The ultimate step-by-step guide to
Picking a Fertility Clinic for Egg Freezing or IVF
Fertility treatment isn't necessarily a walk in the park so choosing a clinic that delivers exceptional quality and patient care can have a massive impact on both your outcome and your experience. This is your go-to guide for taking the fear out of fertility clinic selection.
There are around 500 fertility clinics in the US and more are cropping up every year (making there plenty to choose from!). Reproductive medicine is a very competitive specialty for doctors, but despite this, not all clinics and doctors are created equally. The fertility industry is a fast-growing market; labs are easy to start and surprisingly loosely regulated. Therefore, it is essential to do your homework and make sure you’re trusting your eggs to the best possible team.
In lieu of formal regulation, most likely due to political reasons, there’s instead a system of “self-regulation” via industry bodies like the ASRM and SART, which is just something to be aware of when you’re doing your due diligence before picking a clinic. If there’s one take away from this, it’s that it is vital that you properly vet your potential fertility clinic and only go ahead with a clinician you are comfortable with. Ensure that you your potential fertility clinician is able to counsel you clearly, fairly and openly. Knowing the right questions to ask your fertility specialist is key to the fertility process. Asking the right questions can have a tangible impact on the success of your fertility journey. When searching for a fertility clinic in your area, make a visit to the clinic, ensure that you feel comfortable and at ease, ask the clinic staff questions you are concerned about. We have curated a step-by-step guide below to make selecting the best fit fertility clinic for you easy.
Start by getting recommendations from trusted sources
When it comes to picking a clinic, finding the perfect place to start can be a challenge. A good place to start is by asking your gynecologist if she or he can recommend a local fertility clinic . You can assume their recommendations will be based on success or feedback from their other patients, whether it’s for egg freezing or other fertility treatments.
If you’re open to it, it’s also worth asking your friends and friends-of-friends to see if they had a fertility clinic or doctor that they’d recommend, either for egg freezing or other fertility treatments such as in vitro fertilisation (IVF). Don’t be shy to ask specific questions that matter to you. Ask what made them select that specific fertility clinic? Did they feel like their fertility specialist took the time to educate them on the process and options available? Did the fertility clinic they choose offer services such as in house counselling? These insights might put you at easy and help eliminate certain clinics from the start.
“Even before I was sure I wanted to freeze my eggs, I wanted to get some of the tests done and talk to a fertility doctor about my options. I found a few websites with patient reviews about various fertility clinics in my area but it just wasn’t enough. So I decided to send out a group message to a few of my close friends to see if they know of anyone that had undergone fertility treatment and if they’d be willing to chat about their clinic experience. I was astounded how many of them had their own experiences to share and how open and willing they were to talk about it! I was able to find a fantastic fertility doctor and my friends were so supportive all the way through.” - Bryana, 36
“I’ve had the same gynecologist for years. When I mentioned to her that I was thinking about freezing my eggs, she put me in touch with a clinic that her other patients really loved. She knows me and my health history so it made the whole process really easy to navigate.” Cherise, 37”
Look for clinics within a close proximity
Location, location, location. Finding a fertility clinic that is within a reasonable distance from your home or work is important, this is because you're going to be visiting them a lot. You'll be going in for your initial consultation, potentially some bloodwork and scans. Once you begin your fertility journey with the stimulation cycle, you'll need to go into your chosen clinic anywhere from every day to every 3-4 days per week for monitoring appointments. It depends on the fertility clinic, but they often do what they call "monitoring appointments" or "ovarian scans" very early in the morning so they'll know how much medication to advise you to take that day.
An additional consideration is the flow of traffic at the given time of day that you'll be visiting the clinic. The physical distance on a map can be very deceiving if you're trying to get to the clinic during the heart of rush hour! (Clearly this is a cautionary tale...)
Check out our fertility clinic and fertility specialist directory, you can filter clinics and doctors by city to find fertility clinics near you.
Look for doctors and clinics that deliver 'whole patient care'
Whole patient care simply means that the fertility doctor and clinic go beyond just the clinical and focus on the WHOLE YOU. Let's face it, fertility treatment is about much more than your ovaries or gonads, it's about building the life you want. The road may be long and bumpy, so having a doctor and a clinic that can help you navigate through the hard times and the good will make 100% of the difference.
This can be summed up into 4 key pillars.
1. Mental and emotional health
Clinical staff should be supportive: compassionate, empathetic, respectful, and non-judgemental. They should counsel you around potential emotional challenges of care. They should provide you with adequate support resources and allow you to play an active role in your care.
Why? Because fertility treatment of ALL types can be difficult and you never know if or when you may need to be given the support resources you need. Make sure that you ask the staff at a fertility clinic you are considering what kind of support they offer, and how they can answer any questions you may have regarding your fertility journey.
