Wondering how to choose the right doctor for IVF/egg freezing? Our fertility expert, Rachel Winston, walks us through it.
After experiencing years of infertility, I decided to meet with a fertility specialist (reproductive endocrinologist, also called the “RE”) based on a recommendation from a friend who had a friend, who had a cousin who allegedly had success at a particular doctor… so I made an appointment. Little did I know that in the complicated, expensive, and overwhelming world of IVF, not all doctors and clinics are equal. We ended up doing multiple (8, so far) IVF cycles in different places all over the country. I met with over a dozen different doctors from NYC, Miami, Atlanta, Las Vegas, to Los Angeles. I felt like I was interviewing them for a coveted spot on a prime-time reality show. So here’s what I’ve learned:
- First, read my article on thinking about IVF/egg freezing, and get tested for everything ASAP.
2. Now in actually choosing the right place for you… Once you figure out your condition (if you have one), like infertility due to PCOS, endometriosis, diminished ovarian reserve, male factor, “older” age, or unknown- whatever the initial test results tell you, go to The Society For Assisted Reproductive Technology, SART.org. There are published IVF success-rate statistics for most clinics in the United States, and that’s important. Look at the success rate statistics of your age group and condition for all the clinics in your area (or if you’re crazy and willing to travel like me, the entire USA). So for example, the first clinic I haphazardly fell into had a success rate with my particular condition (DOR, diminished ovarian reserve) of about 18% for women ages 36-38 (my age range). I only found this out after doing independent research and learning about SART. No one told me about the resources available, especially not the doctors. It turns out, there was a competing clinic that had a 35% success rate. Now I’m not amazing at math (just kidding, yes I am), but even my four year old daughter can tell you that 35 is greater than 18. Doing some research on the published statistics can help save some time and money in choosing the right RE. Fertility shouldn’t be a gamble.
3. Getting recommendations from people. Ah, so it’s important to “consider the source” for this one. Depending on whom you ask, you can have very different opinions on even the same clinic (clinics usually have multiple doctors). I find that everyone I speak to about IVF recommends their doctor because they either had a good experience or the doctor had an exceptional bed-side manner. If you’re 40 and talking to a 29 year old about the best RE, it might not be the best recommendation for you. Always check recommendations against SART published statistics. If you find a clinic with great SART statistics, it makes sense to ask around to find the best doctor at that clinic for you: you can also interview different doctors at the same clinic. If someone has done more than four cycles without success at one doctor, but let’s say did 10-20 cycles with that same doctor before they saw success—avoid that RE at all costs. Which brings me to my next point….
4. Give the doctor a chance, but not too much of a chance. Don’t be afraid to go to different RE if it doesn’t work out after the first few tries, even if you love the doctor. If you are unhappy after the first try, go somewhere else. If you don’t see success after 2-3 times at a clinic (maximum 4 tries), go to a different clinic. Don’t waste valuable time and money just because you feel like you should stick with one place or love the relationship with a kind doctor. Just make sure to keep your records. I see too many women getting stuck at one place and being taken advantage of. There are a lot of places that look at you as an annuity: IVF is a cash-cow business and unfortunately when they see you coming, all they hear is “mooooo.”
5. The doctor is not as important as the lab. Wait, what?! IVF and egg freezing happens in the lab. The embryologist/lab is way more important than the doctor. The doctor can do everything perfectly—give you the right dose of medications, extract your eggs perfectly, have an amazing bedside manner—but if the embryologist is sloppy or the lab has old technology and equipment, it won’t matter if Jesus/Moses/Mohammed is your doctor: your IVF cycle won’t be as successful. Find out when the clinic last re-tooled/renovated/updated their lab. If it was more than 5 years ago, find somewhere else. This may be one of the most important lessons in how to choose the right doctor for IVF, because IVF technology moves like the life-cycle of a gnat: very quickly. New technology, techniques and methodologies in the lab have changed drastically even in the last two years. Ask when the last time they renovated the lab, and verify with the doctor or embryologist. You can also ask to meet the embryologist to ask questions. Make sure they can take embryo biopsies in their own lab, or if they have to send it out to a separate lab—that’s one indicator of the skill of the embryologist and the technological capabilities of that lab (sending out biopsy samples is standard, but doing the biopsy itself in-house an indication about the ability of that lab).
6. Do your research. Don’t be afraid to “interview” different doctors, and ask a lot of questions before committing to a place. You’re commitment to a place is as long as you choose it to be, don’t be intimidated by anyone. Be picky!