When researching fertility clinics, it is important that you know what to look out for – the good, the bad and the ugly.
There are many, many articles out there offering advice to help couples and singles find the best IVF clinic. In contrast, there are very few offering practical advice on how to identify – and avoid – the worst IVF clinics. This means clinics that are not open and honest with their patients or otherwise act in a manner which may not be in the best interest of their patients. The last thing you want to do is waste precious time and money on a clinic that does not reach the expected standards.
We won’t be naming individual clinics here, as often the perception of ‘the best’ and ‘the worst’ clinics is subjective. Instead, Fertility Road is highlighting the red flags which may indicate that an IVF clinic is not all it seems. Here are several things you should look out for when researching an IVF clinic.
Transparency of IVF treatment costs
As we covered in our guide to IVF costs in the UK, IVF can be an expensive business, so it is important to find a clinic that is open and upfront about its pricing.
Most fertility clinics include a price list on their website so you can compare these with other clinics to make sure you are getting the very best deal. However some insist that you get in touch with them to request a price list, which requires you to hand over your contact details – something that you may be reluctant to do at this early stage.
If the clinic only provides IVF treatment as packages, ask for a breakdown of costs for each package to find out exactly what you are getting for your money. This includes medication, as the costs can vary wildly from patient to patient. A good clinic will be able to tell you from the start how much you should expect to pay for medication.
If a fertility clinic seems reluctant to discuss costs with you, or if they are not transparent about any potential extra charges you may face, then this means you should approach with caution.
They are vague about waiting times for egg and sperm donors
If you are planning on using a donor egg, sperm or both in your treatment, check the waiting list times. At the time of writing (April 2023), in the UK you can expect to wait anywhere from one month to one year for a donor. As there is a national shortage of Black, Asian and mixed ethnicity donors, in some cases the wait may be even longer.
If the clinic cannot give you an estimated wait time for a donor, or if it seems excessively long, we recommend looking elsewhere.
IVF clinics do not give you the full picture about ‘add-on’ treatments
It is highly likely that the clinic you are researching offers at least some ‘add-on’ treatments, such as assisted hatching, Embryoglue or endometrial scratching. Sometimes these treatments may be described as extra optional treatments, tests, surgical procedures or new treatments or products. If you opt for an add-on treatment, this could add hundreds, or even thousands, of pounds onto your IVF bill.
There are differing views about whether most IVF add-on treatments are effective. The Human Fertilisation & Embryology Authority (HFEA) has devised its own traffic light system for IVF add-ons, to show which have proved their worth at high-quality randomised control trials (RCTs) and which others have yet to be proven.
The Competition and Markets Authority (CMA) has previously raised concerns about possible cases of mis-selling of add-on treatments. It reiterated that patients should be given all the information they need before deciding whether an add-on is right for them.
If clinics are advertising treatment add-ons then, under consumer law, they should also provide information about the price, potential benefits, risks, evidence and information from the HFEA. If the clinic is not prepared to provide this information, but is continuing to give you the ‘hard sell’, they are breaking UK law.
IVF clinics do not have a full-time embryologist
In a nutshell, a fertility clinic with a full-time embryologist means better patient care. A full-time embryologist, working at one site, can base an IVF procedure on the woman’s natural menstrual cycle. Embryologists who split their time between clinics have to do IVF cycles in batches, which means manipulating the menstrual cycle in order to do all the egg collections on the same day. By having one full-time embryologist, this also reduces the risk of human error and sample mix-ups.
The HFEA recently revoked the licence of a fertility clinic in southern England. Various issues were raised, including concerns about staffing levels. The clinic had only one Health and Care Professions Council (HCPC) registered embryologist, who was also working at another centre some 53 miles (85.2 kilometres) away.
IVF clinics do not provide you with photographs of your embryos
Not only is it good practice for a fertility clinic to provide you with photos of your embryos, but it also builds trust between clinic and patients. Seeing photos of the embryos gives you confidence in the embryologist’s skills and shows that the clinic is open and transparent.
Even if the quality of the embryo is poor, it should still be properly documented. If the IVF cycle fails, the doctor can refer to the picture to identify how the treatment should be tweaked for future cycles.
If the cycle fails and you decide to seek a second opinion at another fertility clinic, the likelihood is they will ask to see pictures of your previous embryos. If a clinic says it won’t provide you with any photos of your embryos, consider this a big red flag.
IVF clinics won’t provide details about their complaints procedure
Although everyone hopes for the best outcome when embarking on IVF treatment, unfortunately sometimes things just don’t work out as planned. If you have a complaint about any aspect of your treatment, then you should be informed as to how to take this further.
