How to Pick A Doctor/Infertility Clinic
If you’re having trouble conceiving, you need to see a reproductive endocrinologist (RE). Your standard OB-GYN is not going to be enough. Why?
This how-to guide assumes that you are looking for a reproductive endocrinologist. If your main point of contact in regards to your difficulty conceiving has not been a reproductive endocrinologist (and has instead been an OB-GYN, Urologist, etc.), you may be making a mistake. Read this FAQ to learn more.
This guide also assumes you are American.
Step 1: Do you have insurance?
Yes: Use your insurance’s online tool or give them a call in order to find the 10 closest reproductive endocrinologists.
No: You’ll instead want to just search for the 20 closest reproductive clinics and order them by the price they charge for an initial consultation. The price of initial consultations may be posted online or you may have to give them a call and ask their prices. If cost is a big concern for you, consider going to the cheapest doctor to get your diagnosis, then later shopping around for doctors that offer cheap treatment.
Regardless, you’ll want a doctor that’s close to your home or job. While going through the IVF process, you have to go to your doctor for monitoring every two days. This can be a big hassle if you’re doctors too far out the way.
Step 2: Is your doctor board-certified?
From your list of 10-20 doctors from step 1, cross out any doctor that is not board certified. You can check if your doctor is certified by checking the American Board of Medical Specialties Website. The site requires you create an account. To avoid spam, considering using Temp-Mail to create a temporary email address. You want a doctor with the following certifications:
- Obstetrics & Gynecology – General (General indicates Primary Certificate)
- Reproductive Endocrinology/Infertility – Subspecialty
This is what the page for my doctor looks like:
Step 3: What is the clinic’s specialty?
If you have unique needs, you may want to check if your clinic has the ability to accommodate you. For example:
- If you are LGBTQ, you will likely want to pick a fertility clinic that specializes in donor eggs, donor embryos, donor sperm, or surrogacy.
- If you have an autoimmune disorder, it will likely be best to search the web for doctors with experience with it. If you find the best doctor for your issue is on the other side of the country, give that doctor’s office a call and see if they can recommend an RE near you.
Step 4: Check out IVF Techniques (if applicable)
If you will be going through IVF, you’re going to want to know the following:
- What method of freezing does the clinic use? You want a clinic that uses vitrification (which has a higher success rate for thawing) over a clinic that uses slow-freezing. Studies lauding vitrification over slow-freezing are very consistent. Cross out any doctor/clinic on your list that doesn’t use vitrification. (source: blog post, research paper, research paper, research paper)
- Does your clinic use ICSI? If male factor infertility is contributing to your difficulty conceiving, you’re going to want a clinic that offers ICSI.
Step 5: Check Patient Outcomes
Fertility clinics that are a member of Society for Assisted Reproductive Technology (SART) are required to report their patient outcomes. Check out the outcomes for each clinic/doctor on your list. When comparing your clinics outcomes, consider using the Colorado Center for Reproductive Medicine as your comparison point. Generally speaking, you want a clinic:
- That has a verified lab accreditation.
- Has treated more than 100 patients in a year.
- Has a singleton live birth rate for women under 35 that is at least 36% (cumulative outcome per egg retrieval cycle).
Step 6: Check Out FertilityIQ.com
Many reviews are “verified” meaning you can be sure to check that the person writing the review is actually a patient of the doctor. Take reviews with a grain of salt: many reviewers are simply upset because their IVF cycle was unsuccessful. People are also more likely to write negative reviews than positive reviews. This may not necessarily be the fault of the doctor. Here are some warning signs you should be wary of, particularly if it’s mentioned by multiple patients:
- Difficulty scheduling appointments with the doctors.
- Poor recordkeeping
- Scheduling of wrong procedure
- Lost results
Yelp! can also be a good resource, but keep in mind the reviews are not verified and the format is less structured. You’re more likely to see more complaints about insurance and less about the doctor’s actual treatment approach.
Step 7: Make an Appointment
Listen to the person who picks up. Do they seem in a rush or irritated? That’s a bad sign and something you can’t expect to get better once you’re a patient. Many fertility clinics have a shortage of nurses. The result is more mistakes and more stress on your part. Another bad sign? If your only option is to leave a voicemail (i.e. there’s no receptionist to triage phone calls).
Step 8: Don’t be afraid to switch doctors
Don’t feel like you have to commit to a doctor. If you go for a consultation and find that something about the doctor rubs you the wrong way (e.g. the doctor is an hour late or has no experience with your case), see a second doctor. Furthermore, you can switch at any time. The best time to switch is after you’ve had all of your diagnostic work done. If you have a diagnosis, it’s very easy for you to send your medical records to another doctor and get a second opinion (and perhaps a cheaper quote).
Always: Be your own advocate
As much as it seems like you should be able to, you can’t expect your clinic to handle everything. This is partially because your doctor doesn’t always know your goals. If you’re 32 with diminished ovarian reserve and you want three kids, you’re going to want to do a few rounds of embryo banking before doing any FETs. However, if your doctor doesn’t know you want three kids, she may not recommend embryo banking. You will have to bring it up. Regardless of your clinic, you’re going to want to do the following:
Stay on top of everything. Make sure insurance is being billed on time. Take notes during appointments. Never leave your RE’s office without your next appointment scheduled. Mark important dates in your calendar.
Reach out to others with similar diagnoses. Learn what protocol is most common for your diagnosis and what other treatments are recommended. Ask your doctor why they went with some treatments as opposed to others.
Consider traveling if you have 3 IVF cycle failures with a doctor. This advice goes double for any doctor that refuses to change up your protocol or doesn’t recommend ways to improve your cycles going forward.