This is a guest post by Professor Dr Geeta Nargund, Medical Director, CREATE Fertility Clinic in Birmingham.
When embarking on the IVF journey the sheer number of clinics and the wide range of treatment options available can be confusing when trying to decide what is best for you.
In taking the first steps towards choosing a clinic there are a number of important questions you need to ask; not only about the treatments on offer but also about how the clinic will go about catering to your specific needs. Here are my ten essential IVF questions you should always ask a prospective clinic before agreeing to treatment.
1. What are the differences between your clinic and others?
Most IVF clinics offer different types of treatment depending on the expertise of their staff and the resources available. It is important to note that not all of the registered IVF clinics in the UK provide every kind of treatment, so make sure you visit a few to get options. If you already know what type of treatment you are looking for (perhaps due to a pre-existing condition), then you will need to find out whether a prospective clinic can meet your needs and whether you are happy with their experience and success rates for someone in your situation.
2. Is the IVF treatment personalised to my needs?
Different clinics operate in different ways. Many will offer a one-size-fits-all blanket IVF treatment, which may not be right for you. Women who suffer from conditions such as low ovarian reserve, endometriosis or Polycystic Ovary Syndrome (PCOS) will need specialised treatment and you will need to check that your preferred clinic offers this.
3. How do you decide which treatment is best for me?
Treatment programmes will differ person to person, and factors such as your individual history, existing conditions, test results, past experiences (if you have previously had IVF treatment) and also the clinic’s specialist areas will determine their recommendations.
4. What types of treatment exist other than conventional IVF?
There are now a number of different types of IVF available following growing awareness that the traditional method is not always the most effective or safest for many women. Other lower, or no drug, treatments are now offered by some clinics, and include:
Natural Cycle IVF: which aims to collect the one egg that has been naturally selected by the body, and is carried out without the use of any fertility drugs.
Modified Natural Cycle IVF: a form of Natural Cycle IVF where medication is given to the woman for just 3-4 days in order to block spontaneous ovulation. A small dose of stimulation hormone is also given in order to keep the follicles healthy and growing.
Mild Stimulation IVF: takes place within the natural menstrual cycle using a minimal amount of fertility drugs. For just 5-9 days stimulating medication is given, compared to 4-5 weeks of medication in traditional IVF.
In Vitro Maturation (IVM): includes the collection of immature eggs from the ovaries, which are then matured in the lab before being fertilised. This treatment retains the benefits of IVF, but gives an opportunity for multiple embryos to be created and frozen for later use.
5. What tests do you recommend before treatment?
Before you begin fertility treatment, a clinic should carry out thorough tests on both you and your partner. These tests can be crucial in identifying any fertility problems or issues you may have before treatments are decided or take place. Alternatively, they may discover that you may not need fertility treatment, and that you just need advice to help you conceive naturally. A fertility MOT is a simple process that can help to identify cases of infertility and may mean less invasive and more affordable fertility treatments are suitable.
6. Would you advise any tests during the IVF treatment?
During treatment, clinics will usually offer vaginal ultrasound scans to monitor your ovaries, as well as blood tests. Clinics may offer ‘state of the art’ tests or imaging systems, which are not always necessary for the success of the treatment, but can add to the cost. It is always worth discussing with your consultant whether such tests are necessary and what costs are attached, then determining whether you need or can afford them.
7. What are my success rates at your clinic?
It is important to remember that not all clinics measure fertility success rates in the same way – some may only accept patients with a good prognosis in order to improve their results. Make sure you know how your prospective clinic measures success rates, particularly relating to your individual circumstances…
In summary; treat IVF success rates with caution, and always ask for a specific success rate for someone in your situation.
8. Do you provide treatment to women who have low egg reserve and high FSH or low AMH?
Clinics may turn away women whose prospects for successful IVF treatment under their current programme are low, and would therefore lower their overall success rates. It is important to ask your clinic this upfront if you know that you are affected by low egg reserve, low AMH or any other issues.
9. Are there often complications in treatments from the clinic? Have any patients been admitted to hospital?
Ovarian Hyper Stimulation Syndrome (OHSS) is a condition that affects the ovaries of some women who undergo high stimulation IVF treatment. Most cases are mild and can include symptoms such as nausea, vomiting and abdominal bloating, but in rare cases the condition can become severe and lead to serious illness or death. It is possible to entirely avoid incidences of OHSS by using more patient-friendly lower drug IVF treatments, so if a clinic has had patients admitted to hospital with OHSS then it may be an indication that they favour a high drug approach and you should consider if this approach is right for you.
10. How much is a full cycle and are there any other costs involved?
IVF is an expensive process and the cost of treatment is a deciding factor for many couples. Generally, clinics will charge blood tests, supplementary tests and medication as additions to your treatment, so it is important to check with your clinic for information on how they charge and what the overall cost of your cycle will be.
Disclosure: This is a collaborative post