Many couples who plan to have a baby have to wait for a long period but the wives still cannot get pregnant. Many of them plan to consult with a doctor but they are wondering : Which clinic should they go to? Who is the best doctor? Some may receive information from relatives or friends. Many couples begin from searching for information from the internet by typing something like “want to have a baby” or “fertility problems”. Couples can look for information in the website of any clinic and call to ask for general information. The couples may visit the place, talk with the staff or with other customers who have experience getting treatments from the clinic before. Each couple may have different reasons for choosing a clinic. A clinic that works well for a friend may not be the right one for our couple. Before choosing which clinic will be right for you, couples may use the below decision-making criteria.
Factors to Consider When Choosing a Fertility Clinic or Hospital
1. There are several different types of fertility clinics. Small clinics operate with 1-2 doctors, while big clinics have 3-8 doctors. Some fertility clinics are in private hospitals or medical schools’ hospitals. Good things about small clinics are the high level of privacy and the convenient and easily access to doctors. The advantages of big clinics or clinics in hospitals are that they have a comprehensive range of instruments, equipment and laboratories on site. Therefore, they are quicker at providing laboratory results and more convenient in case you need to consult with other doctors who specialize in relevant fields when other treatments are needed. They have patient rooms so if any complications from the treatment occur the doctor can monitor the patient closely. However, it is usually difficult to have access to the doctors. Instead, you will more likely get to talk with nurses. In a fertility clinic couples may not get to see the same doctor every visit and the result may not be as good as getting treatment from the same doctor.
2. Has the clinic or the hospital been granted the license for Assisted Reproductive Technology according to the Medical Council’s announcement or not? Those without the license may not comply with the treatment standards required by the Medical Council.
3. Does the clinic have doctors specializing in other fields? If the cause of the problem is from husband, it may be necessary to have consultation and medical procedures with a doctor specializing in treating problems of the male reproductive system and the urinary system. Does the clinic have a doctor specializing in the female reproductive system surgery? Does it provide surgery for ovarian cyst and endometriosis? Are there psychologist or fertility counsellors who can help you handle the stress during the treatment?
4. The clinic’s location and service hours: The location may not be the main factor in decision making for some couples but the service hours may be important for couples who work full-time and cannot take much time off. Such couples may have to see the doctor after their regular working hours and should check if the clinic is opened during evening, weekends or public holidays. If it is not open during weekends, how are medical procedures managed when scheduled on Saturday or Sunday. If the couples have a question or an urgent need at night, how can they contact the staff?
5. What are the levels of knowledge, expertise and service mindedness among the medical team and staff in other sections of the clinic?
Ways to Choose a Fertility Doctor for Your Treatment
Many couples may get recommendations from friends about a great doctor, a famous one or a doctor who has good reputation. Some people may read from posted messages on the internet. Members of ‘fertility clubs’ may give you the names of the doctors they have worked with either successfully or not. So you may end up with a long list of smart doctors finding it is very difficult to decide who you should see. To help make a decision, couples may use the ways provided below.
1. Does the obstetrician specialize in reproductive medicine and how many years of experience in fertility treatments? Does the doctor have any special areas of expertise?
2. How much time does the doctor have for talking with the couples about their treatment? Some couples may need a lot of time to talk with the doctor and ask questions. Famous doctors are more likely to have less time for their patients. Some doctors can give advice and answer questions via telephone or e-mail while others cannot.
3. Does the doctor work full-time at the clinic or extended hours? The major problem about doctors working extended hours is that they may have less flexibility in appointment scheduling and the couple may not get the best service for their treatment.
“A clinic that works well for a friend may not be the right one for our couple.”
Consideration of Laboratories
1. What types of laboratories does the clinic have? For example, does it have hormone Lab, Sperm Lab, embryo lab or genetics lab? Check whether it holds the Medical Laboratory accreditation according to ISO 15189 granted by the Bureau of Laboratory Quality Standards, Department of Medical Sciences, Ministry of Public Health.
2. Can the embryo laboratory culture the embryo until it reaches the blastocyst stage? How many years has this service been provided? Can the embryo be tested and diagnosed for chromosome abnormalities before being put back into the uterine cavity? If yes, does the process take place in the clinic or another laboratory and how good is it against the standards?
3 .How many embryologists work in the laboratory? Do they work full-time or part-time? Clinics with embryologists who work only on specific days may have limitations in taking care of the embryos.
4. Does the laboratory provide sperm freezing, egg freezing and embryo freezing services? If not, is the outside freezing and storage service provider up to standard and how efficient is the safety system?
Consideration of the success rate
Each clinic’s report about the success rate may not use the same standards. Statistic reports may intentionally include or exclude some data in order to have a high success rate. Data of difficult cases and cases with low potential to succeed may be avoided or the report may present only the age group with a high success rate. Remember that a clinic with a high success rate may not always be the best one. Married couples should ask each clinic for the statistical report of the pregnancy success rate. At least you should choose a clinic with an above-standard success rate. Besides the pregnancy rate, the miscarriage rate and the live birth rate in each age group of the mothers should also be considered.
Consideration of the Treatment Cost
The cost of the treatment is an important factor in choosing a clinic. Small clinics and clinics in medical school hospitals are usually much cheaper than big clinics and clinics in private hospitals. Married couples should ask for the details of the cost estimated by the staff. What does it cover? Does it cover the medical fee, the medication and the embryo freezing service? What are the payment terms? Do you pay when the actual cost occurs or do you have to pay in advance? In case an advance payment is required, what is the financial obligation if the treatment cycle is cancelled? Expensive treatments do not mean they are always the best. We should choose an affordable clinic based on our family’s income and the information we have collected. Some couples may need to go through several treatment cycles before they can make it. The choice should not be made because of the cheapest cost. Consideration should be given mainly to the treatment and the safety standards.
Once a couple has had enough information and gone through the recommended ways to choose the right fertility clinic for themselves, they should call to get more information on the treatment, the estimated cost. The next step is to make an appointment for a visit and an introductory counseling session. If this gives good impression and confidence in the clinic and the doctor, the couple may decide to go for the treatment. If they are not confident yet, they may check out some other interesting clinics for comparison because one of the important success factors is the trust and the confidence in the doctor.
Head of counseling and co-ordinator
JETANIN Journal Vol.5 No.2