drugs that can cause emotions to run high you need a team that you can rely on absolutely. It can be a tough journey.
You need to know that the IVF clinic has YOUR best interests at heart.
Trust is not something that develops overnight. It comes from having confidence in each of your interactions with a clinic.
When you visit the clinic’s website look closely. Do they set out their expertise and specialisms? Do they provide bios of team members? Are their success rates clearly displayed, with no “careful wording” that leads visitors to believe they are higher than they actually are?
If you go to an open day you can meet some of the staff, have a tour and here about their services and approach.
Of course, websites and open days are marketing opportunities for the clinic. They are obviously going to try to show themselves in the best light. They may well genuinely be warm and welcoming but you should not lose sight of the reason clinics host such events: to generate business.
The key moment is when you first meet them as a patient or serious potential patient. Do the staff inspire confidence? Do they answer all your questions clearly and completely? Do you have good rapport with them? Do they propose a treatment plan tailored to YOU rather than a one-size-fits-all approach? Do they give you a realistic prognosis?
I’ve said it above but I’ll say it again: you need to feel complete trust in the people helping you.
It would also be wise to check that the people you develop trust in would be caring for you throughout the process. This is not always the case.
Treatment options
Does the clinic offer only or mainly IVF? Or does it offer a range of fertility treatments? IVF may or may not be the best treatment option for you. If a fertility clinic only carries out IVF then you may be encouraged in that direction even if it is not the best thing for you.
Whether IVF is the right thing for you depends partly on the cause of your fertility issues. This makes the initial diagnostic tests critically important. We’ll look at these later.
Lifestyle advice
Lifestyle tweaks can be extremely powerful in increasing your chances of having a baby with IVF. A quick look at other posts on our blog shows just how effective they are.
These are just the tip of the iceberg but, unfortunately, many fertility clinics are not aware of them. Those that recommend these type of things as part of their treatment protocols have higher success rates.
Is the clinic one of them?
There are lots of simple, easy-to-follow lifestyle tips that you can use to boost your chances. If a clinic is not able to provide this advice then consider seeking out people who can.
Diagnostic tests
Before recommending any course of treatment the best IVF clinics carry out a full range of tests to diagnose the cause of your issues. These tests should include:
- x-rays (called HSGs or hysterosalpingograms) to check that your womb and fallopian tubes are healthy and free of obstructions
- hormone tests at the start of your menstrual cycle to identify any imbalances that may affect your fertility
- ultrasound and blood tests to establish any issues with availability of eggs (ovarian reserve)
- sperm function tests to establish sperm count, volume, motility (movement), morphology (shape), pH level (acidity) and presence of white or red blood cells or immature sperm
If a fertility clinic recommends a certain form of treatment without having carried out these tests you should be very wary.
Specialisms, experience & expertise
If you have already undergone testing and have been diagnosed with a specific condition, does the clinic have experience in helping patients with this condition?
Equally, if you are over 35, does the clinic have experience in treating women of your age?
These are vital.
A clinic that is right for you is one with experience and expertise in treating patients in your position. Don’t be swayed by headline success rates. Look for clinics that have higher success rates for treating patients like you.
Also, do not feel that you have to stick with the clinic that performs the diagnostic tests. If it turns out that you have a condition that the clinic is not experienced in treating (or not treating successfully) find a clinic that is.
Fertility clinics that specialise usually advertise the fact on their websites. However, it may be that only certain members of the team have the specialism. When you speak to a clinic establish who has the relevant expertise and insist on being placed under their care.
Next, how long has the clinic been established? Who is the lead clinician/doctor and what are their qualifications and experience? Have they, for example, published scientific studies on IVF, contributed to medical textbooks and practiced for 20 years?
If the person who will care for you is not the lead clinician, what is their background? How closely do they work with the top guy?
The lead doctor will be the one who designs the clinic’s standard treatment protocols but how much input will they have in YOUR treatment?
