Things to Consider when choosing the right Fertility Clinic for You

By MD, FACOG, FACS, FACE (reproductive endocrinologist), BSc, MSc (embryologist), MD, MSc (gynecologist), BSc, MSc (embryologist) and BSc, MSc (psychologist).
Last Update: 10/26/2021

Those who are unable to conceive, either due to infertility problems in the couple, single women, or couples of women, will have to resort to fertility treatment to be able to fulfill their dream: to have a baby.

This is the beginning of a hard road that, depending on the individual patient and the cause of infertility, may even last several years. Therefore, it´s very important to choose the assisted reproduction center that best suits the preferences of each person.

Therefore, there is no one best-assisted reproduction clinic. Spain has a multitude of prestigious centers with very good results and each patient should find the one with which he/she feels most at ease and inspires the greatest confidence.

From InviTRA.COM we want to help our readers with this difficult choice. For this purpose, we have selected the most important factors that should be assessed in an assisted reproduction center before starting a fertility treatment.

Provided bellow is an index with the 13 points we are going to expand on in this article.

How to choose an assisted reproduction center?

Spain has a wide variety of assisted reproduction centers distributed throughout the country. However, it is true that the largest offer of fertility clinics is found in large cities such as Madrid, Barcelona, and Valencia.

There are small clinics, large clinics, older clinics, newer clinics, clinics located in hospitals, private practices, etc. With so much choice and diversity, it is normal for patients to find themselves lost when it comes to choosing which assisted reproduction center to go to.

However, we will now discuss the aspects that should be taken into account when choosing an assisted reproduction clinic.

Quality

First of all, before deciding on a fertility clinic, it is important to make sure that it is an officially licensed center.

As stated in Article 17 of Law 14/2006 on Assisted Human Reproduction Techniques:

All centers or services in which assisted reproduction techniques are performed, or their derivations, as well as gamete and pre-embryo banks, will be considered health centers and services [...] and will require the corresponding specific authorization for the practice of assisted reproduction techniques.

Therefore, it is necessary for an assisted reproduction center to have this authorization, which provides security to patients. In addition, normally, almost all fertility clinics display on their website all the official recognitions obtained.

On the other hand, the clinic must be adapted to comply with data protection laws but guarantee the traceability of the samples (so important in a field such as assisted human reproduction).

Facilities

In order to undergo an assisted reproduction treatment, whether of low complexity such as artificial insemination (AI) or of high complexity such as in vitro fertilization (IVF), it´s essential that the center has the appropriate facilities.

From our point of view, it is essential for an assisted reproduction clinic to have its ownlaboratory and operating room.

However, we are not only referring to the fact that the fertility center has the necessary physical facilities, but also to the equipment and amenities that the clinic has in each of its areas. Thus, we believe that it is important to value the assisted reproduction center's facilities in:

  • Reception.
  • Waiting room.
  • Offices.
  • Recovery room after follicular puncture.
  • Semen sample collection room.
  • Blood sample extraction room.

In addition, it may be useful to know in advance if the center has its own egg bank and/or sperm bank.

Clarity and transparency of information

The first contact with assisted reproduction can be difficult. However, the road will be more bearable if the clinic has a good transparency policy.

Treatment information

It is common for patients coming to a fertility clinic for the first time to be unfamiliar with how the reproductive system works. Therefore, it is of utmost importance that the specialists explain clearly what the infertility problem is that the patients suffer from, as well as everything related to the assisted reproduction treatment they are going to start and why it is the indicated treatment in their case.

It is a lot of new information that patients must assimilate all at once and this is not always easy. However, for the center to keep patients fully informed will make patients feel that they are in control of their fertility treatment.

In addition, the professional must explain as many times as necessary what the treatment will consist of and resolve any doubts that may arise during the process.

Budget clarity

To the extent possible for each individual or couple, price should not be a determining factor in choosing an assisted reproduction clinic. However, the high cost of many fertility treatments does pose a limitation for many patients.

All clinics offer an initial quotation before starting the whole process of reproductive treatment. Therefore, it is advisable to ask for an estimate at two or three different fertility centers in order to be able to compare.

However, it is very important to make sure what is and is not included in this initial budget. Some clinics may seem a priori cheaper than others, but the patient must be clear about what is included in each of the budgets.

