Choosing a Fertility Doctor: 10 Tips

Choosing the right infertility doctor can be one of the most important decisions you make when seeking help starting a family. The following guidelines can help you choose a fertility specialist that will inspire confidence and help you achieve the the best possible experience and outcome:

1. Success Rates: What percentage of the program’s patients have babies? Though this is the most common way of evaluating an IVF program, it is by no means a simple issue. Many factors relating to success rate must be considered:
a. How is success rate defined by the program, i.e., chemical pregnancy, clinical pregnancy, live birth?
b. Does the program provide any differentiating factors besides age in their success rate information? They should be able to give you success rate information for patients with a comparable diagnosis to your own.
c. Does the program turn down difficult cases (age, diagnosis, repeated IVF failures) in order to pad their success rates?
d. Does the program transfer a higher than average number of embryos in order to increase their success rates? If so, this raises the issue of high-order multiple pregnancy (triplets or more), increasing health risks for mother and babies.

2. Accessibility: How accessible are the doctors, nurses and staff? Do they provide patients access to channels of communication throughout treatment? You should be able to get in touch with someone at the office on short notice at any point in your treatment. Next, does the program value your input and feedback? Are they willing to give you a say in your own treatment? Will they keep you informed through every step of the process? Remember, you are paying for the treatment and they owe you this.

3. Caring: Do the physician and his staff project an attitude and atmosphere of caring? This applies to their treatment of patients as well as their treatment of other staff members:
a. Patients - How do they treat patients in person and on the phone? Are they willing to answer your questions and address your concerns? Any quality clinic – regardless of its size or the number of patients it serves – should make compassionate and caring treatment its highest priority.
b. Staff Members – There should be open and harmonious communication as well as mutual respect among the staff (doctors, nurses, clinicians, embryologists, coordinators). Be sure to consider the doctors as well as the clinical and administrative staff, since you’ll be working closely with all of these parties.

4. Accountability: Does the program track the diagnosis, treatment and outcome of every patient in order to constantly and continuously refine their techniques and improve their treatment? Do they provide their patients with accurate statistics and realistic expectations based on individual circumstances? The answer to these questions should be "yes." Every clinic should also provide a follow-up consultation on unsuccessful cycles in order to address the patient’s questions and concerns, and determine the best course of action for the future.

5.Reputation: How are the doctor and program perceived by those who have undergone IVF there? What do other doctors say about the program? A wealth of information from IVF veterans and current patients can be gleaned from online discussion boards.

6. Experience: How many IVF cycles does the doctor/program do each year? How much experience do they have with couples with a similar diagnosis to your own? Is the doctor involved in ongoing research and development in the field of IVF?

7. Personalized Care: Does the doctor/program tailor treatment to each patient’s particular circumstances or do they apply a "one-treatment-fits-all" philosophy? Do they have experience dealing with unusual and complex cases? Each patient’s profile is different and should be treated accordingly.

8. Breadth of Services Offered: Does the program offer ancillary services such as:
a. Cryopreservation (freezing) of embryos
b. Intracytoplasmic Sperm Injection (ICSI) for male factor issues if applicable.
c. Preimplantation Genetic Diagnosis (PGD) for identification of aneuploidy (genetic abnormalities) and/or gender selection.
d. Egg Donor and Surrogacy Services – Does the program offer assistance in locating egg donors and surrogates if applicable? There is a great amount of coordination to be done in donor and surrogacy cases, so a center that can h
e. In-house lab and procedures – Does the program do all procedures (retrieval, transfer, etc.) and lab work (blood tests, embryology services) in-house in a controlled lab facility? This provides superior quality assurance and reduced lead times.
f. Embryo Grading/Scoring system for evaluating the best embryos for transfer.

9. Financial Factors: What are the costs involved? In addition to the basic cost of the IVF cycle, you’ll need to factor in medications, travel expenses, room and board (if you’re traveling to another city for treatment) and incidentals. Find out if the quoted price includes things like anesthesia, ICSI, cryopreservation of embryos, and blood tests. Remember that price isn’t always an indication of quality and success, though more successful programs generally command a premium (generally due to higher overhead including skilled and reputable physicians, embryologists, nurses, and cutting edge equipment). Next, does the program provide a number of payment alternatives to make financing your treatment less stressful and more convenient?

The following are examples of available options:
a. Financial Risk Sharing – A limited number of programs offer this type of plan which provides a partial or full refund if your treatment doesn’t result in a successful outcome. Most offer up to 3 cycles of IVF for a single fee – usually less than the cost of 2 individual cycles. Make sure you find out how the program defines a successful outcome, i.e., a live birth, a second trimester pregnancy, a positive pregnancy test, etc., as this varies from program to program. Also, find out the details on qualifying criteria, whether frozen embryo transfers are included in each cycle or count as a separate cycle, and what the particulars of the refund are. Most programs are different in some or all of these respects.
b. Financing – Many programs offer access to financing options through third party organizations.
c. Special Access Plans – Some programs offer reduced-cost IVF treatment to low-income couples, military couples, school teachers and other specific groups.
d. Insurance Facilitation – A high-caliber program will handle the bulk of the insurance billing and tracking for you.

10. Gut Feel: Does it feel right? The doctor you choose must inspire confidence and peace of mind. Second guessing your choice of programs during your IVF treatment will only add to the tension of an already stressful experience. Bottom line: after all your research is done, trust your gut.

Sher Institute for Reproductive Medicine
Extensive Information on Infertility Diagnosis and Treatment