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What should be the criteria for choosing the best IVF clinic?

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3 fertility expert(s) answered this question

Answer from: Stephen Davies, BSc MBBS DCH DRCOG

Gynaecologist, IVF specialist & retired NHS GP
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Answer from: Stephen Davies, BSc MBBS DCH DRCOG

Gynaecologist, IVF specialist & retired NHS GP
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I absolutely agree with that and I think it’s an issuance first time, I’ve really seen it in because for having spent 25 years essentially working in NHS services but obviously those NHS services have to treat private patients because of the poor eligibility criteria that are available but I think the the attitude the private providers take to treating patients is fundamentally different. If you go through to a private IVF clinic, they make money from treating you. It’s to their advantage to a) investigate but then b) as quickly as possible get on and treat and if you’re not having to worry about NHS criteria and as someone as long as it’s clinically reasonably safe to treat that lady then, why would you mess around and if there’s a simpler treatment, for example, insemination are you going to offer that when actually IVF statistically clearly does better but also IVF clearly statistically is where the money is and that’s a challenge and I think it’s an area where there is a clear difference, not just in in in repro-med but as a GP you develop an awareness over the years of clinicians in the private sector who you respect and do the right thing from a clinical perspective because it’s always very easy to do more than is necessarily, the right thing, very very difficult to sort of shoot down in flames as like I was saying for endometriosis if you see someone privately who’s got some pelvic pain, it’s very easy to say “well, you definitely need a laparoscopy”. That’s the flip side – you can make a lot of money doing procedures that you’re very skilled at and become very very good at. The whole drama in the United States where you have cardiologists who spend all day stenting people and sometimes put six stents in the same patients, fifteen thousand dollars a go – why wouldn’t you? The other half of their cardiology societies are basically saying that’s completely unethical, those patients are much better treated with medical treatment, losing weight, looking at their risk factors, maximizing their lipid profile and you get the same thing in infertility. There are some very very very wealthy people who work in infertility and it’s very challenging for the regulatory authorities, the HFEA in the UK to really control what’s done on a treatment level and to make sure as you say that some of those simpler things are done and you don’t, for example, push straight through to saying “well, I think at the end of the day let’s just do a cycle of high-dose IVF and we’ll do ICSI as well” because it’s a bit borderline so, we’ll do the very difficult to regulate against that and the patients aren’t going to disagree and to some degree patients often are very happy to be pushed up the technology ladder. Some patients aren’t and I think there are some patients who come through, who want to be considered in a more holistic way and if there are options which allow simpler treatment, they want to pursue those but there’s a very big cohort who actually the only the only question they want the answer to is what’s the treatment that’s most likely to get me pregnant, well, the answer to that is always IVF. Actually, if that’s the question you ask nobody’s, nobody’s leading anyone astray that they’re actually answering the question honestly but they’re not really looking at it in the broader context, are they? So, it’s a very tricky area and I try we see a lot of ladies who are in their mid 40s, I have to say I’m always brutally honest with them, I cannot countenan saying to these ladies that whatever protocol we use or whatever that they’ve got a high chance of getting pregnant, they absolutely haven’t and I will tell them to go away and look at the national data on getting pregnant when you’re 45 using your own eggs and it’s disastrously poor and even if we get you pregnant, it’s extremely likely with the genetically untested embryo that you will miscarry and they have to understand that before they embark on the pathway. So, that I’m not sure everyone else or I’m not sure a lot of people necessarily and again if their livelihood depends on it, how much do you need to say. So, I think there are lots of really complex ethical areas there where the ethics and the morals of what you’re doing potentially conflict with the business model and one of my very good friends now works for the HFEA in London having worked for many years within the clinical IVF world and I think she finds it very challenging to try and keep clinical practice aligned with the right thing to do, very very challenging because business is business at the end of the day, isn’t it and for lots of people it’s in a private clinic you pay your staff by the revenue you generate and your profits accordingly are about the patients you treat et cetera. So, the NHS is if you work in the NHS it’s different, you get paid your salary every month whether you’re treating 100 patients or 50 patients or 70 patients so, maybe you’re you’re cocooned to some degree from those realities of the private health care world and so, it’s challenging, it’s very challenging but yeah I think from a personal point of view, I think if I felt that I wasn’t able to be honest with patients then, that’s the point I’d be wrapping it up because I think when it becomes driven by money you then end up compromising your decision-making really and that’s never been the way I’ve wanted to practice.

Answer from: Sergio Gonzalez, MSc

Embryologist
Fenomatch
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Facing fertility treatment is something big and big in every aspect of the word. If this is going to be a journey, why not try to increase your chances of fulfilling your dream? Clinics perform almost the same techniques but with different aspects in the procedure. This leads to different success rates. However, success rates are not everything in this process. The way of caring about the patients, the recommendations that you have been given and other things that affect you should be taken into account.

Also, new technologies are have been arriving in the lab and patients also consider this aspect when choosing a clinic. For example, Fenomatch has arrived into the IVF labs to help clinics choose the right donors for patients. If you are going through a donor selection process, you should take it into account and see if the clinic has this tool that can lead you to your dream.

About this question:

What to look for before deciding on an IVF clinic?

What criteria should you take into consideration when selecting a fertility clinic for your treatment? What matters and what doesn’t? This is certainly an important decision and should not be taken in a hurry.

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