Finding the right fertility clinic before you start treatment is crucial, but with over 88 registered IVF clinics in the UK it can be hard to work out which one is best for you.
We spoke to Professor Dr Geeta Nargund, Medical Director at CREATE Fertility who gave us 10 questions she advises asking before starting treatment.
- What makes your clinic different from others?
Clinics will offer different types of treatments depending on what they specialise in and the staff and facilities that they have. It is worth remembering that not all registered clinics will carry out every kind of treatment. If you know that you need or want a certain type of treatment then you will need to ascertain whether a prospective clinic can carry out the procedure, and that they have sufficient experience.
- Is your treatment tailored for each individual patient?
Some clinics may only offer a blanket IVF treatment to patients and in some cases this may not be the treatment that works best for certain conditions, such as endometriosis or polycystic ovary syndrome (PCOS).
Remember that no one person and their situation are the same, so ensure your chosen clinic will offer you a treatment programme that is personalised to your needs.
- How do you decide which treatment I should undergo?
Your personalised treatment programme should depend on your history, test and investigation results and existing conditions, but will also be influenced by the clinic’s specialism and areas of expertise.
- Which tests would you advise prior to an IVF cycle?
Any clinic that does not perform thorough initial tests on both you and your partner to investigate potential causes of infertility should be avoided. Determine upfront what the clinic offers and consider whether you are happy with this approach.
Tests such as a fertility MOT for the individual or couple may identify upfront causes of infertility and may mean that less invasive and/or lower cost treatments would be suitable. They can also highlight where your best chances of success may lie.
- What kinds of treatment might I be offered?
In conventional IVF, fertility medication is given to the woman to suppress her natural cycle and to encourage the ovaries to produce more eggs than usual. A number of eggs are then collected to be fertilised outside of the womb. However, there is a growing acceptance that this method is not always the safest or most effective for many women and other lower or no drug treatments are now starting to be offered by some clinics, including:
Natural Cycle IVF aims to collect the one egg that has been naturally selected by the body. It is carried out without the use of fertility drugs. By utilising natural selection in this way, the hope is to be able to collect a high quality egg and therefore increase the chances of a high quality embryo being created. Studies have linked Natural Cycle IVF to a healthier birthweight for babies born as a result of this method.
Modified Natural Cycle IVF is a form of Natural Cycle IVF. Medication is given for 3-4 days in order to block spontaneous ovulation and a small dose of stimulation hormone is given in order to keep the follicles healthy and growing. Again, the focus is to collect one high quality naturally selected egg, though sometimes more than one egg can be collected.
Sometimes referred to as ‘Mini IVF’, Mild Stimulation IVF is carried out within the natural menstrual cycle and uses minimal doses of fertility drugs in order to achieve a mild response to stimulation. Stimulating medication is given for just 5-9 days, compared to the 4-5 weeks of medication used in conventional IVF.
In Vitro Maturation (IVM): is the collection of immature eggs from a woman, which are then matured in the lab using special and advanced culture conditions to create several embryos.
- Which tests do you advise during IVF treatment?
Clinics will usually offer vaginal ultrasound scans to monitor your ovaries and, in some cases, blood tests, during the treatment. You may find that some clinics will offer tests or imaging systems which are not always necessary for the success of the process, but can add to the cost of your treatment.
To avoid unnecessary tests and costs, be clear on what your clinic offers at the outset of your treatment and ask to discuss the evidence behind specific tests or treatments to determine whether you need it.
- What are the clinic’s success rates and what is the success rate for me in particular?
Bear in mind that not all clinics use the same criteria for measuring success rates. IVF success rates should be treated with caution, but you will want to know that your chosen clinic has a strong track record. It is important to ask how the clinic measures success rates, specifically regarding your circumstances and the treatment you are considering.
- Do you accept women with specific conditions?
Some clinics may turn away those with particular conditions (low egg reserve, high FSH and low AMH), if they think that their prospects of success under the clinic’s current programme are low, to avoid damage to their success rates. It’s unfair, but it does happen, so ask your clinic upfront if you are affected by a specific issue.
- Have you had patients admitted to hospital as a result of complications?
Ovarian Hyper Stimulation Syndrome (OHSS) is a condition affecting the ovaries of some women who undergo high stimulation IVF treatment. If a clinic has had patients admitted to hospital with OHSS then it may be an indication that they favour a high drug approach and you should consider if this approach is right for you.
Most cases of OHSS are mild and can include symptoms such as nausea, vomiting and abdominal bloating, but in rare cases the condition can become severe and lead to serious illness or death.
- What is the cost of one full treatment cycle & are there any hidden costs?
Costs vary from clinic to clinic depending on the procedure and additional costs of medication, blood tests and additional tests. Be clear on the total cost of treatment before you agree to start the process.