Finding hope: Navigating your way to the best fertility clinic

When you’re having trouble conceiving on your own, making the decision to seek fertility treatment is often a life-changing step towards building your family. Whether you’re navigating the limited options of a rural area or the overwhelming abundance of choices in a bustling metropolis, finding the best fertility clinic can feel daunting.

As a board-certified reproductive endocrinologist, the founder of a fertility clinic, and a father through egg donation and surrogacy myself, I have gained a unique perspective on which factors most impact a patient’s experience and chances of success.

In this guide, you will learn how to research and compare fertility clinics in order to find the practice that best aligns with your unique needs and preferences.

Where to begin your search 

If you’re feeling overwhelmed by online search results or simply aren’t sure where to start, tap into your existing healthcare providers and personal network:

• Your OB-GYN likely refers patients to local fertility clinics regularly and has well-established relationships with local providers. Ask them which fertility specialists they recommend in your area.
• If you’re comfortable bringing the topic up to friends or family members, this can be a great way to find a new doctor. You’ll likely discover that more people than you expect have experienced infertility and have suggestions to share. 

Note: The internet can also be a great resource, but keep in mind that healthcare providers can pay to have their name shown first on search engines. Just because you see one clinic repeatedly pop up in search results doesn’t necessarily mean it’s the best one. Take note of results marked “sponsored” as you sort through your options.

Should you trust online reviews?

Well, it depends! The National Center for Health Research offers these helpful guidelines for evaluating a medical provider’s online reviews and what to consider as you read them:

“Online reviews should only be taken seriously if there are many reviews and a clear ‘trend’ in the comments (for instance, most reviewers complained about the receptionist, but felt the doctor really listened to them). Until you visit a doctor for the first time and see for yourself, there is limited information you can gather. Also, just because a doctor went to a well-respected medical school doesn’t mean he or she has good bedside manner or is punctual.”

How to choose the best fertility clinic

As you comb through reviews, websites and referrals, ask the following questions to help narrow down your search and find the right fit for your personal needs and goals:

1. Are the doctors board-certified reproductive endocrinologists?

In addition to four years of medical school and four years in residency for obstetrics and gynecology, reproductive endocrinologists must also complete three years of specialty training in reproductive endocrinology and infertility (REI).

After 11 years of intense training, they must pass extensive knowledge-based tests (both written and oral) in order to receive their board certification. In short, board-certified reproductive endocrinologists are the elite option in family building.

Be aware that any provider can call themselves a fertility specialist, but not all will have these specific credentials. Here’s how to look up a provider’s certifications and status.

2. How many physicians/locations does the practice have?

Office location is a major factor for most fertility patients, though not all. For some, a two-hour drive is a deal breaker. For others, it’s their only option. 

The good news is that some practices will let you do your morning monitoring at a local lab that’s more convenient for you. The local facility will need to have a partnership with the fertility clinic and be fully equipped to administer all necessary bloodwork and procedures on their behalf.

Multi-provider vs. single provider fertility clinics

Are you more comfortable seeing one doctor in a smaller office with fewer patients? Or would you prefer to see a larger team of doctors and have access to multiple office locations?

Option 1: Small practice / single provider

• The pros of a small practice may include the ability to establish a closer relationship with your doctor and feel like you are receiving hyper-individualized care.
• The cons of a small practice might be inconvenient appointment times, long waiting lists, and not as many supplemental resources (e.g. on-site laboratories and storage or holistic support services like nutrition and acupuncture).

Option 2: Large practice / multi-provider

• The pros of a larger practice often include multiple convenient office locations, plenty of appointment slots to choose from, and having access to a robust team of experts who work together on your case.
• The cons of a larger practice could be feeling like a number or seeing new faces in the hall at each visit. That said, if a clinic is good at what they do, they’ll make sure you always feel comfortable and cared for.

3. What are the clinic’s success rates?

You want to choose a clinic that offers transparency around their success rates and reports cycle data to the Society for Assisted Reproductive Technology (SART). This organization tracks pregnancy rates from participating clinics across the United States, publishing comprehensive reports on its website annually. Clinics that choose to share their data with SART must follow strict guidelines and report all information accurately.

Note: Don’t just look at the total live birth rate on a SART report: check out your particular age bracket, comparing the number of total cycles with that specific percentage of success.

