Judging by the most recent annual report done by the Society for Assisted Reproductive Technology, the amount of American women who have used medical assistance to get pregnant only continues to climb. More couples are turning to fertility specialists than ever before. This is not necessarily because fertility in America is declining, but is most likely due to the fact that people are choosing to wait to have children until they are older.
In 1980, most new mom’s were 22 years old and these days the average age is closer to 26 (according to the CDC). Now, since you are reading this, you undoubtedly have come to the conclusion that you require some assistance with conception. Also, considering the topic we are discussing, you are beginning to wonder if you are with the right fertility clinic.
Treatment is not cheap, and you want to be sure that you are spending your money somewhere where it is really going to count. It is very common for people to have such thoughts, especially after multiple failed cycles. It is easy to become frustrated, but before you come to the conclusion that your current clinic is not right for you, you may want to consider the factors discussed below.
How Much Time Have You Given This Clinic?
When you first go in for fertility treatment, you want the first treatment to be the only treatment that you will need. Unfortunately, there are many couples that will not have a successful result and will need to consider a second cycle. There are a handful of reasons why the first cycle may not have taken.
Some common examples are:
- Embryo quality: when it comes to IVF, often times a cycle is not successful because of the embryo quality. It is very common for embryos to have trouble implanting after they have been transferred to the uterus because they are somehow flawed. Embryos can look perfectly healthy when they are in the lab and still have defects that are untraceable to the doctors eye and cause them to die instead of flourish.
- Egg age: also with IVF, the age of the eggs being used is even more important than the actual age of the woman undergoing treatment. A woman’s ovarian reserve begins to lower in quality and quantity as she grows older, and this has a major affect on her ability to get pregnant. Only around 25% of transferred embryos will successfully result in a live birth, and women under the age of 35 using their own eggs have an implantation rate of around 45%. This number greatly decreases for women who are 40 and older who choose to use their own eggs.
- Ovarian response: it can happen that a woman’s ovaries do not respond to the medication given by their doctor that is meant to produce multiple eggs. If this is the case, the doctor should make an adjustment in the fertility medications being given to you for the next IVF cycle.
- Chromosome response: another common factor that can cause IVF to fail is the existence of chromosomal issues in the embryo. This can occur with a naturally conceived embryo or one that is developed in the lab. This is also a common cause of most miscarriages.
- Lifestyle influences: the majority of fertility clinics make it a requirement for those that they treat to stop smoking months before treatment begins. If you continue to smoke, you will need twice as many IVF cycles in order to successfully conceive and are more likely to miscarry than those who do not. Also, women with an unhealthy body weight are less likely to find success with treatment. The health of your body contributes greatly to its ability to conceive.
When you have a failed cycle, your fertility specialist will evaluate what went wrong and consult with you about why this happened. Based on your age and current state of health, and how many attempts you have made with the same response, you should be able to determine if it seems like there is something the doctor is missing. It is always a good idea to get a second opinion when you are experiencing such feelings.
Has Your Specialist Suggested Another Type Of Treatment?
When you had your initial consultation with your specialist, they may have suggested a certain type of treatment based on the information they knew about your current state of health. Yet, after 1-3 failed attempts, they may suggest that you take a different approach. It is understandable if this makes you wonder how much you can depend on this doctor, but it is also very common for certain factors about your body to become evident once you have actually attempted a treatment.
As the doctor continues to learn more about how your body responds, they may determine that another approach makes more sense for you. After multiple failed attempts, this is the conversation you should be having. If your doctor specializes in one area and seems to be pushing for more tries with this one treatment, you will want to get a second opinion. There are many different types of options for fertility treatment. If you feel like you are taking the wrong approach with treatment, talk to you doctor, or other doctors about the treatments listed below.
- Fertility Drugs: These are drugs that are injected or taken in pill form. They release hormones into the woman that are meant to induce ovulation in order to create a higher egg count and make the uterus more receptive to embryo implantation. This treatment is best for women who have inconsistent ovulation or a partner with poor quality sperm.
- Artificial Insemination (Intrauterine insemination or IUI): When “washed" sperm is inserted directly into the uterus through a thin, flexible catheter during IUI. t is also often recommended by doctors for the woman to take fertility drugs along with IUI to enhance to probability of conception. This is often recommended to couples where the man has poor quality sperm or there is suspected communication issues between the couple’s reproductive systems.
- Donor Sperm: When sperm from a man outside of the couple is used during IUI or IVF. This treatment can be suggested to couples experiencing male-factor infertility or genetic disorders. The male’s sperm and physical well being should be examined when the woman is undergoing tests during the initial stages, as it is just as probable for either or both people to be the one with the existing infertility conditions.
