How to Choose Your Fertility Specialist

Factors for Assessing a Fertility Specialist

Compare how various fertility clinics rate in these areas:

• Fertility preservation success rate
• Pregnancy success rate
• Your personal level of comfort with the practice
• Qualifications and experience of personnel
• Experience treating cancer patients
• Type of fertility treatments offered
• Support services available
• Cost
• Convenience
• Recommendations and reputation

Researching Success Rates

The following sources provide reliable information for you to make informed decisions and understand the likelihood of success with different treatment options:

• Centers for Disease Control (CDC)
• Society for Assisted Reproductive Technology (SART)

The numbers from these sources are a few years old and can sometimes be reported differently by different centers, so these figures should not be the only factor that you consider. Also keep in mind that treatment results vary based on many factors including age and number of embryos transferred.

Questions to Ask a Fertility Clinic

• What procedures do you offer?
• How much experience do you have in these procedures and what are your success rates?
• Do your physicians have experience working with cancer patients?
• What are your criteria for seeing patients (e.g. waiting list, age limits, single vs. married, etc.)?
• What screening tests are required?
• What is the time commitment?
• Does the program meet and follow ASRM (American Society of Reproductive Medicine) guidelines?
• Is the program a member of the Society for Assisted Reproductive Technology (SART)?
• Does the program report its results to the SART Registry and the CDC?
• How many physicians will be involved in my care?
• Are your physicians board certified in reproductive endocrinology and in good medical standing?
• What types of counseling and support services are available?
• Do you have an outline of the costs of the tests and procedures I may need?
• What are your available payment options?
• Is staff accessible to answer questions about treatment, forms, or payment?
• Do you accept insurance?
• What are the on-going storage costs of tissues (sperm, eggs, etc.)?

Choosing a PGD Provider

Talk to your health care team about the need for genetic testing before pursuing fertility treatment. Through preimplantation genetic diagnosis (PGD), it is possible for people with serious genetic disorders, illnesses and cancer to decrease the risk of passing on these health problems to their future children. Pre-implantation genetic diagnosis (PGD) and the associated processes may be completed by your fertility clinic and/or a third-party company that specializes in PGD.

PGD is used during the in vitro fertilization process to test embryos for genes related to certain disorders or cancers. After the embryos have developed in the laboratory for three days, a single cell can be removed. This cell is then tested for the problematic gene. If the embryos do not contain the gene, they can be implanted in a woman’s uterus to try to achieve pregnancy or be frozen for future use. If the embryos do contain the gene, they can be discarded or donated to research.

Some couples may still choose to use embryos that have tested positive for the disorder or cancer. This may be the case if the gene will result in a predisposition for a disease or disorder, as opposed to a guarantee. For example, women with BRCA 1 or BRCA 2, the genes that cause a predisposition to breast cancer, might still choose to use embryos with those genes.

Questions to Ask a PGD Provider

• How many PGS/PGD cases have you done?
• Do you offer PGD for all indications? If not, what do you offer PGD for?
• Do you offer genetic counseling and information about PGD for patients?
• What is the false positive error rate (where a normal embryo is mislabeled as abnormal)?
• What is the false negative error rate (where abnormal embryo is labeled as normal)?
• How are these rates determined?
• What is the likelihood that there will be no results per embryo?
• Do you have techniques to reduce these rates?
• What is the timeline for the process and the results?
• How much does PGD cost?
• The following are questions you may want to ask the company/center that will be performing the biopsy of the embryo to remove the cell for PGD testing.
• What is the experience of the technician performing the embryo biopsy and cell fixation?
• How many cases has that person performed?
• How many PGD cases has your center performed?
• What is the implantation, pregnancy and live birth rate for your PGD cases?

Need More Help?

As you face fertility issues, we encourage you to spend the time you need to select a fertility specialist and program that best meets your unique cancer diagnosis, treatment and where you are in your treatment plan.

Contact Livestrong Fertility to receive personalized guidance, including finding financial assistance programs for which you might be eligible.