While IVF technology has miraculously made successful pregnancy possible for almost every couple, not all IVF clinics are created equal. Protect yourself from ineffective treatment and possible physical damage by learning how to identify a good IVF clinic.
Guidelines to help you identify good infertility specialist and IVF clinics:
All clinics are not equal even if they claim to be so. Patients naively assume that all IVF clinics are equally good. They often select a fertility clinic because it is close to them; because they charge less; or because they know of someone who took treatment there and got pregnant. However, remember that there is a world of a difference between a good IVF clinic and a bad IVF clinic – It can be far more cost-effective to fly down to a good IVF clinic with a high pregnancy rate, even if this does cost a little more, as your “cost per baby” is likely to be much less, rather than to do IVF in a local fertility clinic with a low pregnancy rate.
Few IVF specialist enjoy jetting around or travelling from place to place. They set up a “chain of IVF clinics” all over the country and also to surrounding developing countries to get more patients, and then spend their energies running around from clinic to clinic. This often means that they are not available to monitor your treatment. You may find that you only see the “big-name” doctor once and then they are nowhere to be seen in town thereafter! It is obvious that such doctors cannot be expected to devote their energies to any particular centre to ensure the best success rates.
Some IVF clinics in India depend upon the services of a part-time embryologist, who flies down only once or twice a month to perform the IVF procedures. These fertility clinics batch all their patients together, and then perform about 5-20 treatments over a period of 2 days. This can be dangerous for you! Not all patients grow eggs at the same rate! Suppose yours grow too slowly or too fast. The doctor has no choice, but to perform egg collection on the pre-scheduled date, thus resulting in a major drop in your chances of conceiving. Moreover, the maintenance of embryology lab requires in house embryologist. Over usage of incubators with batches of patients lead to frequent changes in air quality and temperature adversely affecting pregnancy rates.
Clinics are mushrooming all over the country in large numbers. For any IVF clinic to establish and have reasonable and constant pregnancy rate, it requires years of persistent quality control and quality assurance. Running to newly opened centres even if they attract you by names which have foreign associations because this does not mean anything in terms of providing good IVF services as long as the embryologist and clinician working there are one amongst us and the environment is the same as all other clinics. Moreover these clinics will charge more because they have to pay heavily to the foreign associate to use their names to run their clinics.
Using IVF, we can help couples who could never have a baby with any other technique to start their own family. However, a lot many centres merely have a pregnancy rate of 15 to 20% but project higher figures (40 to 45%), as there is no audit which compels any centre to announce their actual pregnancy rates.
HCG injections are used after embryo transfer as luteal phase support to help implant the newly transferred embryo. However, these injections should not be given atleast 7 days before pregnancy test is undertaken otherwise these will falsely test as positive pregnancy test in blood as well as urine of the woman. It is alarming to see that there are doctors and centres which give hCG injections to patients as luteal support just before pregnancy test is to be done and patients assume that they are pregnant. Later on when this hormone injection is stopped and the pregnancy test becomes negative, one has the impression that they had an abortion which is even more heart breaking. You end up losing confidence in IVF technology, when the facts are found. Blaming yourself or cursing the doctor afterwards does not help, which is why you need to be very careful when deciding which fertility clinic you want to go to and it is also very important that you do your homework carefully – you are making a major investment not only monetarily but also toward fulfilling your dream of completing your family!
Another word of caution if a couple requires semen donation as fertility option and the wife is normal one does not require IVF. For such couples one only needs IUI which is 15 to 20 times cheaper than IVF.
Some fertility clinics compromise by using underhand methods. They “share” your eggs with other patients without informing you, thus earning an additional income from their egg sharing programs, which they advertise to attract infertile women who need donor eggs! However, not only is this grossly unethical, it also means that your chances of getting pregnant are drastically reduced!
There are clinics that charge per 3 cycle treatment or have money refund policies after a certain period after one has deposited a large amount sum initially. Most of them might have you pregnant by left over embryos of other patients who get pregnant in their first cycle as only 25% of couples have embryos frozen after fresh transfer of 2 or 3 good embryos.
It is better if you can select a clinic where all fertility enhancing procedures are done under one roof: such as ovulation induction in women who have irregular menstruation due to no ovulation, laparoscopic and hysteroscopic correction of pelvic pathologies leading to infertility and availability IUI and IVF at the same frequency, then only you will be taken for the correct procedure which you need. Otherwise, in clinics where only IVF is offered as the only solution, even if you deserve a less complicated and cheaper option or need a treatment method such as laparoscopy and hysteroscopy, which will permanently restore your fertility to normal, you shall end up going through only IVF every time to have a baby involving higher cost and a limited pregnancy rates.
Many stand alone IVF clinics also do not offer the full range of services which a good IVF clinic should. Thus, they do not offer embryo freezing facilities, and they criticize embryo freezing technology, claiming that the pregnancy rates with frozen embryos are poor! Fertility clinics which cannot freeze embryos are technically inadequate; and will often “donate” your spare embryos to other patients without your consent! It is also important to know whether there is any arrangement of an IVF clinic (especially stand alone IVF clinics) to manage complications even though rare, such as ovarian hyper-stimulation syndrome which may require multidisciplinary and ICU services.
A discharge summary at the end of your treatment is mandatory and is given by all good centres especially if the cycle has failed. This report should have the details of oocyte and sperm quality, the breakup of the whole embryology details, difficulties encountered between oocyte pickup, fertization and embryo transfer. It is very distressing to see patients who have been through many IVF treatment cycles, but know little about their treatment details, because the clinic never provided them with this information.
Some clinics resort to unproven medical practices to raise your hope of getting pregnant.
These could rather harm you than help. LIT is not proven to improve implantation and may cause long term complications which could be serious in nature.
Anti TB medicines are toxic drugs with many side effects and can be harmful not only to the mother but also the baby and should not be used based on their being positive on screening test only unless active genital disease is diagnosed definitely.
Since knowledge is power, the best way of protecting yourself is by becoming well-informed, so you can critically assess the “facts” for yourself. Books are excellent starting points in your quest for information.