2. Lifestyle factors
The clinical staff should indicate that they value a multidimensional, integrated approach to patient care and that they actively promote preventive care. They should also support a range of holistic treatment modalities, where there is appropriate evidence. They should also be able to offer personalized lifestyle interventions, especially when there is a known influence.
Why? There's a growing amount of evidence that lifestyle factors can increase success rates of fertility treatments (some indicate upwards of 27%!). You want to be given the tools in which to get the most out of your fertility treatment cycle.
3. Patient-centric operations
It should be clear that the fertility clinic has committed time and resources in order to deliver satisfaction with billing, wait times and appointment scheduling. They should be highly communicative and offer information and education in a way that is easily accessible & understood.
Why? For anyone who has been unable to reach the clinic in a time of need (i.e. administering hormone injections in the wee hours 💉) and hasn't been able to get to the clinic. Or someone who has been given a laundry list of line items that have been incorrectly billed. Or anyone that has waited for an extraordinary amount of time just to get into the clinic for a scan... IT MAKES A DIFFERENCE. Knowing how the clinic goes about billing can be a key deciding factor. Fertility clinics create their paymentstructuree in various ways, some fertility clinics include all the vitamins and medication in the cost, while others may charge separately. Look for a fertility clinic near you that is transparent about their costing and is willing to explain this to you as the fertility patient.
4. Diversity, equity & inclusion
The clinic should be able to indicate that they have placed diversity, equity and inclusion at the forefront of their decision making. Your fertility clinic should use language and visuals that are inclusive to people of all genders, sexual orientations and stages in the fertility journey.
Why? There is no such thing as a one-size-fits all when it comes to a fertility journey. The fertility process that you are embarking on should be unique and tailored to your needs. You should never feel marginalized, unwelcome, unheard, unseen, or under-represented by a fertility clinic. They need to show you they care about that.
If you want to know more about the fertility doctors at each clinic, read more about their individual approaches HERE.
Should I get fertility treatment abroad?
It’s never an easy decision to undergo fertility treatment outside of your home country. While the cost savings of going overseas can be great, there’s a lot of different inputs that go into weighing up if it’s the right option for you.
The laws of the country itself:
Not all countries’ medical, legal and political systems are robust and reliable. Of the estimated 103 countries around the globe with fertility centers, 42 operate with what’s deemed “legislative oversight” (i.e. a regulatory system), 26 with voluntary guidelines, and 35 operate with neither. Interestingly, the US falls into the “voluntary” category, which basically means fertility doctors self-regulate and most European countries practicing non-medical freezing don’t have a specific law governing it. It’s a good idea to check around and see which laws, regulations and guidelines around assisted reproductive technologies are in place for the country you’re traveling to, as that might form part of your decision making process.
Using a clinic overseas obviously makes it harder to swing by to check it out. In our opinion it makes sense to gather as many reviews as possible. Now we’re in the age of Zoom, it could be possible to easily arrange for a video consultation with your fertility doctor. If the country does have a fertility industry regulator or reporting mechanism, check the reputation/reviews and “live birth rate” statistics for the clinic. You’ll want to see if it’s on or above the national average, and then maybe compare that to your home country’s average too. Don’t worry about getting too in the weeds with the data - it’s hard to compare apples with apples, but a top level check can be indicative of a good clinic. The same important questions apply as in the US - staff qualifications, clinic and lab standards and things like storage security / power backups. You could also ask if they regularly have overseas patients and if there is a system to manage them, as this would likely streamline your experience. (Note: we have a list of good questions to ask and anticipated answers here).
Although treatment costs may be substantially lower, remember to calculate added costs like flights, visas, transportation, accommodation, insurance and other travel costs.
Regular travel insurance will not cover problems arising from egg freezing overseas. In some cases, even claims that have nothing to do with the procedure will not be covered if the trip is taken for medical tourism purposes. However, you can find specialist medical travel insurance (coverage for people traveling specifically for surgery) usually at a pretty reasonable cost.
If something goes wrong:
In the very small chance that anything goes medically wrong (maybe you have a reaction to the sedative, for instance) it’s worth considering if you would be comfortable being far from home and potentially alone? Of course, your medical travel insurance should cover any additional hospital stay and treatment, but it’s a good idea to think through every scenario, and possibly prepare for the worst and have a clear plan of how to deal with it.
While you can take the contraceptive pill to time your cycle and plan your travel, the ovarian stimulation cycle isn’t a fixed length. For most of us, the stimulation cycle lasts for 8-12 days but it can reach up to 14, not including recovery time. Some people start their stimulation meds in their home country, then travel only for the procedure itself. This involves your overseas clinic doctor working in unison with a doctor in your home country. Personally, bloated and a little anxious about doing anything to disrupt the outcome, we’re not sure we would have wanted to fly during the stimulation cycle itself - especially after around day 5. So if you feel the same that would mean a couple of weeks away. After the retrieval, it is possible to fly 24 hours after your procedure, but without knowing how you might feel or in the rare event that there are any complications, you might consider adding on a few days post-procedure to allow time for a full recovery.
