If you’ve decided to pursue egg freezing or in-vitro fertilization (IVF), kudos to you for making a big (and sometimes quite difficult) decision that has the potential to impact and change your future.
We understand that it may have taken a lot of time and thought to get to this place, so we worked with Modern Fertility’s own fertility nurse, Jill Kerwin, to make your next steps straightforward and easy. Below, we put together a guide to finding a fertility doctor and clinic. Before you ever step foot in a fertility clinic for a consultation, here are the steps to take and questions to answer.
Fertility docs 101
While OB-GYNs offer general women’s reproductive health care needs and assist before, during, and after pregnancy and childbirth, reproductive endocrinologists (REIs) help with fertility treatments and fertility-related issues.
Reproductive endocrinologists are typically OB-GYNs who specialize in fertility hormones and treatments. These medical professionals complete a three-year fellowship and additional training to become experts in their field, so they can best guide you during your egg freezing or IVF journey.
Finding a reproductive endocrinologist and clinic
Who hasn’t received or sent the following text message: “Looking for a new gyno…. anyone go to someone they like?” Needless to say, the search for medical practitioners can be complicated. Here’s how to narrow down your search for a qualified RE as quickly as possible:
How to generate a list of clinic options
- Clinics are where most REIs work. The Society for Assisted Reproductive Technology (SART) database collects information on more than 90 percent of the assisted reproductive technology clinics in the United States. These clinics meet the highest standards for quality, safety, and patient care.
- To find clinics in your area, click on Find a Clinic on the SART homepage.
- Use your zip code to locate the clinics nearest to you. They are usually located in bigger cities, so you may need to expand your geographic range. The more options you have to compare, the better.
How to narrow down your options
- Learn the clinic’s listed number of cycles per year by selecting “Success Rate and Clinic Details” beneath each option. This information is located in the blue box beneath the clinic profile. Typically, more cycles indicate that the clinic has more experience.
- A high-performing clinic will want to brag about its success by reporting their success rates to SART. As you scroll down, you’ll find graphs displaying outcomes per egg retrieval cycle and live birth per new patient. We recommend looking at the outcomes for your age range — you want a clinic that has demonstrated success for others your age. Nurse Jill tells us that selecting the most experienced clinic for your needs will save you time, money, and stress.
- Review the frozen embryo success rate and donor egg success rates, too. Nurse Nurse Jill advises selecting clinics with 60%-80% percent success.
- You can compare your selected clinic against national average success rates here.
Sadly, SART doesn’t do this comparison work for you. To save you headspace and help you collect this information in one place, we created this worksheet for you. On each tab, just type the name of a clinic you’re considering. We’ve gone ahead and listed the information you need to gather and questions you need to ask — simply copy and paste this over for each clinic.
How to find an LGBTQ+-affirming clinic
While trying to conceive, it’s important to feel like your care team supports you and your goals. Though the SART search tool doesn't allow you to filter by specialties, there are a few steps you can take to find an LGBTQ+-affirming clinic:
- Ask any LGBTQ+ people you know who’ve gone through fertility treatment for personal recommendations.
- You can search Family Equality’s database for fertility clinics (as well as cryobanks) with specialized training in LGBTQ+ family planning.
Before scheduling an appointment
Once you have a list of clinics, pay a visit to their individual websites to try and answer the following five questions. Doing so can help you continue to narrow down your list and prepare you for an in-person consultation. If you can’t find answers to the questions on the website, give them a call to inquire.
(We also put a copy of the questions in the worksheet so you can jot down the answers.)
1. What tests will you need to do before IVF or egg freezing?
You don’t just immediately jump into egg freezing or IVF. Your doctor will first want to learn about your health, make sure you’re a strong candidate for a procedure, and design the best program for you. Each patient is evaluated to maximize their chances for success, often through procedures like ultrasounds, physical examinations, and hormone tests. Simply knowing what to expect can boost your confidence and empower you as a patient — before you ever step foot inside the clinic and actually become a patient.
If it’s recommended that you undergo a hormone test, Modern Fertility can help. For $159, Modern Fertility offers at-home fertility hormone testing. All it takes is a finger prick to get access to the same insight you’d get from a reproductive endocrinologist, for a fraction of the price ($1,000+ at a clinic).
2. How much is the procedure you're considering — including the consult?
Speaking of price — IVF and egg freezing are big financial investments. Doing research on this exact topic can help prevent any surprises down the road. It is essential that you understand the cost for every step of the procedure: consult, initial appointments, procedure, medication, freezing, storage fees, and potentially repeating the procedure. Like we mentioned above, there may be multiple introductory appointments and tests before the actual egg freezing or IVF procedures that cost money. Dig up what information regarding cost you can from the clinic’s website, and don’t be afraid to call to ask.
This is a good time to ask about potential coverage through your insurer or employer, too. Your procedure costs can depend on this.
3. How long does a cycle last and how many times will you need to go to the clinic? Will you have to take time off?
According to UpToDate, an IVF cycle can last for a period of weeks and you may need more than one cycle. On average, egg freezing takes 10-14 days to complete. Both procedures include a two-week period of blood tests and transvaginal ultrasounds every couple of days. Some women take off from work during this period, but this is ultimately up to you. Afterwards, there’s an appointment for the egg retrieval procedure and, if you are trying to immediately get pregnant via IVF, an embryo transfer.
Why is knowing this information for each clinic important? Well, you’ll likely be visiting the clinic more than once — perhaps frequently. It’s important to find one whose protocols mesh well with your lifestyle and personal and professional responsibilities.
4. What specific method does the clinic use for freezing eggs?
Nurse Jill says that these days, cutting-edge clinics use vitrification rather than a method called “slow freezing.” Vitrification freezes eggs rapidly using very low temperatures to preserve the cells and tissue and eliminate possible damage from ice crystal formation. Eggs frozen by vitrification also often have higher survival rates. Double check that a clinic uses vitrification — it’s now considered a best practice.
5. What happens during the initial consultation?
Understanding what happens during the initial consultation ensures you’ll get the most out of it and effectively prepare. For example, do you need to bring copies of your medical records or insurance information? It may also be useful to download the raw results of your Modern Fertility Hormone Test from your account dashboard.
You’re not alone in this journey. We're right here with you on this path. Learning the role of a reproductive endocrinologist and getting the answers to the right questions will not only help you find the best clinic and specialist for you and your needs, but also help you feel confident and prepared. Once you've made the decision to freeze your eggs or pursue IVF, rest assured that there are steps you can take (and spreadsheets you can complete, if you’re so inclined) to put your plan into action in an empowered and informed way.