Choosing an expert to help you get pregnant is one of the most important decisions you’ll ever make.
To help you in your quest, we went to the top authorities for inside advice on what to look for when choosing a fertility specialist.
When is it time to see a fertility specialist? “If a couple has been trying to have a baby for a year without success if the woman is under 35—and six months if she’s over 35—they should have an infertility workup,” says Owen K. Davis, M.D., associate director of IVF at The Center for Reproductive Medicine and Infertility, and chief of the division of gynecology at the Weill Medical College of Cornell University in New York City. “Your ob/gyn may be able to do part of the workup. If not, you’ll need to see a reproductive endocrinologist, a board-certified ob/gyn who is also board certified in infertility.” To find a reproductive endocrinologist:
Ask your ob/gyn for a recommendation. And if you know someone who has been successfully treated for infertility, find out who her doctor is.
Get referrals from a national medical society. The American Society of Reproductive Medicine, www.ASRM.org, and the Society for Reproductive Technology, www.SART.org, will provide you with the names of reproductive endocrinologists in your area. Patient organizations like the American Infertility Association, www.americaninfertility.org, and RESOLVE, www.resolve.org, can also recommend fertility doctors.
Find a physician who does it all. “Look for a reproductive endocrinologist who offers a full range of services—from the basic evaluation and diagnosis of your problem to treating it,” says Dr. Davis. “A good one can do the whole gamut.”
Set up a meeting and bring your partner. This is known as the initial consultation, and it should be thorough. The doctor will review your medical history and records looking for factors that might explain your infertility, and you’ll be given a physical exam. “After that, you’ll talk about the game plan, says Dr. Davis. “Will it be further diagnostic testing or treatment? Will the treatment be surgery or inducing ovulation?”
Be sure the chemistry is right. You may end up working with the physician for months—or longer. “Infertility treatment is emotionally difficult and physically taxing,” says Dr. Davis. “You need a doctor with whom you feel comfortable.”
Find out how accessible the fertility specialist is. “Ask ‘if I have a question or problem, can I talk to you? Will you communicate with me by email?’” advises Dr. Davis. If tests indicate that IVF (in vitro fertilization) is your best hope of having a baby, “it’s very important to do your legwork in determining which clinic to go to,” says Dr. Davis. Your reproductive endocrinologist is probably affiliated with an IVF clinic, and if you like your doctor, you’ll want to check out the facility he or she works with. You can also get referrals from RESOLVE and the American Infertility Association. Here’s what to look for when evaluating a fertility clinic:
Success rates: By law, IVF clinics have to report their success rates. The information is published at www.SART.org. The statistics will tell you how many patients the clinic has treated and in what age groups. “Look for ‘live birth rate,’” says Dr. Davis. “What you want to know is not how many women got pregnant at the clinic, but how many took home a baby.” Under age 35, the live birth rate at the top clinics nationwide is 50 percent or above. At age 40, the most successful programs have a live birth rate in the high 20s to 30 percent.
Team spirit. The clinic should be open seven days a week with doctors on call around the clock. The specialists on staff should include a urologist who has treated male infertility, a reproductive surgeon, and psychologists, psychiatrists, or social workers who specialize in infertility issues. “Treating infertility involves intense psychological issues,” says Dr. Davis. “Access to a mental health professional is crucial.”
Lab certification. Fertility clinics should have both an andrology lab that does semen analysis and prep work for insemination, and an embryology lab for the transfer of embryos during IVF. Look for labs that are certified by the state as well as by a national organization like the American College of Pathologists and the ASRM.
The payment process. Find out if your health insurance covers infertility treatment. If not, ask how the clinic handles billing. At most centers, you pay at the time of treatment. Some fertility clinics have payment plans; others offer risk-sharing or money-back guarantees if infertility treatment is unsuccessful. “Risk-sharing plans are controversial in the medical field,” says Dr. Davis. “But with full disclosure by the clinic of how the process works, and the full understanding of the patient, they may be okay.” The bottom line: “Buyer beware,” says Dr. Davis. “Make sure there are no hidden fees involved.”
A version of this article originally appeared in the 2004 Premier issue of Conceive Magazine.
Related Topics: Assisted Reproduction; Fertility Drugs; Infertility Stress; Infertility Support; IVF