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If you’re trying to conceive, and you’ve made the decision to seek out a fertility clinic, where do you even start? There’s the overall patient experience to consider, as well as the clinic’s success rates. Given the rising costs of fertility treatments like in-vitro fertilization (IVF), and the toll infertility can take on your mental health, it’s imperative patients choose a clinic where they feel not only supported but confident their treatments will result in a healthy pregnancy.
Sure, prospective patients can research clinics via online reviews and patient recommendations. But this type of information only helps you choose a fertility center based on patient experience. How do you go about researching the center’s success rates? Better yet, what do fertility specialists look for in a desirable fertility clinic?
These can be tough questions to answer, because “unfortunately, there are still no standardized measures of clinical success that are both reported and independently verified,” says Peter Klatsky, M.D., a board-certified reproductive endocrinologist and co-founder of Spring Fertility (with clinic locations in the San Francisco Bay Area, New York City, and Portland). But that doesn’t mean there isn’t evidence-based data available.
Read on for a behind-the-scenes look at how infertility specialists like Dr. Klatsky determine the quality of fertility clinics.
Top questions to ask a prospective fertility clinic
Dr. Klatsky highlights three important metrics that are worth asking your potential fertility provider:
1. What is the Day-6 blast development rate?
This question asks about “the probability that a fertilized egg develops to a blastocyst stage embryo by day 6,” says Dr. Klatsky. He goes on to say that “top centers will know this number by age group, as the number declines with age.”
2. What is the live birth rate for a single frozen euploid (chromosomally normal) embryo?
Translation: “For every tested/euploid embryo warmed, what is the chance that it could become a baby?”
3. For those freezing their eggs: “What is the clinic’s frozen egg survival rate?” and “What is the fertilization and blastocyst development rate for these eggs?”
Dr. Klatsky recommends asking these questions if you’re a patient freezing their eggs because “the data is not reported anywhere, unfortunately.” Still, some tools can offer a transparent look at your chance of success with your frozen eggs. Spring Fertility created the Egg Freezing Calculator to help you develop realistic expectations around egg freezing and to estimate your chance of having a healthy baby with your frozen eggs. As always, the biggest factors in your success will be your age when you freeze your eggs, the number of eggs you have frozen, and the experience and skill of your clinical and lab teams.
Can the ‘SART’ report help in determining a clinic’s success rates?
SART stands for the “Society for Assisted Reproductive Technology,” a voluntary professional organization of U.S. fertility clinics. Although this group collects and publishes birth outcome data from their member clinics, Dr. Klatsky doesn’t advise using their reports to compare clinic quality: “The metrics and process that SART uses have not kept pace with changes in technology, clinical advances, and patients’ desires.” Even though SART has tried to update its reporting, “it has become complicated and almost impossible to interpret, whether you are a physician or a patient,” says Dr. Klatsky. “It often creates more confusion than clarity.” Plus, he says SART even includes a disclaimer acknowledging their report “can’t compare quality between clinics.”
There is one element of the SART report, however, that can be valuable when researching a clinic’s success rates, which is the reported cycle volume at your particular fertility center. “This is an indicator of the size of your clinic,” explains Dr. Klatsky. Depending on your needs and preferences, clinic size can be a pivotal factor in your decision-making. “Smaller clinics may offer a more intimate and warmer experience but may lack the resources to keep pace with important scientific improvements,” he says. On the flip side, “larger clinics may have you feeling like a number in a big machine.”
When it comes to fertility treatments, personalized care is key
Finding the right fertility clinic shouldn’t be a black-and-white process. Why shouldn’t patients receive personal care along with up-to-date resources? It’s for these very reasons Dr. Klatsky emphasizes the importance of an individualized approach.
“At Spring Fertility, our goal is to provide the superior scientific resources with the most advanced labs that can accommodate thousands of cases using the latest technologies,” he says, “while still providing individualized care through close physician care teams around each patient so that patients experience the intimacy and warmth typically seen at a smaller practice.”
It’s natural to want assurance that a clinic has high success rates, but “everyone’s physiology and set of goals is unique,” says Dr. Klatsky. “Finding a clinic and fertility specialist that has the flexibility to get to know you, review your detailed medical history, and prescribe a treatment plan tailored specifically to your needs can make the difference between a successful and unsuccessful outcome. Spring Fertility physicians are specially trained to create treatment plans that maximize our patients’ likelihood of success.”
How much emphasis should I put on success rates?
Given how expensive fertility treatments can get, it doesn’t make good financial sense to completely dismiss a clinic’s success rates. But considering the lack of standardized and verified reporting, Dr. Klatsky puts more of an emphasis on “patients finding a fertility doctor and care team that they feel comfortable with.” He recommends checking out resources like Fertility IQ, and inquiring about free information sessions at various clinics: “We encourage patients to inquire about the care team process, communication, as well of course as outcomes and how to think about success rates.”
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So, what should I look for in a fertility clinic?
Remember that there’s no “one-size fits all“ when it comes to fertility clinics, says Dr. Klatsky. “I would advise people to look for clinics that strive to deliver on both success rates and on patient experience.”
On the success rate side, open communication with your team is key. That means, after an initial consultation, your fertility doctor “should be able to give you a range of mature eggs that you can expect to retrieve during an IVF cycle, and roughly how many embryos that translates to,” says Dr. Klatsky.
While he says each clinic will offer different advice based on the success rates in their specific embryology lab, “great IVF centers are focused on incremental improvements throughout each stage of the process.” This includes the entire spectrum of “stimulation to retrieval to fertilization to blastocyst development, all with the end goal of maximizing your chances for a healthy pregnancy.”
In addition to open communication, success rates also depend on the facts of your individual case: “Patients need information to understand their particular prognosis at that specific center,” explains Dr. Klatsky. “Critical to this is how many mature eggs an individual can get and what the prognosis is for each usable egg at your center.”
On the patient-experience side, Dr. Klatsky extols the importance of sharing your needs with your community to find the right fertility clinic. “It’s likely that people within your circle also have experiences with different fertility clinics in your area, and you may gain some valuable insights as well as an invaluable support system,” he says.
By combining both informed research and preferred patient-experience criteria, rest assured you will find the best fertility clinic for you.
Sarene Leeds holds an M.S. in Professional Writing from NYU, and is a seasoned journalist, having written and reported on subjects ranging from TV and pop culture to health, wellness, and parenting over the course of her career. Her work has appeared in Rolling Stone, The Wall Street Journal, Vulture, SheKnows, and numerous other outlets. A staunch mental health advocate, Sarene also hosts the podcast “Emotional Abuse Is Real.” Visit her website here, or follow her on Instagram or Twitter.