- In Vitro Fertilization (IVF): When the doctors extracts the woman’s eggs and combines them with the sperm in a lab. The embryos then develop in the lab to be later inserted back into the woman’s uterus. Women who are older or who have damaged reproductive organs often are recommended this treatment, as well as couples experiencing unexplained infertility.
- Intracytoplasmic Sperm Injection (ICSI): When an embryologist selects the healthiest sperm from the male's semen and injects it directly into the egg with a microscopic needle. After the embryo has developed it is transferred into the uterus through IVF. This is often recommended to couples where the man has a very low sperm count or poor sperm quality.
- Donor Eggs: When another woman donates her eggs so they can be fertilized by sperm from the recipient's partner. Once the embryos are made they are then transferred into the woman’s uterus. This is often recommended to women whose ovaries are damaged, or those have had to undergo chemotherapy; older women with poor egg quality; and women who have genetic disorders.
- Donor Embryos: When a couple undergoing IVF donate the extra embryos they have made which are left over once they become pregnant, so they feel they no longer need them. The donated embryo is then transferred into the woman’s uterus. This is often recommended to couples where both the woman and man are suspected to be infertile.
- Reproductive Surgery: This is surgery that may require a hospital stay or could also be done on an outpatient basis. It is used to correct reproductive abnormalities or remove scarring or blockages within the man or woman’s organs.
Are You Considering Changing Clinics For Other Reasons?
It is very common for couples to decide to try another clinic when they have tried and failed too many times with a specialist. A lot of times, this does not necessarily mean they disliked the specialist, they simply just thought it was time for a fresh pair of eyes. There are other cases, however, that a couple has not been with a clinic for long and quickly feels the need to change. Friends and family might encourage this couple to stay put and give the clinic a chance, but it could be that the clinic simply was not what they originally thought it was.
You may be experiencing some doubts, and that is okay. Take a second to check in with these doubts and examine why exactly it is that you might be having them. Is it based on your uneasiness with getting treatment, or does it have something to do with the actual clinic and/or physician that you are seeing? There are a few ways that you can analyze your clinic to ensure that it is, indeed, the right place for you. Some examples can be found below.
How does this clinic make you feel?
When you are visiting your clinic and specialist you should always feel:
- welcomed and respected
- a sense of calm and safety
- that you are being taken care of
- that you can truly be yourself
- that you can depend on your healthcare provider
- that you are truly being listened to
- that you know everything there is to know about your treatment
- that you are just as important as the other patients being treated there
You may not have even realized that you were having doubts or discomforts based on these factors, but if you find that any of the above is not true, then it is time to look elsewhere.
Do you feel as though you connect with your doctor?
The clinic may be exceptional, but if you do not connect well with your doctor you are never going to feel comfortable. Infertility treatment is already uncomfortable as it is. Your doctor should be someone that makes you feel secure and confident in the steps that you are choosing to take together.
If you do feel a good connection with your doctor, know that it is not easy to find a relationship like that. If you and your doctor make a good pair, be sure that you have truly given them sometime before you start worrying that you should be treated elsewhere.
Do your research on this person if you are concerned that their credentials aren’t valid. If their qualifications are solid and the connection is strong, you may want to think twice before you flee the coop until you are sure another direction is necessary.
What is your financial situation?
You may have chosen a clinic based on it’s high success rates without worrying too much about the price. Just because a clinic has high success rates, does not mean they will find success with everyone. They may specialize in one specific type of treatment that actually is not right for you.
On the other hand, you might have thought ahead and matched yourself with a facility that is within your budget. In any case, it is important that you continue to work with facilities that you can afford. If you choose a location with a high price point, you could find yourself having to stop treatment halfway through due to lack of funds.
No matter what your situation, don’t make a decision that will leave you completely empty handed.
Is the clinic willing to be flexible with your schedule and convenient to get to?
You should not feel like you have to bend over backwards to make it to an appointment at your clinic. It should be evident that your scheduling conflicts are important to them and that they want to make arranging your appointments as painless as possible. Your life should not have to go on hold because of your treatment, and the clinic should be more than understanding about this.
After addressing all of these different factors, you can see there is a lot to consider when it comes to switching fertility clinics. If you feel as though you have a good situation and could give the clinic a little more time, then you should absolutely do so. On the other hand, if it is evident that something is wrong, do not stick around because you feel guilty. Your treatment is about you and your partner and no one else. You should be sure that your clinic is nothing but an exceptional fit.