Choosing a clinic
Imagine a fertility clinic is like a coffee shop. Some folks are going to be drawn to the known quantities, the Starbucks, the Peets. You’ll have the big name with the big numbers, a generally decent quality experience with some pleasant, though a bit corporate-canned interactions. There’s the off chance of a fluke crappy experience but overall you’re in good hands. Others will gravitate to the boutique third wave chic coffeehouse experience. Here you’ll get an intimate and personalized experience, where you may have one primary doctor guide you through every step of your journey and be there for every procedure day, but there will be tradeoffs. In a larger clinic, the sheer volume of cases means extremely refined procedures and protocols. No one is referencing the instructions to refresh themselves on how many minutes those oocytes need to sit in equilibration media. And again on the other hand, you may feel like just another number, a nurse may forget to call you back with instructions.
No two clinics will be the same, and the only certainty is that no clinic will be without both satisfied and dissatisfied customers. Because this is the business of family building, dissatisfied customers are generally those who do not find a path to growing their family, regardless of the cause. This is unfortunately part of this field. No clinic can guarantee you’ll walk away with exactly what you want, only that they’ll provide you with the best shot they can, given the many varied and diverse circumstances with which patients walk in the door.
Factors that as an embryologist, I would consider and advise others to consider as well:
SART data. This will tell you some of the basics of a clinic, such as the cycle volume they handle, specific success rates, ratios of oocyte freezing to embryo freezing, etc… While this data doesn’t tell the whole story, there are very real reasons why rates vary between clinics.
Doctors. If you got the name of a great REI (reproductive endocrinologist) with glowing reviews from a friend, consider their doctor! You may have specific qualities you’re looking for, such as location, availability, gender, ethnic background, language spoken, experience with LGBTQI+ patients, etc… These are important things to consider since you’ll be putting your trust in their hands.
Reputation. Now this can be tricky. The names associated with a clinic does not necessarily represent the quality of the lab, doctors, or experience you’ll have. I would not suggest choosing a clinic based on the ivy league school or fancy sounding hospital it’s affiliated with. The relationship between REIs and the embryology lab is symbiotic, in the sense that a lab works with what the doctors give us, and the doctors entirely rely on the quality of the lab work. Without one, the other cannot exist. So a big name fancy doctor at a prestigious institution does not indicate the same caliber personnel in the lab, and vice versa.
Years in the trade. I personally feel that startup clinics can be a very risky move. It may be great, it may be bad. The reasoning behind this is that there’s a lot of money out there from investors looking to start businesses in an extremely high demand field. The problem is that there are just not many embryologists and REIs out there. This means when a startup crops up, they’re poaching people from other clinics, and when you cobble together a team of people who haven’t necessarily worked together before, from various types of labs, there can be a high rate of turnover. Don’t be fooled by the fancy social media campaigns and beautiful waiting rooms.
If you get a consult at a clinic and it feels off, there’s no need to continue down the path out of obligation or fear mongering of time running out. This is a big decision, you can always change clinics, and it’s a lot of money, energy, and commitment. It will be worth it to spend the extra bit of time to find the right clinic for you.
for your bros.