When you need medical care in order to conceive a baby, it can feel like nothing is more important than which fertility center you choose. How exactly should you make that choice when there’s so much at stake? You may live in a more rural or remote area where there are only one or two choices available to you and that will limit your options if you want to work with someone locally. However, fertility centers are popping up all over and soon you may have more options to select from. And if you live in or near an urban center, the choices may seem endless. So how do you make a choice, particularly when your decision affects not only you, but your gestational carrier too? Here are some of the key factors to consider:
If you haven’t checked it already, the best place to start might be with your insurance coverage. Depending on what state you live in and the specifics of your individual policy, you may find that some or even all of your IVF fees may be paid for. If this is the case (lucky you!), be sure to check to see which fertility centers near you participate with your insurance.
Don’t choose a fertility center just because it’s covered on your insurance, though – just because the clinic has a contract with your insurance carrier does not automatically make it the ideal choice for you and your unique situation. Be sure to look at all of the various factors that contribute to IVF success and make your decision taking everything into consideration.
Also, be aware that while your insurance may cover the cost of going through IVF for yourself, they may not cover all or even any of the cost of going through IVF when using a gestational carrier. Be sure to ask your insurance carrier to specify the limits of their coverage. In many cases they will cover your part of the cycle and medications, but not your surrogate’s – so be sure to ask.
Clinical Success Rates
Once you’ve made a list of possible clinics to work with, you should research the success rates of each center you’re considering. You can compare fertility center success rates through the ART Success Rate page on the CDC’s website. While you want to choose a clinic that creates a respectable amount of pregnancies each year, don’t feel obligated to choose the one with the highest success rates, because the statistics are not as straightforward as they seem.
Many different factors influence a clinic’s success rates, including ages of their patients, the type of procedures being performed, and how the clinic screens who takes part in their treatment, among other things. The fact you’ll be using a gestational carrier definitely affects your own personal success rate – usually for the better. So take success rates into consideration along with other factors. In addition to the CDC report, fertility centers should post their own success rates on their websites – if they don’t, be wary.
Size of the Fertility Center
Fertility centers can range in size from a solo practitioner, who will be the doctor you’ll see at every single visit, to large, multi-office centers that employ a big staff. While it’s uncommon for there to be only one doctor on staff (given the 365-days-a-year demands of fertility treatments), there are many centers that are small and offer very personalized care with a team of two or three reproductive endocrinologists. Many people enjoy this smaller and more intimate atmosphere.
When you choose a large fertility center, you will most likely have comprehensive resources available to you, including a full nursing staff, an in-house lab, social workers and psychological support including support groups, and perhaps even wellness services such as yoga, nutritionists, meditation, etc. Larger fertility centers usually have in-house egg and sperm donor programs as well (with small clinics you might have to use an outside resource). A drawback to the larger centers is that you probably won’t see the same doctor at each visit, though you’ll likely have one nurse who coordinates your care and who you’ll speak with on the phone.
Personally I’ve worked with one vey large fertility center (the largest in the country, in fact), two medium-sized centers, and one small office, and each experience had its benefits and drawbacks. I liked the one-stop shop aspect of the large clinic and the convenience of their many locations, but I also appreciated the very personal service we got from the small clinic. And ultimately I was successful with all of them, which is the bottom line.
There is no one right-sized fertility center for everyone – it’s a lot like choosing a college – it’s not exclusively about size, it’s about the right match.
Once you’ve narrowed your possible choices down to one or two (or three at the most), you should contact each fertility center to set up an initial meeting. Many clinics have open house nights and more and more centers are hosting webinars where you can find out more about the doctors, staff, and what they offer.
When visiting a fertility center you can find out what’s done onsite and what’s done at other facilities (such as a lab, hospital or satellite location), and what’s contracted out (like social work or psychological services). If you visit during the day, you can get a feel for the atmosphere of the office – is it loud or disorganized or does the staff seem rushed? Or do they make you feel comfortable and confident and do things seem to be running smoothly? Do you find the doctors warm, compassionate, and engaging, or are they more clinical and distant, leaving the “warm fuzzies” for the nursing staff? You should get a tour of their facilities (within reason of course, considering patient confidentiality and sterility) and an explanation of what’s unique to their facility.
Cost and Financial Management
IVF and surrogacy are very expensive, it goes without saying. If you’ll be paying out-of-pocket for your cycle, what does their fee include? When comparing costs between fertility centers, make sure that you’re comparing similar scopes of service. Also, ask about what financial arrangements they make with their patients – some centers expect full payment up front, while others have financing plans available, and yet others offer different types of money-back guarantees based on age and diagnosis.
It’s highly likely that you’ll be making multiple (many!) visits to the fertility center as you prepare for, and then take part in, your transfer cycle and then monitoring afterward. You could be in for a lot of driving. While you shouldn’t choose a fertility center on location alone, you may want to consider it as a factor if you’re weighing several possible options. If the clinic you like the best is some distance from you, ask them about what procedures can be done at other facilities that are more convenient to you. Not everything has to be done at their office, so it pays to ask how you can minimize lengthy travel.
It’s always valuable to talk to patients from the fertility centers you’re considering. If you don’t know anyone personally who has used a particular clinic, check online review sites (though like anything online that’s open to the public, take everything with a grain of salt – it’s usually the extremes who are motivated to share online – the extremely happy and the extremely dissatisfied).
Above all, trust your instincts. If you feel an affinity toward one clinic, that’s probably the best place for you. And if something doesn’t seem quite right with the most known clinic in your area, that’s good information too. There is no one best solution for everyone, so trust your own research and your gut and you’ll be most likely to make the best and most successful choice for you.