4. How does the clinic communicate with patients?

If the practice only communicates via phone, has a complicated patient portal, or takes a long time to follow up with you, it can strongly impact your overall experience.  

Consider your personal preferences:

• Do you want to be able to text or message your team regularly?
• Do you have any specific expectations for response times?
• How often would you like to communicate with your primary doctor vs. clinic nurses and other staff?

5. Does the clinic perform extensive testing?

Diagnostic testing is another key component of modern, state-of-the-art clinics. Here are some of the services to look for as you evaluate your options:

Fertility testing

Though it can be tempting to jump straight into fertility treatment without undergoing extensive fertility testing first, doing so before understanding the root cause of your infertility means your team will be “flying blind.” This will typically lead to more unsuccessful cycles, a longer time to pregnancy, and immense frustration – not to mention costing you a lot more money.

By taking the time to first assess your uterus, fallopian tubes, and ovaries, evaluate your hormone levels, and perform a semen analysis (for male partners), your doctor will get a much more complete picture of what you need to succeed. 

Genetic carrier screening

Genetic carrier screening is typically performed during the initial round of testing and examinations and will assess whether you and/or your partner are carriers for any genetic mutations (i.e. cystic fibrosis, Tay Sachs disease, or sickle cell anemia). This is especially important if you and/or your partner have a known family history of any genetic conditions.

Embryo testing

Preimplantation genetic testing (PGT) allows embryos created through IVF to be carefully biopsied and evaluated to ensure each embryo has the correct number of chromosomes. This type of testing can expose potential chromosomal abnormalities that might lead to pregnancy loss or severe health complications for a future child.

All of this information helps the doctor and Care Team understand you and/or your partner’s unique genetic makeup so they can help you select the healthiest, strongest embryo to transfer—potentially avoiding miscarriage and helping you achieve pregnancy sooner. 

6. What treatment options do they offer?

If you’re new to the world of infertility, you might be surprised to learn that there are other options than just heading straight to in vitro fertilization (IVF). While it’s true that IVF offers the highest success rates, it is also the most invasive and expensive pathway to parenthood.

Make sure you’re choosing a clinic that offers a variety of treatments, not a one-size-fits-all approach. Some examples of other treatment options include timed intercourse, ovulation induction, and intrauterine insemination (IUI).

7. Do they have their own in-house laboratories?

Many smaller fertility clinics will not have their own embryology and andrology labs on-site, while larger practices often do. Consider where the clinic’s labs are located, how samples or gametes (i.e. eggs, sperm, or embryos) are transferred to and from the labs, and what quality control procedures are in place. 

It’s important you feel comfortable and confident in every aspect of how your clinic operates—even the parts you don’t see.

8. Is the clinic LGBTQ+ friendly?

This is especially important for hopeful parents in the LGBTQ+ community. 

Feeling welcomed as a queer patient should be the bare minimum! Ideally, you’ll want to work with a fertility clinic that regularly cares for LGBTQ+ patients, has plenty of family-building pathways to offer you (i.e. reciprocal IVF, gestational surrogacy, trans fertility preservation), and shows a high level of respect and understanding of your unique needs.

One way to find an LGBTQ+ inclusive clinic is by using the Human Rights Campaign’s helpful online search tool. You can also call a clinic and specifically ask what support they offer LGBTQ+ patients. 

9. What insurance do they accept? Are they upfront about costs?

If you have fertility coverage under your health insurance plan, one of the most important things to determine is whether a clinic accepts your insurance. Unfortunately, many insurance policies still do not cover fertility care. 

If your plan doesn’t offer these benefits, know that you still have options. 

• Make sure you’re tapping into every insurance or employer benefit to which you’re entitled.
• Look into grants, loans, and financing, including discounts that might be offered by the fertility clinic.
• Talk with your HR representative (if insured by an employer) or ask to speak with a fertility clinic’s financial counselor.

You deserve exceptional care on your fertility journey

The fertility clinic you choose can greatly impact not only your chances of success, but also your overall experience. Navigating infertility can be an incredibly stressful and difficult process, which means that having the right team by your side can make all the difference.

By taking the time to conduct thorough research and compare each potential provider using this set of questions, you will be able to find a practice that best aligns with your values, preferences, and helps you achieve your family-building goals.