|What Is A Fertility Clinic?
A fertility clinic is a specialized medical center that helps infertile couples have a baby with the assistance of technology. Most couples who are worried about their fertility usually start by visiting a family doctor or gynecologist. If after several months of charting their progress (or lack of) the doctor feels the case is more complex than he can handle, or that they require assisted reproductive technology, he will refer them to a fertility specialist. Most fertility specialists work in clinics. A clinic will offer a full range of services and is staffed by endocrinologists, embryologists, physician assistants and nurses.
What Services Do Fertility Clinics Provide?
Services offered may include:
Fertility Tests: Blood tests, ultrasound scan, hysterosonogram, hysteroscopy and laparoscopy. This will be carried out to discover the likely cause of infertility.
Ovarian Stimulation: Boosting ovulation with the use of infertility drugs. This is the most common type of infertility treatment.
Artificial Insemination: Semen is inserted with a syringe as close as possible to the uterus to make fertilization easier.
In Vitro Fertilization (IVF): Eggs and semen are combined in the lab and inserted back into the woman.
Assisted Hatching: A special process which helps the embryo hatch and implant.
Embryo Transfer: Transfer of embryos directly into the uterus. This may be part of IVF or egg donation treatment.
Day 5 Embryo Transfer: Extending the time the embryo spends in the lab so it can grow, before being inserted into the woman. Only the best will survive, so it reduces the failure rate of IVF.
Surgery: Many clinics will also perform specialized surgery for women whose fertility has been affected by uterine fibroids, endometriosis or ovarian cysts.
Male Fertility Tests: Semen analysis and testicular biopsy for testing infertility in men. These test help highlight the causes of infertility in men.
ICSI Procedure (Intracytoplasmic Sperm Injection): A single sperm is injected directly into the female egg in a lab. This is the most common form of artificial insemination.
Extracting sperm for IVF: Sperm is extracted from the testicles by a very fine needle. This procedure is combined with ICSI.
Other Possible Services
Egg Donation: Egg donation is where a donor provides an egg, it is fertilized by the father's sperm and the resulting embryo is implanted in the mother.
Genetic Counseling: Genetic counselors can recommend specific genetic testing if necessary.
Gender Selection: If one partner has a genetic disorder (such as muscular dystrophy) that affect only one gender, it is possible to select the gender using pre-implantation genetic diagnosis (PGD) before IVF treatment.
Fertility Preservation: If you would like to freeze your eggs for future use, you can do so with a process called cryopreservation. You may choose to do so if you need to undergo cancer treatment or if you are getting older and want to keep your options open. The process is the same as IVF, but the eggs are not fertilized.
Hybrid Babies: Donor cytoplasm involves injecting part of a donor's egg into the mother's egg. The resulting egg is fertilized with sperm and implanted into the mother. The embryo will have genetic material from 3 parents.
When Do I Need To See A Specialist?
The American Society for Reproductive Medicine recommends seeking the advice of specialist if you are aged under 35 and are not able to achieve pregnancy after 12 months of unprotected intercourse; or after 6 months if you are aged over 35. However the National Infertility Association (RESOLVE) advocates talking to a specialist if you can answer yes to any of the following questions (regardless of how long you've been trying):
• You have irregular periods.
• You have painful periods.
• You have difficulties pinpointing when you ovulate.
• You or your partner has a history of sexually transmitted diseases (STDs).
• You have had one or more miscarriages.
• You have an unhealthy body mass index (BMI) - either you are very overweight or underweight.
Initially you may start by contacting your family doctor or gynecologist, this might be more convenient if you live in a small town or a remote area. If you fail to conceive with a few months, you may then consider a fertility clinic. On the other hand, all clinics offer basic fertility tests, so you may opt to work immediately with one.
How Do I Choose A Good Clinic?
Get Their Rates Report
The Centers for Disease Control (CDC) are required to publish a report every year on the success rates of clinics. Known as the ART (Assisted Reproductive Technology) Success Rates Report, you really should not consider using a clinic unless it has been audited in this report. The report however only provides information on surgeries which involve removing the woman's eggs and combing them with sperm in a lab. They do not cover lower-tech procedures where only the sperm is handled (such as artificial insemination) or where the woman takes drugs to stimulate egg production without the intention of having the eggs retrieved. To locate an audited clinic near you visit the Society For Assisted Reproductive Technology's (SART) website. It provides a list of clinics by State as well as their individual ART report:
Check Their Accreditation (United States)
Additionally you should ensure that the clinic have attained SART membership. SART is a professional organization and is affiliated to the American Society for Reproductive Medicine (ASRM). Members of SART have to report all their pregnancy data on a yearly basis and this is subject to audit. They agree to an embryo laboratory inspection and certification every two years by an external agency. And all new practices must have a Board-certified reproductive endocrinologist as medical director. For more resources, see our list of infertility resources.
In the UK, choose a clinic which has been accredited by the Human Fertilisation Embryology Authority (HFEA). The HFEA inspects every clinic they accredit and they publish the reports from those inspections. They also provide the success rate for each clinic showing the number of treatments carried out within a year and the number of pregnancies or live births as a result of those interventions.
Human Fertilisation and Embryology Authority (HFEA)
103-105 Bunhill Row
London, EC1Y 8HF
Phone: 020 7291 8200
Other Points To Consider
When choosing a clinic, you should also consider:
1. The location of the clinic - how convenient is it for you to attend treatments? You may still opt for a clinic that is further away if it has a partnership with a local hospital for certain parts of the treatment.
2. First impressions - how do you feel about the appearance of the clinic, does it look modern? Do you like the way the staff treat you?
3. Eligibility: Some clinics only take couples under a certain age, others may not take single women or gays.
4. Cancellation Policy: What is their policy if you change your mind and want to stop treatment?
5. Success Rates: How successful is the clinic with your specific treatment and age group?
10 Questions To Ask On Your First Visit
1. What treatment do you recommend for me and why do you think it's the best option?
2. Are there alternative treatments and why do you think they are less suitable?
3. What options are open to me if the treatment fails?
4. What drugs will I need to take and what are the side effects?
5. Can you give me a breakdown of all the costs involved?
6. Is there any way to reduce these costs? See, for example, what is the cost of egg donation?
7. What lifestyle improvements can I make to improve my chance of success or to help me prepare for pregnancy?
8. Do you provide counseling services? How much does it cost or are there any free sessions?
9. Do you offer finance packages if my insurance company doesn't cover the costs?
10. Do you have a patient support group where I can talk to other patients?