How to Choose an IVF Treatment Program

Infertility is common, but the idea of seeking support and finding the right place for assisted reproductive technology (ART) like in vitro fertilization (IVF) treatment may feel overwhelming. How do you select from hundreds of IVF programs across the country?

“First, choose an IVF program that reports its pregnancy and live birth rates to the Centers for Disease Control (CDC), and The Society for Assisted Reproductive Technology (SART),” says Mark D. Hornstein, MD, a Mass General Brigham reproductive endocrinologist and AMC Division Chief of Reproductive Endocrinology and Infertility in the Infertility and Reproductive Surgery Program.

Most IVF programs report their statistics to the CDC and SART. It would be a red flag if a program doesn’t, according to Dr. Hornstein. SART members follow clinical and ethical guidelines, ensuring a high standard of care within the program.

Below, Dr. Hornstein shares tips for finding the right IVF program for you.

Focus on IVF success rates.

Dr. Hornstein advises paying attention to live birth rates, as a patient might become pregnant, but they could miscarry or have a tubal pregnancy which doesn’t result in a live birth. An IVF program should display this statistic on their website.

In patients under 35, Dr. Hornstein notes that you want to see a live birth rate of at least 40% per cycle initiated. The chances for a live birth are lower for more advanced reproductive ages (over 40 years old).

Keep in mind that IVF programs with the highest birth rates are not necessarily the best choice. According to Dr. Hornstein, some programs won’t treat patients with less-than-optimal odds of success, as these “challenging cases” might negatively impact success rates.

5 things to consider about an IVF clinic

Most people start their search for an IVF clinic online. Here are 5 things to consider as you browse an IVF program’s website:

1. Reputation: How long has the program been established? Are the specialists board-certified? A physician must complete 3 years of additional medical training and pass written and oral exams to have a subspecialty certification in reproductive endocrinology and infertility.
2. Affiliations: A program that partners with an academic medical center (AMC) is committed to advancing research and education in the field. Their IVF programs often have access to the latest technologies and evidence-based treatments.
3. Research: Programs with academic affiliations may conduct clinical trials. IVF programs that conduct research can enroll patients in trials that may offer innovative therapies often not available elsewhere.
4. Infertility services: Does the program offer a range of infertility treatments? While IVF is a well-established treatment for infertility, there may be situations where other therapies are more appropriate. This may include medication or surgery to treat conditions that affect fertility, intrauterine insemination (IUI), or third-party reproduction, which is an option for LGBTQ+ couples.
5. Location: Is the program conveniently located? Does it offer several locations and convenient hours? Can they see patients on weekends? How close is the program? Even if a facility is far away, a top program or specialist with whom you trust can be worth the trip.

Hospital-based programs vs. freestanding IVF clinics

IVF treatments can be more complicated for those with medical conditions like heart disease or kidney disease, cancer, or extremes of body weight, which can impact a person’s fertility. Such patients typically require a hospital-based program as opposed to a freestanding clinic.

“Egg retrievals in patients with certain medical conditions, for example, require coordination of care between fertility specialists, anesthesiologists, nurses and often other health care professionals,” says Dr. Hornstein.

The advantage of a hospital-based program is that it can provide comprehensive services as well as consultations with experts such as a high-risk obstetrician. This kind of obstetrician specializes in caring for patients with a high-risk pregnancy, like if they’re carrying more than one baby (multiple pregnancy), or have a condition like preeclampsia or gestational diabetes. A multidisciplinary team coordinates your care with the right experts and works closely with you throughout your fertility and pregnancy journey.

In addition, hospital-based programs are often involved in research and teaching, which means they can usually offer patients the latest technologies and treatments.

Some hospital-based programs, such as the IVF/ART Program at Mass General Brigham, also offer counseling, support groups and alternative treatment options (for example, acupuncture).

Finding the right IVF specialist

Your relationship with an infertility specialist should be similar to your relationship with your primary care provider (PCP). Find a specialist who engages in thoughtful discussions that address your concerns, preferences, and treatment options.

Also, try and determine the specialist’s competence and level of experience. Find out how long they have been practicing and confirm that they are board-certified in reproductive endocrinology.

Questions to ask your IVF specialist

When you meet with an IVF specialist, don’t be afraid to ask questions. These may include:

• What is my diagnosis?
• What is causing my infertility?
• What particular infertility treatment do you recommend and why?
• Do you offer other infertility treatments besides IVF?
• Are there any clinical trials exploring new treatment options?

Options for IVF at 40 or older

If you’re over 40 and considering IVF, your chances for pregnancy are lower than patients younger than 40. When researching where to get care, find out if the program offers IVF with donor eggs.

Most programs will not use a patient’s own eggs if they are over the age of 44. In that case, you could explore donation if a donor program is available. Most IVF programs receive their eggs from donor agencies. Alternatively, a patient could use eggs from a relative or friend.

No matter your age, Dr. Hornstein notes that your PCP or obstetrician-gynecologist (OB/GYN) can help guide you to the right care. Navigating fertility treatments while trying to get pregnant can take an emotional toll. It’s important to find an IVF program where you feel comfortable and confident in your care.