Ready for a big number? There are about 480 fertility clinics scattered all across the United States.
The good news? Depending on where you live, you hopefully have plenty of places to choose from to take the next step in your fertility journey. The bad news? Pretty much the same thing—you've got to choose between 480 different clinics, spread all across the United States.
So how do you find the best fertility clinic for you? There are plenty of factors to consider, but here are some of the biggies to help you decide between the clinic your OB/GYN suggested and that hotshot doc your friends are raving about.
Location, location, location
Don't start packing your bags just yet. While you may have heard amazing things about a nationally-known doctor, it's best to start your search close to home, says Dr. Paul Lin, M.D., a reproductive endocrinologist with Seattle Reproductive Medicine and president-elect of the Society for Reproductive Technologies (SART). If possible, he even recommends starting with a clinic within 50 miles of home.
The benefits of sticking as close to home as possible?
- Less stress: Traveling always has the potential to create some degree of stress. Now imagine adding that to the stress you might already have when going through fertility treatments. These treatments are often specifically timed with your cycle, and you may need daily monitoring or to head into the clinic on super short notice (say, if your period comes a day or two earlier). In most cases, save your sanity and go where is most convenient.
- Lower costs: Even when health insurance pays for fertility treatment, it rarely pays for travel to and from a clinic, so Lin reminds couples to consider whether or not they can afford airplane tickets and hotel bills if they choose a clinic far from home.
- Time to build a relationship with your clinic: Clinics try their best to make things easier on patients who have to make a long haul to get to them. Typically that means phone or Skype sessions in place of face-to-face meetings with everyone from the billing department to the actual doctor when you can't make the trip. It's good when necessary, Lin says, but the more time you have to sit face-to-face with everyone on staff, the easier the process can be.
What if you don't find the right clinic close to home? Don't worry. There are other factors to keep in mind that may end up being more important to you than location.
They all get the same degrees and go through the same kind of training, so every reproductive endocrinologist (that's the doc who you'll see at a fertility clinic) must offer the same treatments, right?
Some clinics run the gamut from providing patients of any age with follicle stimulating hormones through working to help them achieve pregnancy with a gestational donor, Dr. Lin says, but others focus solely on in vitro fertilization (IVF), and they limit their patient pool to women 35 and up.
When you start scoping out an office, it's best to find out just what sorts of procedures they offer, and what they'll do if you end up requiring treatments that they don't currently offer. Some questions to ask:
- Do you have an age requirement for your patients?
- Do you have an embryologist on staff, or are the lab portions of IVF done by an independent lab?
- Do you have an in-house egg donor team or would I have to find an agency?
- Do you work with gestational carrier surrogates, should I need one?
Does size really matter? That depends on what you're looking for in a clinic.
When a doctor has a small office, they may not get much demand for certain procedures, Dr. Lin says. In turn, the treatment you need may not be available at that smaller clinic.
Other things you'll need to consider when it comes to practice size:
- Do you expect to see one doctor, every time? Small practices tend to offer more one-to-one time with your chosen doctor, while you may see a mix of practitioners in a large office, including nurse practitioners and/or physician's assistants.
- Could you use a (free) second opinion? At Dr. Lin's clinic, for example,there are 12 reproductive endocrinologists, and they're constantly bouncing ideas off of one another. Larger practices offer a second opinion that's just one chat between colleagues away.
- Is there a support team to help you? Regardless of how many doctors are in the practice, it's standard for clinics to have a billing office. But not every office has people available to help walk you through all your concerns and help you talk to your insurance company or find grants to pay for your treatment.
OK, deep breath. You already know fertility treatment can be costly, and when it comes down to it, the right clinic for you might just be the only clinic you can afford. Don't be shy when it comes time to talk dollar figures. This is your future on the line.
- Do you take my insurance? If you've got insurance coverage for fertility treatment, this is the very first question to ask.
- Do you have a global fee, and what does it cover? Many clinics lump their costs into a flat or "global" fee, says Amanda Garcia, practice administrator at New York fertility clinic Colorado Center for Reproductive Medicine (CCRM). But just because it's "global" doesn't mean it covers everything. Ask the billing office to address everything that's included and anything that's not—such as medication or the freezing of embryos.
- Do you have any grants I can take advantage of? Some clinics have their own grants, while others are partnered with nonprofits to provide them. In New York State, there are even clinics designated to receive state funding to cover patients' treatment. So look around, and choose wisely.
Why did we save this factor for last? Surely, it must be the most important one. Yes, and no, says Dr. Lin. In fact, SART, which maintains a database of all accredited fertility clinics within the United States, also keeps track of clinic data—the same data that's collected by the federal government—to confirm their reported outcomes are actually true.
"If they're doing Octomom-level practice, we're going to ding them and go and see what's going on," he adds, alluding to a clinic that made headlines in 2009 after one of its patients gave birth to octuplets. That doctor eventually lost his medical license.
Success rate data is yearly, providing a look at the number of patients, their ages, types of procedures performed, and how many babies were born as a result; i.e. how successful the treatments were at creating brand new bundles of joy.
So why did we leave this one for last? SART discourages patients from using the data to compare clinics en masse because different fertility clinics, with their different treatment offerings and patient population, are like apples and oranges.
Instead of picking the "best in the country" based solely on numbers, Dr. Lin suggests using the data to find out:
- Individual clinic experience with patients your age and with like diagnoses
- An across-the-board look at the chances that a new patient to the clinic (regardless of age or fertility diagnosis) will end up giving birth
To sum it all up
You've got a lot to consider. But believe it or not, there's not as much variation from clinic to clinic as you might think, at least not according to Dr. Lin. All fertility specialists undergo similar training, and all labs are held to rigorous standards. At the end of the day, what matters most might just be the relationship with your doctor.
Arielle Spiegel is a Cofertility Co-Founder and Advisor. She previously founded the original CoFertility, a community and content platform that aimed to answer every fertility question, inspired by her own experience trying to conceive. She is incredibly passionate about starting the fertility conversation at an earlier age. Before founding CoFertility, Arielle spent several years in digital marketing at Victoria’s Secret PINK. She also led global social media activations for Coach and spent years agency-side, building social media strategies for various consumer brands. Today, Arielle lives in the Boston area with her husband, dog, and two miracle babies. She currently engages as a marketing strategy consultant for brands across industries.
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