# Criteria for selecting a clinic



## kimchi (Feb 4, 2012)

Hi,
I'm new to IVF. I have one son conceived naturally, he's 5 now. I've had several miscarriages since and now no longer get pregnant. I've had lots of tests done and Dr.Braverman in New York is currently doing more tests to see whether antibodies I'm producing against my husband's HLA genes are aggressive. I do have MTHFR issues also.
Due to age, 41yrs, I'm looking for an IVF clinic.
How do I go about selecting the best clinic for my situation? What else do I look at other than the following?
success rates for age
Experience with immune issues
Cost
Feasibility of travel

I read for example that Argc is v.different to other clinics, how?

Thanks.


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## ElsieF (Nov 26, 2009)

Hi Kimchi,


I have used 3 clinics, 2 in the UK and one in Spain. In my experience the main differences between them was their level of 'control freakiness' 
But here are the reasons I chose them and what I experienced:


The first clinic I chose was when I was living in London. I asked a friend who was a fertility doctor at Attenbrooks in Cambridge (ie first place that Ivf's was ever done) and he said to choose a dr who is well respected I research. He recommended Dr. Trew who along with Dr Lavery heads the fertility clinic at Hammersmith Hospital. They also have a private practice at 92 Harley Street, which is where I went.


I was very happy with them. Dr Trew is quite candid, which I know is not for some. He was upfront after the results if our first Ivf's, and explained all the possible factors and the % likely chance as to why our biggest problem was most likely to be my age (he was right but it took me 7 cycles to admit it ;-))
According to my dr friend, Dr Trew is 'famous' for getting the drugs dose right to get the max quality eggs. I got the ideal number of 11/12 with him every time.
The main difference between this clinic and the Argy is that they are quite hands-off during cycling i.e he sets the protocol at the beginning and they follow that through. When I did a natural FET (they were one of the first to try this 3 years ago) they scanned me once to check lining and I was told to use an OPK stick and give them a call to arrange transfer. They did not want me to use any drugs at all. (It worked by the way)
It is cheaper than most because they use Hammersmith hospital for egg collection, so you don't have to pay for private facilities.




I then moved to Scotland and used a clinic in Glasgow, which was definitely the best in the area at the time (but there wasn't much to choose from!) They were ok, but much more disorganized than no92, which was quite stressful, and over time has made me loose confidence in them. I now use them for coordination with the third clinic, IVI Valencia. (But even that seems to be a bit beyond them these days)


Ivi was first recommended to me by dr Trew, who knows the drs there and has visited. He said he was very impressed. They do do research that is highly regarded worldwide. They are a Huge clinic in Valencia with smaller outposts all around Spain. After a bit of a ropey communications at the start, I found them to be highly efficient and I have been very well cared for there. They are slightly more controlling that no 92. During the natural DE cycle I had there they had me scanned me every other day, I took ovitrelle to control the ovulation and progesterone as back up afterwards. (This cycle gave me DS)


I have not been treated at the Argy, but I understand that as far as drugs and monitoring, they are the other end of the spectrum to no 92. As I understand it, people have blood tests daily, and the results of these determine the drugs to be taken the next day. As a result the Argy is Much more expensive than any of the other clinics. 


As far as choosing in success rates - I think that is hard to judge. For me it only weeded out the really bad clinics, but isn't that helpful in identifying the best. If a clinic takes on more difficult cases (eg older women or women with specific problems) then their success rates will obviously be lower. And presumably the 'best' doctors will be more interested in the difficult cases. 


On the whole, looking back at my experience, I think Dr Trew's hands off approach was probably a reflection of his experience and confidence. At IVI my dr was quite young ( but guided by the consultants whom I never saw) so I suspect that that is why she wanted to monitor me more. 


I think the Argy is a different thing altogether though. Most clinics have consultants who also work in the NHS (and this is where they get their credibility re research etc) but I believe the Argy is, and always has been, totally private.


I don't know much about immune issues. I tried some immune treatments in 2 of my cycles (the clinic in Scotland advocated that it was much cheaper to just try the drugs than it was to get tested, so I went along with that ) I decide I didn't need them so didn't seriously look into them.
Saying that, if you follow my decision tree of going with the clinic that does the best research in the area, then that would be CARE clinic. 




Hope that was of some help at least! 
Good luck,
Elsie


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## Marmot (Aug 6, 2009)

When I asked my GP for advice on choosing a clinic she mentioned location and opening hours (convenience), and involvement in research to keep up to date. She said not to focus wholly on success rates for the reasons given above (that clinics that take more difficult cases won't have such good success rates even if they're doing very good work). 

I must admit that I *was* swayed by success rates and it influenced my choice. But I listened to my GP's advice too. If you work then the importance of convenience shouldn't be overlooked. And I have felt reassured that my consultants have cited research and seem interested in the latest thinking. Appointments are often running late though and that annoys me but seems very common! 


We went to open evenings at a couple of clinics that met our criteria (success rates, location, reputation, research) and then chose the clinic we preferred on gut feel.


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## Cay23 (Jan 12, 2011)

When we chose a clinic to have a self-funded cycle we considered (not in this order):

- location & ease of getting there
- price
- reputation
- success rates for our age (bearing in mind the points named above)
- acceptance criteria (some clinics won't accept FSH above 10)
- willingness to test for immune issues
- ease of communication with consultants (e-mail)
- opening hours
- emergency contact arrangements out of hours
- specialities of consultants (eg. Low AMH, older ladies)

I chose 5 possible clinics based on the criteria above and emailed them for info. Based on their communication (or lack of it!) I then narrowed it down to 3. Then we went for a visit/open evening and chose the clinic where we felt most comfortable. If this had been difficult, we would have had a consultation at the clinics to see which we felt was best for us. As it was, we didn't need to. We then chose our consultant from the clinic based on their interests, reputation (I googled each of them) and field of expertise.

It is such a difficult decision as you want to choose the clinic that's going to get it right first time. It took quite a bit of deliberation for us to choose the Lister, but at the moment I'm glad we did as they seem to genuinely treat us as an individual case and doesn't have a one size fits all approach, which I think is so important. Also our consultant is willing it to tell it as it is and seems to genuinely want to make our treatment a success - rather than us just being on a conveyor belt which is how we felt with our NHS experience. Good luck with your choice.

xx


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## kimchi (Feb 4, 2012)

Hi ElsieF, Marmot, Cay23,
thank you all so much for responding. Your responses have been very helpful.
More research and consultations required I think for me.
Thanks again.


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