Nevertheless, it´s worth mentioning that the price of hormonal medication is not usually included in the budget since it can vary greatly from one patient to another. For this reason, an additional €400-1,000 of hormonal drugs will have to be taken into account.

Another point that clinics sometimes fail to clarify in their budgets is their policy in the event of cancellation of the cycle. For example, if no mature oocytes or viable embryos are obtained for transfer, the cycle will be canceled. In these cases, the patient should know in advance what the cost would be if the treatment were to be canceled at each of the points at which this could happen.

Finally, it should be noted that, in general, all assisted reproduction clinics offer the option of financing treatments. If you want to know in detail the prices of all assisted reproduction techniques, you can continue reading here: Overview of the Main Costs of Fertility Treatments.

Team of professionals

A fertility treatment consists of several steps that require different specialists: gynecologists, embryologists, anesthesiologists, etc. All these professionals must be qualified and experienced.

In addition, all fertility treatments must be carried out in a totally personalized way, as it will depend on the cause of infertility, age, hormonal analysis, medical history, etc. For this reason, it´s common for patients to appreciate the fact that the same doctor knows their particular situation perfectly well and attends them in all their visits to the clinic.

Patients should keep in mind that they are placing their assisted reproduction treatment in the hands of a team of professionals. Therefore, it must inspire total confidence and security.

Likewise, another aspect to be considered when choosing an assisted reproduction center is that the clinic provides patients with a person who keeps them constantly informed and answers all their questions. This support may not seem decisive at first, but it provides great confidence throughout the process.

Laboratory

As mentioned above, it is essential that the assisted reproduction center has its own laboratory and operating room. However, they must have the up-to-date technology required to perform any reproduction treatment.

Other points to consider are that the laboratory has quality certificates, that it has adequate cleaning and sterility conditions, air filtration systems, and controlled and optimal conditions for embryo development.

Finally, it is interesting to know what technologies they have in the laboratory. For example, the patient can ask if time-lapse incubators such as Geri or Embryoscope are available, as they allow a better selection of the embryo to be transferred.

Success rates

When patients want to know the success rates of an assisted reproduction clinic, they should know that the only official rates are those issued by the Spanish Fertility Society (SEF) in its National Registry of Activity. This is why it is necessary to consult the Registry before being misled by the success rates published by the clinic itself.

On the other hand, it is very important to know at all times what the fertility clinic means by "success rate". Under this concept, they may be talking about fertilization rate, transfer rate, implantation rate, gestation rate, delivery rate, or live newborn rate.

However, it is obvious that two success rates cannot be compared when one refers, for example, to the implantation rate and the other to the live birth rate.

First visit conditions

One of the aspects that patients value most when deciding on a fertility clinic is how they have felt at the clinic. For this reason, it is highly recommended to choose assisted reproduction centers that offer a freefirst visit.

In this way, you can get to know several clinics without having to make a financial commitment to them. This will allow the patient to compare the treatment received and freely decide which center to choose for reproductive treatment.

In addition, this first contact gives a clearer idea of the tests to be performed, the steps to be followed and, if performed in several clinics, will provide several medical opinions.

Services available

Another point to keep in mind for patients who are looking for an assisted reproduction center is the number of services that the clinic offers. These services include the following:

Diagnostic tests
some clinics may offer to perform all or most diagnostic tests at the same center.
Emergencies
more and more clinics are including a telephone answering service to deal with urgent matters of great concern to patients, such as forgotten medication, very annoying symptoms, bleeding during beta-waiting, etc.
Other specialties
some clinics also offer other medical specialties that their patients may need at any given time, such as psychological assistance or urology services, among others.

In addition, it will be important to check the clinic's hours of operation to know which days they are open. Although medical specialists do not consult on weekends, it is important that the clinic does perform important procedures such as a follicular puncture or embryo transfer on Saturdays and Sundays, since it is not convenient to advance or delay these procedures in order to guarantee the success of the treatment.

FAQs from users

When should I visit a fertility specialist to achieve pregnancy?

By Zaira Salvador BSc, MSc (embryologist).

A couple should consider infertility when, after one year of unprotected intercourse, pregnancy does not occur. From this moment on, it is time for them to visit a fertility specialist in order to go through a fertility evaluation. The goal is to find what is preventing them from achieving pregnancy and start the most adequate treatment based on it.

Is fertility treatment cheaper abroad?