And whilst this person will be in overall charge of your care there may be many others working behind the scenes. For this reason, you should also check the background of other key people:
- embryologists, the specialists who will assist with diagnostic testing, collect eggs, analyse the quality of eggs and sperm, select the best for fertilisation, fertilise eggs, freeze and thaw embryos and monitor embryo development
- if applicable, andrologists, the experts in male fertility issues
Is the clinic a member of any associations designed to ensure high quality patient care and ethics? In the UK clinics have to be licensed by the HFEA before they can carry out IVF treatment but in other countries the requirements can be less stringent.
In the US, for example, only around 80% of clinics are members of the closest equivalent, SART.
Technology & techniques
IVF technology and techniques are improving all the time. To give yourself the best chance of success a clinic should use the latest equipment and techniques.
In recent years there have been a number of advances all of which can increase success rates. These include:
- better and less invasive monitoring of embryo development using Embryoscope
- improved embryo implantation from EmbryoGlue
- fast embryo freeze/thaw techniques to improve embryo survival rates
- intracytoplasmic morphologically selected sperm injection (IMSI) where the healthiest sperm is identified then used to fertilise an egg
If a clinic does not offer state-of-the-art treatment then chances are it is putting profit before patient care.
Embryo transfer policy
In Real IVF Success Rates (What Your Clinic Isn’t Telling You) we touched on how the number of embryos transferred can be used to influence success rates. The more embryos transferred at a time the more likely it is that you will become pregnant.
At first that sounds great doesn’t it? Not so fast…
The big issue with transferring multiple embryos is that the chances of having twins or triplets greatly increases.
Again, at first look that doesn’t necessarily seem a bad thing. You’re desperate to have a baby so you’d be overjoyed with two.
Multiple pregnancies often lead to healthy babies with no harm to the mother but as we saw in our Ultimate Guide to IVF there are some serious risks. Miscarriage, premature birth and birth defects are all much more common in multiple pregnancies.
Even transferring just two embryos instead of one increases the chances of a multiple birth from 2% to 29%. Many fertility clinics encourage patients to transfer even more than two.
When my wife and I came to choose we simply did not want to take any unnecessary risks. We opted for single embryo transfers and took the view that we could always have another transfer if one was not successful.
The decision is a very personal one and the “right” choice is one that both you and your partner are comfortable with.
In the Ultimate Guide we looked at the recommendations of the UK’s National Institute for Health and Care Excellence (NICE) and the US American Society for Reproductive Medicine (ASRM) for the number of embryos to be transferred. NICE’s recommendations are partly based on what is best for the patient but they are also factor in budgetary considerations. The UK’s National Health Service has a limited budget so NICE has to take this into account.
The situation is different with ASRM. They are able to focus on the best interests of the patient. For this reason, their recommendations for the maximum number of embryos to transfer at a time (which can be higher than NICE’s advice) are probably the best guide.
So, if a clinic routinely transfers more embryos than is recommended by ASRM it may be that they are chasing higher success rates rather than putting their patients first.
Don’t allow yourself to be pushed in a direction that you are not comfortable with.
Costs & insurance
Our Ultimate Guide to IVF looked at costs in detail. Unfortunately, unless you are based in the UK and able to get treatment though the NHS cost is going to be a factor.
Costs vary but a single cycle is likely to be between £7,000 and £9,000 ($12,000 and $15,000) with the best IVF clinics charging up to £18,000 ($30,000). In the US some insurance plans will cover certain costs at certain clinics but in the UK this is not the case.
I won’t repeat everything here: check out the Ultimate Guide for more details.
Eligibility
Will the clinic accept you as a patient?
Why wouldn’t they? Unless you’re having treatment in the UK through the NHS, fertility clinics are businesses so surely they would want the custom?
Not always.
Some clinics will turn away patients in order to protect their success percentages. If, for example, a women is over a certain age or has low egg reserves the likelihood of the treatment being successful is lower and this would affect the clinic’s success rate. A lower success rate can then make it more difficult to attract other patients.
There are really two points here. Firstly, there’s the question of whether you meet any eligibility criteria. Secondly, and perhaps more importantly, if a clinic has eligibility criteria at all it may suggest that they are not as ethical as they might be. This, of course, may impact your trust in them
Fertility clinic location
It shouldn’t be seen as the most important factor but location is, of course, a consideration.
