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Planning for pregnancy and conceiving are such a personal thing for any couple. No body wants to conceive in a fertility clinic.
However, life does not always go as we plan. For some couples conceiving can be challenging and fertility treatment becomes the necessity.
But how to choose the right clinic? There are so many clinics and all of them boasting about their success rates and uniqueness. Internet is flooded with information about various clinics and all seems very glittery.
In this article we will discuss five essential things to consider while choosing a fertility clinic:
1. How the clinic is performing –
A. Success rate - Obviously you would like to be successful in your treatment. So you would look for a clinic that has a successful track record. However, it could be hard to understand the way the success is reported by the clinic so that you can make a fair comparison.
Watch out for following:
- Reporting Live birth– You are interested in knowing the take home baby rate and hence live birth rate is more important than just pregnancy rate. Not every pregnant woman will achieve a live birth. There will be pregnancy losses due to miscarriages, ectopic pregnancy. Hence live birth rate will be lower than pregnancy rate.
- Look at how it is reported – per couple/ per cycle/per egg collection/per embryo transfer. Live birth per embryo transfer excludes all women who did not reach the embryo transfer stage due to their cycles being cancelled for various reasons. So this is not accurate. 'Per embryo transfer' success rate is likely to be higher than 'per cycle' success rate. The best way to report success of the unit is per 'IVF cycle started'.
- Do they consider the various factors that affect success of IVF cycle while reporting? The success rates should be reported according to the age of the women, ovarian reserve, previous cycles, number of embryos transferred.
- Do this clinic decline treating women who has lower chances of success like older women, those with lower ovarian reserve? In that case their success rate will be higher as they are treating only selective cases.
- Selective reporting - Ideally the clinic should show you their full report of all treatments done. Some clinic might only report the good outcomes selectively.
B. Multiple pregnancy rates – This is one of the key considerations to be taken care of. To achieve success, many clinics would transfer more than one embryo. However, this will increase the risk of multiple pregnancies. You might think, this is not a problem but multiple pregnancies are high-risk pregnancy with increased risk of miscarriage, preterm labour, pregnancy complications like high blood pressure, clots in legs and lungs (thrombosis), increased need for operative deliveries.
So a clinic with high multiple pregnancy rate is not doing any good service to you.
As per HFEA, the multiple pregnancy rates should be <10% of IVF births.
2. What treatments do they offer?
- Not all clinics offer all treatments, so it is good to check before going.
3. Patient feedbacks:
- This is something to look for, as it will give you some insight about the clinic. Remember, not everybody will be satisfied for any particular clinic. If majority is saying well about the clinic, then you can be reassured.
However, your personal experience is something that you will only know with time.
A. How friendly and supportive the clinic is:
Once you step in a fertility clinic, you might be there for few months to few years. You will have daily, weekly or monthly interactions with various members of the staff. So it is very important to feel homely, at ease in the clinic. It is only possible if every member of the staff is caring, compassionate and supportive. You should be able to feel that positive vive as you step in.
Counselling service: Fertility journey can be stressful. The clinic should be able to offer you free counselling. So check out for that. However, your main interactions will be with doctors, nurses, sonographers, and receptionist. The main support should be from all of them in every interaction with you. Whether this is there in a clinic, is something you will know from people having treatment there.
B. Admin issues:
The last thing you want is the stress for not been able to speak to someone in the clinic when you desperately need help. So check out how is the admin staffs, response rate from the doctors/nurses. Again, this is something you will know from people undergoing treatment there.
C. Waiting time: Some clinics have long waiting time to even start the IVF treatment. While every month seems like a decade while you are trying to conceive, you would not like to choose a clinic with a very long waiting time. This will not only add to the stress and lose valuable months but also reduce your chances of success, as you get older.
4. Cost of the treatment:
Fertility treatment can be expensive. So check out the cost and financial options.
5. Location of the clinic:
It is very important to choose a clinic, which is commutable. Remember, IVF treatment can be lengthy and involve multiple visits to the clinic. Most of the treatment can be done while working. It would be good to choose a clinic, which is near to your work place, so that you can continue with your treatment with minimal disruption to your work life.
HFEA website has a page dedicated to help you in comparing and choosing fertility clinics in the UK.
Remember to read the HFEA inspection report and rating, which will give you an insight as how the clinic is performing.
Written by Dr Anupa Nandi
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