By Zaira Salvador BSc, MSc (embryologist).

It basically depends on the destination country. However, seeking cheaper or low-cost fertility treatment is one of the most common causes why patients decide to pursue IVF or any other procedure abroad. In fact, that is the reason why patients from the USA, in spite of having one of the most permissible and well-developed fertility care systems, travel to countries of similar characteristics but with lower prices.

You can learn more about the cost of IVF and egg donation treatments by visiting the following post: Donor-egg IVF cost in the USA.

What are the requirements for choosing a fertility clinic?

By Silvia Azaña Gutiérrez BSc, MSc (embryologist).

When choosing an assisted reproduction clinic, it is important that it meets certain requirements:

  • To be an authorized center.
  • To have the appropriate facilities and technologies and, if possible, its own laboratory and operating room. In addition, the laboratory conditions should be optimal for embryo development.
  • Provide the patient with as much information as possible about treatments and budgets in a clear manner.
  • To have a team of professionals that the patient trusts.
  • To have a team of professionals that the patient trusts.
  • To have a team that the patient trusts.
  • Have good success rates.

In addition, it may be interesting to consider whether the clinic offers free first visits or if it has other services such as psychological care.

Is location important when choosing an assisted reproduction clinic?

By Silvia Azaña Gutiérrez BSc, MSc (embryologist).

The area where an assisted reproduction center is located may be a factor that patients take into account when deciding on one clinic or another. However, location should not be a determining factor when choosing a fertility center.

It is true that visits to the clinic may be frequent during assisted reproduction treatment, which makes patients consider the distance to be traveled. Despite this, it is often the case that the clinic that best suits the needs of each woman or couple is not the closest one. For this reason, location should not be a key factor in the choice of the assisted reproduction center to go to.

Is there a maximum age for assisted reproduction treatment?

By Mark P. Trolice MD, FACOG, FACS, FACE (reproductive endocrinologist).

The American Society for Reproductive Medicine (ASRM) recommends the upper age limit for a woman to carry a pregnancy should be no greater than 55 years due to increasing pregnancy complications. Using her own eggs, a woman’s success with IVF drastically declines wtih age throughout her 40s. As a result, women in their mid 40s and beyond, typically utilize and egg donor.

When should you see a fertility specialist after miscarriage?

By Zaira Salvador BSc, MSc (embryologist).

Anyone who has experienced 2 or more miscarriages should visit a fertility specialist (reproductive endocrinologist). The goal is to detect what is causing you to miscarry and apply the most adequate treatment. Common causes include problems like diabetes, genetic abnormalities in the embryo, thyroid disease, advanced reproductive age, structural problems in the uterus, etc.

If you want to obtain detailed information about assisted reproduction clinics in Spain and get an approximate idea of their services, we encourage you to visit our directory of centers at the following link: Assisted reproduction clinics in Spain.

To read a little more about assisted reproductive techniques, to know the differences and when they are indicated, you can access the following post: What Are Infertility Treatments? - Definition, Types & Costs

Our editors have made great efforts to create this content for you. By sharing this post, you are helping us to keep ourselves motivated to work even harder.

References

Alberto Reche y Manuel Martínez Moya. Manual de Buena Práctica Clínica en Reproducción Asistida. Sociedad Española de Fertilidad (SEF).

Alper M, Brinsden PR, Fischer R, Wikland M (2002). Is your IVF program good? Hum Reprod; 17: 8-10.

ASRM, American Society for Reproductive Medicine. Guidelines for advertising by ART programs. (October) ASRM Practice Committee Report. American Society for Reproductive Medicine, Birmingham, AL; 1999.

ASRM, American Society for Reproductive Medicine (2002). Revised minimum standards for in vitro fertilization, gamete intrafallopian transfer, and related procedures. A Practice Committee Report. Guidelines and Minimum Standards.

Brian, K. (2010). The Complete Guide to IVF: An Insider’s Guide to Fertility Clinics and Treatments. Published by Hachette Digital, London.

Fernández A, Castilla JA, Martínez L, Núñez AI, García-Peña ML, Mendoza JL, Blanco M, Maldonado V, Fontes J, Mendoza N (2002). Indicadores de calidad asistencial en un programa de FIV/ICSI. Rev Iberoam Fertil; 19: 249-52.