When we went through stimulation and had our egg collection my wife and I lived relatively close to the clinic. However, we then moved over 250 miles and a 5 hour drive away.
If you have read our About page you will know that we froze our embryos whilst we beat my wife’s leukaemia. When it came to using the embryos we felt that the same team was the best option for us.
To make things easier we had consultations by telephone and scans at a fertility clinic closer to home. When it came to the endometrial scratch and embryo transfer procedure we stayed overnight in a hotel to spread the travel over 2 days. It took some organising but everything worked smoothly.
Of course, in an ideal world the clinic would be within an easy drive of where you live but if the best option for you is further away the distance can be managed. Below is a list of things you would need to factor in:
- additional travel costs
- costs of scans at other clinics (which would normally be included as part of your clinic’s charges)
- additional time off work
- impact of travel on the discomfort you will feel after egg collection, endometrial scratch and embryo transfer
- added stress from co-ordinating treatment and travel
Accessibility
Timing is critical in IVF. Your clinic should be open 7 days a week for scans, egg collection, embryo transfers, etc. If the clinic is open only Monday to Friday or only carries out certain procedures on certain days your chances of success may be affected.
Delaying a step even for a day or two can mean missing the optimal window.
Top IVF clinics are also available to answer questions out of hours. IVF can be a nerve-racking process and having an expert on hand to offer guidance and reassurance is invaluable.
Counselling
Most people who go through IVF will tell you that it is an emotional rollercoaster. Not only is something very precious at stake the hormones given during the stimulation phase and in preparation for transfer can wreak havoc with your emotions.
Hopefully, your partner will be able to provide some support but the process may be having an effect on them too. This is where access to a trained counsellor can be helpful. Having someone who is not involved in your day-to-day care but who is there just to listen and provide some comfort can help take the edge off the low points.
Inevitably, there will be times when you feel less than optimistic so check what counselling and patient support the clinic offers.
Waiting list
Can you start treatment straight away or is there a waiting list?
This is a double-edged sword. Fertility clinics may have waiting lists because they are good at what they do and so attract lots of patients. On the other hand, you may want to start treatment immediately or you may be conscious of the effect age can have on success.
Having a waiting list is not necessarily a positive or a negative for the clinic. It is just something to factor in to your decision making process.
Frequently Asked Questions
Which IVF clinic has the highest success rate?
In the US, the Center for Disease Control (CDC) publishes statistics each year showing the success rates of IVF clinics. You can search their database here or you can check out their reports on the same page.
What is the best fertility clinic in the UK?
In the UK the HFEA (a Government authority) regulates IVF treatment and produces reports each year showing the success rates of IVF clinics. You can search the HFEA database or check out their latest report here.
Can you trust published IVF success rates?
You need to be careful. The National Institute for Health carried out research into IVF clinics’ published success rates and heavily criticised them for misleading patients.
Of course higher percentages are better for business so you should be wary of any clinic that claims success rates that are much higher than official government stats (21-22% per embryo and 26-28% per cycle).
How do I find the best IVF clinic?
Success rates are the most important factor when choosing the best IVF clinic. In the US you can use the CDC database or download their reports. In the UK the HFEA compiles records of success rates and their latest report is available here.
Don’t just focus on the percentages though. There are 14 other factors to consider and each of these can affect your particular chances of success. You can download our simple comparison table free to help you choose the best IVF clinic for you.
Wrap-up
There are lots of things here but they are all relevant in choosing a clinic that is right for you. Some of the factors may be less important to you than others. That’s ok of course. Equally, other factors may be especially important.
To help you weigh up all the factors I have put together a free comparison tool you can download now.
The tool allows you to decide which factors are most important to you then you can rate several clinics for each factor. It gives more weight to your most important factors then calculates an overall score for comparison.
My wife and I found that carrying an exercise like this helped us come to an objective decision.
I hope that you will find it useful too.
Free Comparison Tool: Choose the Best IVF Clinic That is Right for You.
Don’t get sucked in by glossy adverts.
Choose the top IVF clinic to give YOU the best chance of success. Download the tool and rate multiple clinics on 15 key criteria.