Check that the clinic staff speaks English and that all documentation will be available translated. Perhaps for you, traveling will be a relaxing experience, away from the day-to-day pressures. But if you rarely travel, going overseas for treatment may be a stressful experience, particularly in countries where there are substantial cultural differences. For many, he fertility process in itself is stressful, think carefully if you need the added stress of going abroad.
Traveling overseas for treatment can increase the administrative burden of the experience. There are a number of “fertili-travel” companies focused on egg freezing and wellness vacations, or even agents who specialize in helping with clinic selection, travel logistics and medication/appointment coordination while you’re there. It’s a fast-growing space so check our website to learn more about your options and get some information on the ones we’ve checked out.
If you are traveling overseas, consider your support systems. Friends and family could check in with you over the phone, but with some women reporting feeling lonely and isolated during the process, it might be worth traveling with a companion.
Special considerations for egg freezers
Using your eggs in the future:
By default, your eggs will be frozen and stored in the country in which you have the procedure. For some women, like us, this makes sense because if you end up choosing to use your frozen eggs, you might want to return for the in vitro fertilization (IVF) procedure as you are likely to reap the same cost benefits. Depending on your situation, other realities might come into play - like the availability of donor sperm if you are considering taking that route.
Transporting your eggs:
If you’d rather have your eggs stored in your home country, you can arrange to have them sent via specialist airmail courier to the storage facility of your choice. This can cost anywhere from several hundred dollars to more than $1,000 and involve some administration. Transporting eggs is known to be safe (many US clinics transport eggs to off-site storage facilities), but of course, any additional movement increases risks. Most doctors would advise leaving them in place. Although this is broadly possible, it can also be difficult to arrange the paperwork between some countries - so it’s worth checking out the specific transit rules between your intended fertility clinic country and home country.
Understanding the level of doctor and clinic experience and participation in the process
The experience a fertility doctor has and the time which a clinic has been in operation can be helpful in understanding how well calibrated their protocols and procedures may be. It can also help you understand what you can expect from the clinic during your fertility process.
While some things may matter to you more than others, here are some questions you can ask the clinic:
Are all of your fertility doctors board certified and members of professional bodies like the American Society for Reproductive Medicine and / or the Society of Reproductive Endocrinologists?
How many years have you been offering egg freezing/IVF? How many egg freezing/IVF cycles do you conduct per year?
Is your clinic open 7 days a week?
Is your clinic open 365 days a year?
Who will conduct the monitoring (ovarian scans) during the stimulation cycle? Will I see a doctor, a nurse practitioner or an ultrasound tech?
How often will I see my doctor during the process?
Will I have a nurse advocate or a single point of contact assigned to me for the duration of the process?
Are there any other services available such as counselling or lifestyle advice?
Find out how their costing structure works, what is included and what additional costs are involved.
Breaking down the success rates
Fertility clinic success rates can be found by searching for a specific clinic in the SART database or you can ask your clinic directly. Some caveats with clinic success rates are that they shouldn't be taken as the only metric to consider. There's actually quite a bit of controversy around the accuracy and relevance of them. For example, they aren't drilled down to the particular doctor, they only come out years after the data has been submitted, and they can incentivize clinics to do some unscrupulous things to "get their numbers up."
For example, some clinics may screen out older or more high risk patients because they may decrease the success rate of the fertility clinic. They've also been known to "fire" patients that have undergone multiple, unsuccessful rounds of IVF, specifically because they will do more damage to those marketable metrics of success. The moral of the story here is that these numbers aren't as clear and instructive as they may seem. There might be other factors that are more important to you, friendly staff, clear pricing structures or even the availability of a female fertility doctor.
Questions for egg freezers to ask the clinic:
Of the women that have frozen their eggs, how many have come back to use them at your facility?
And how many implanted frozen eggs have resulted in live births?
What is your “oocyte (egg) cryosurvival rate?”
Which method of freezing do you use? I.e. slow freezing or vitrification
What percentage of fertilized eggs survive to day 5?
Do you culture your embryos beyond day 6 when creating embryos from frozen eggs?
Questions for IVFers to ask the clinic:
Am I a candidate for “Mini IVF” or “Natural IVF”?
What are my options for embryos that won’t be used?
How many eggs will you try to retrieve?
Will you use a 3-day or 5-day transfer?
Are my embryos, eggs and / sperm stored onsite or at another location?
Should my embryos be frozen prior to transfer?
If I have unexplained infertility, is IUI or IVF best?
Do I need PGD or PGS?
How long is the IVF process expected to take from start to finish?
Is there anything about my diagnosis that could negatively impact IVF success?