Gianaroli L, Plachot M, van Kooij R, Al-Hasani S, Dawson K, DeVos A, Magli MC, Mandelbaum J, Selva J, van Inzen W (2000). ESHRE guidelines for good practice in IVF laboratories. Committee of the Special Interest Group on Embryology of the European Society of Human Reproduction and Embryology. Hum Repro; 15: 2241-6.

González E, Castilla JA, Magán R, Ortiz A, Ortiz-Galisteo JR, Aguilar J, Maldonado V, Fontes J, Martínez L, Mendoza N (2004). Consentimientos informados de reproducción asistida y legibilidad lingüística. Rev Iberoam Fertil; 21: 69-74.

ISO 9001, 2000. Quality management systems –requirements International Organization for Standardization, Geneva.

Lyneé Madiera, J. (2018). Taking Baby Steps: How Patients and Fertility Clinics Collaborate in Conception. By The Regnets of the University of California. University of California Press, Oakland, California

Marcus, H.J., Marcus, D.M., and Marcus, S.F. How do infertile couples choose their IVF centers? (An Internet-based survey) . Fertil Steril. 2005; 83: 779–781

Reproducción Asistida ORG. Video: ¿En qué consiste la primera visita en la clínica de fertilidad? (What does the first visit to a fertility clinic involve?), by Valeria Sotelo, MD, Apr 7, 2015. [See original video in Spanish].

The Practice Committee of the American Society for Reproductive Medicine. Revised minimum standards for practices offering assisted reproductive technologies: a committee opinion. Fert Steril, No. 3, September 2014; 102: 682-686.

Wikland M, Sjöblom C (2000). The application of quality systems in ART programs. Mol Cell Endocrinol; 166: 3-7.

FAQs from users: 'When should I visit a fertility specialist to achieve pregnancy?', 'Is fertility treatment cheaper abroad?', 'What are the requirements for choosing a fertility clinic?', 'Is location important when choosing an assisted reproduction clinic?', 'Is there a maximum age for assisted reproduction treatment?' and 'When should you see a fertility specialist after miscarriage?'.

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Authors and contributors

 Mark P. Trolice
Mark P. Trolice
MD, FACOG, FACS, FACE
Reproductive Endocrinologist
Mark P. Trolice is the Director of Fertility CARE – The IVF Center and Clinical Associate Professor in the Department of Obstetrics & Gynecology (OB/GYN) at the University of Central Florida College of Medicine. He is Board-certified in REI and OB/GYN, and maintains annual recertification. His colleagues select him as Top Doctor in America® annually, one among the top 5% of doctors in the U.S. More information about Mark P. Trolice
License: ME 78893
 Silvia Azaña Gutiérrez
Silvia Azaña Gutiérrez
BSc, MSc
Embryologist
Graduate in Health Biology from the University of Alcalá and specialized in Clinical Genetics from the same university. Master in Assisted Reproduction by the University of Valencia in collaboration with IVI clinics. More information about Silvia Azaña Gutiérrez
License: 3435-CV
 Valeria Sotelo
Valeria Sotelo
MD, MSc
Gynecologist
Bachelor's Degree in Medicine from the University of Buenos Aires. Specialist in Gynecology & Obstetrics. Master's Degree in Video-laparoscopic Surgery, and Certificate of Specialist in Gynecology. Associate Member of the Spanish Fertility Society (SEF) and the Spanish Society of Gynecology & Obstetrics. More than 10 years of experience in the field of Reproductive Medicine. More information about Valeria Sotelo
License: 030309166
 Zaira Salvador
Zaira Salvador
BSc, MSc
Embryologist
Bachelor's Degree in Biotechnology from the Technical University of Valencia (UPV). Biotechnology Degree from the National University of Ireland en Galway (NUIG) and embryologist specializing in Assisted Reproduction, with a Master's Degree in Biotechnology of Human Reproduction from the University of Valencia (UV) and the Valencian Infertility Institute (IVI) More information about Zaira Salvador
License: 3185-CV
Adapted into english by:
 Cristina  Algarra Goosman
Cristina Algarra Goosman
BSc, MSc
Psychologist
Graduated in Psychology by the University of Valencia (UV) and specialized in Clinical Psychology by the European University Center and specific training in Infertility: Legal, Medical and Psychosocial Aspects by University of Valencia (UV) and ADEIT.
More information about Cristina Algarra Goosman

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