When Sally* and her wife, Georgia*, needed to choose a fertility clinic to undergo assisted reproductive treatment (ART) with a sperm donor, they didn’t do much research. “We pretty much went with a recommendation from a friend, and launched straight into IVF treatment”, explains Sally.
“Unfortunately, after two failed attempts, we discovered Georgia had some fertility issues.” Sally and Georgia were angry that the fertility specialist didn’t discuss the possibility of doing any assessments before starting.
“We feel like we basically donated several thousand dollars to the fertility clinic,” said Sally.
Is your fertility specialist giving you good advice?
The reality is that just because your fertility clinic has offered to assist in making your dreams come true, they are still a business invested in making money. Indeed, is it possible that the money being made from IVF treatment in Australia (and probably many other countries) might, in some instances, influence the advice your fertility doctor offers?
Unfortunately, research suggests the answer to this question is ‘yes’!
So how do you choose a fertility clinic?
What are some of the things you might consider before selecting a fertility clinic (or independent fertility specialist) to start conceiving with a donor(s)?
1. Donor program
At the risk of stating the obvious, does your chosen fertility clinic have a donor program? Regardless of the type of donor you are choosing – including bringing your own known donor(s) to the clinic – they must cater for the collection, screening and storing of your donor’s gametes or embryos.
Not all fertility clinics offer this service.
2. Choice of donors
The number of Australian fertility-clinic recruited donors available at any one time varies and when it comes to sperm donors for instance, the numbers can range from none to dozens. Some clinics operate Australia-wide and have access to a ‘pool’ of donors that all of the clinics can access.
Some clinics cater for international donors and may collaborate with one or more international sperm or egg banks to provide greater options (note: there are additional risks in using international donors).
3. LGBTI experience
While it is illegal to discriminate based on sexual orientation, gender identification or relationship status, not everyone may be considerate of your needs.
Are the staff at your clinic sensitive to your requirements? Do they offer non-judgmental and compassionate care? Or is their misunderstanding and naiveté adding to the existing challenge that is ART, with comments (directed at you and your same-sex partner) such as, “Make sure you have lots of sex in between artificial insemination (AI) treatments to increase your chances of conception”?
Note that there are some Australian fertility clinics, in some states, that cater exclusively for the LGBTI community.
4. Clinic and specialist experience
When choosing your fertility clinic, ask how long it has been operating. Note that the NHMRC’s Ethical guidelines require clinics to disclose this information to customers.
And what qualifications and experience does your fertility specialist have? Is she fresh out of med school, or has she been doing this for decades? Does she participate in ongoing training? Does your specialist listen to your needs; your partner’s needs?
Is he able to cater for your needs, or is he restricted by clinic policies when recommending a treatment plan for you?
Is your fertility specialist recommending a treatment you don’t believe will add any value for you?
5. Success rates
Are the clinic’s success rates transparent and credible? Or are they pitching you a ‘guaranteed’ pregnancy rate. For instance, are they advertising ‘success’ as pregnancy, rather than a live birth? Are they providing age-based success rates, or is the success rate a generic figure?
Despite the Australian Competition and Consumer Commission (ACCC) warning several Australian fertility clinics about their somewhat deceptive success rates, a further review by VARTA after the audit showed that less than half of the fertility clinics had improved the transparency of their success rate claims.
6. Treatment options
Does your clinic offer a free fertility assessment before you launch into the expensive option of IVF treatment? Will they tailor their approach to your needs?
Some fertility clinics offer more options than others when it comes to fertility treatments, while others are heavily involved in ongoing scientific research and testing for people who may have special requirements or fertility issues.
It’s important to note that advanced treatments generally incur additional costs, and may not be covered by Medicare or your private health fund.
It’s also important to be aware when you choose a fertility clinic that offers advanced (or other) technology – particularly where medication is involved – that the technology must be evidence-based. (This principle is supported by the NHMRC National Guidelines.)
In other words, will the technology or treatment option potentially increase your chances of conception (particularly if you have known fertility issues)? Will it reduce your risk of miscarriage, or alternatively, is there the possibility that it may actually do you or your embryo, blastocyst or foetus harm?
7. Costs
The cost of using a fertility clinic can vary considerably depending on the type of fertility treatments you undergo. And the same treatment can vary between clinics. It is definitely worth ‘shopping around’.
While clinic websites may display some or all of their costs on their websites, it’s important to understand that it’s virtually impossible to predict exactly how much even one cycle of ART will cost you.
One important element to consider when you choose a fertility clinic is whether you are eligible for the Medicare rebate. If you are part of a same-sex couple and intend doing partner IVF, you will also need to check your partner is eligible. And if you are using a known donor and taking them to a fertility clinic for screening and ART, make sure your donor is eligible before commencing treatment.
Ask the clinic to outline all of the possible costs involved, including items not listed on their website – for instance, medication required during the early stages of pregnancy. You can also request an out-of-pocket estimate directly from Medicare. Ask your clinic for details.
8. Payment options
There is no question that assisted reproductive technology is expensive! The way in which you pay for your treatment can vary between clinics. For instance, do they offer a free fertility assessment prior to launching you into a full IVF treatment cycle? Can you pay part of your treatment upfront, and the remainder at a later date?
Can you access your superannuation (or your partner’s) to fund your treatment? Does the clinic offer payment installment plans? And if you are using a sperm donor, can you pay for the sperm per cycle, rather than a bulk purchase?
Do they offer a price reduction once a certain amount of cycles have been completed within one year? How much do they charge for storage of frozen eggs, sperm and embryos? Do they offer complimentary storage for one year?
Some clinics may provide the option of bulk-billing for some procedures, however you may find this comes with some sizeable limitations such as an inflexible treatment program, or the inability to select your specialist.
9. Record keeping and information sharing
Does your fertility clinic have a history of good record-keeping? The fertility clinic’s competence in this area may be the difference between your child’s half-siblings and your donor(s) connecting, or not. If the state or territory in which you undergo treatment does not have a central register (information about all parties including donors, recipients and children are housed in a central register, and then subsequently shared at the relevant age upon request), your fertility clinic is responsible for acting as the central register.
So, does your clinic keep up-to-date records of your donor’s contact details? Do they ensure any medical issues related to your donor can be reported to you and other affected families? When you call your clinic to ask how many other children have been born from your donor, can they provide you with accurate details?
10. Personal care, communication and trust
How much do you trust your clinic and its staff? Do they respond to your phone calls and emails quickly and efficiently, or are you left listening to Four Seasons, Vivaldi for extended periods? Will you see the same specialist throughout your entire treatment so you can make important decisions confidently, or will you just see the person on duty that day?
Do they communicate clearly and kindly with you while you are ‘legs up’ and exposed, or are you left feeling vulnerable and emotionally dismembered? Does the fertility clinic offer a range of communication methods such as texting or patient portals to assist with confidentiality while you’re at work?
Do they treat you like an individual (or couple), with unique and important needs, or are you left feeling like a number?
Summary
There are many elements to consider when choosing a fertility clinic, and this list is certainly not exhaustive.
Make sure you do your homework, talk to people who have done it, ask lots of questions, join online forums, attend free seminars run by fertility clinics and… take your time!
And perhaps the most important question to ask is, how will the choices I make now affect my donor-conceived child later?
Join in the Conversation on Facebook
Good luck with selecting a fertility clinic! Have you had an experience you’d like to share? What were the outcomes?
Join the conversation HERE on Donor Conceived and Beyond’s Facebook Page.
References
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