In the UK, consumer law makes it a requirement for fertility clinics to “give or make available to prospective patients information about your complaints handling policy before they become bound by any contract with you.” If the clinic’s policies, practices or terms have the effect of discouraging someone from making or escalating a complaint, this risks infringing UK consumer law. Complaint handling procedures should be easy to find, easy to understand and deal with complaints fairly and effectively.
When searching for a clinic, always ask about their complaints handling policy. If the staff refuse to share this with you, or you feel they are being deliberately vague about the details, we advise going elsewhere.
IVF clinics don’t offer counselling
By law, a fertility clinic operating in the UK has to offer counselling to patients. This may include one or more free sessions, or you may be expected to pay for all the sessions you may need. If a clinic does not offer counselling, then it is breaking the law. If the IVF clinic does offer counselling for a fee, this should be made clear from the outset, including the amount you can expect to pay.
IVF clinics do not answer your questions
You have probably got a list of questions as long as your arm about everything from costs to success rates to medical protocols. A good IVF clinic will be only too happy to answer any questions you may have. If a clinic refuses to give you answers, walk away and don’t look back.
You might be interested in reading: Choosing the right IVF clinic for your treatment
The worst IVF clinics abroad
All of the above apply if you are seeking IVF clinics abroad, but of course a language barrier can make matters even worse. Clear communication between patients and doctors in any medical setting is vital to ensure patients receive the very best care.
When looking into IVF treatment abroad, check whether the doctors and staff are fluent in your own language. If they are not, then the clinic should be able to provide a coordinator to translate. However it is important that the coordinator has sufficient medical knowledge in order to accurately relay information from the medical team. Miscommunication between you and the team at the fertility clinic could have huge implications on your IVF treatment. If no one at the clinic speaks your language, or if the person translating does not possess enough medical knowledge to translate the message accurately, then you should find another clinic better suited to meet your needs.
On the theme of communication, it is important that you know how to contact your IVF clinic, particularly in case of any emergency.
A good clinic will be happy to provide contact details, and when a member of the team will be available to speak with you. Don’t forget to take into account any time differences between your location and the country where your clinic is based.
When researching your IVF clinic, check what qualifications are required for fertility doctors and embryologists in your chosen country. Don’t be afraid to ask the clinic for proof of these qualifications. If they seem reluctant or unable to provide these details, treat this as a red flag. It is important that your doctor has the right qualifications and that you have confidence in their skills.
Another thing to be mindful of when seeking IVF abroad is the importance of understanding the laws surrounding fertility treatment in your chosen country. For example, if you are having IVF using a donor egg, sperm or both, it is important that you understand the laws surrounding donor anonymity as these vary from country to country. Your clinic should be able to provide you with all the information you need or at least show you where to find it. If they are unable or unwilling to give you this information, walk away.
For IVF outside of the UK, make sure you research consumer rights in the EU or the country where you are seeking treatment. And be sure to find out about the complaints procedure at your prospective clinic. A good clinic will be happy to provide you with the details.
What questions should I ask when searching for an IVF clinic?
Whether searching for an IVF clinic in the UK or abroad, you should consider asking the following questions. This will help to determine whether the clinic is the right one for you.
Remember, a good IVF clinic should be willing and able to answer all your questions regarding your treatment. If you ask these questions and feel dissatisfied with the answers, or if a clinic doesn’t provide you with any answers at all, you should consider going elsewhere.
- What are the benefits of the treatment you’ve recommended and why do you think it’s the best option for me?
- How many patients at your clinic have had this treatment in the last two years and how many of them have become pregnant/had a baby?
- Are there alternative treatments? If so, what do they involve, and why do you think they are less suitable for me?
- What other options are available if this treatment doesn’t work?
- How does my age affect the choice of fertility treatment?
- Why are you recommending an add-on for me specifically?
- Can you tell me what my chances are of getting pregnant with routine IVF compared to my chances if I have this add-on?
- Do you believe the add-on is safe and effective?
- What is the additional cost of the add-on and what is included?
- Will you, or anyone employed by this clinic, benefit financially from me having this add-on?
- Can costs change during my treatment? If so, will these be discussed with me before any decisions are made?
- How many times will I need to visit the clinic?
- What tests will I need to have and why?
- What medication will I have to take and what side effects may they cause?
- Can I get my medication from elsewhere? (Sometimes medication can cost less if not acquired directly from the clinic.)
- Can you break down all the costs of this treatment?
- Are there any other costs that might arise? (Your clinic should provide you with a costed treatment plan.)
- What support is available if the treatment stops or fails?
- Can I have the contact details for someone to answer medical or other questions? When can I call you?
- What are the refund and cancellation policies at the clinic? (Don’t be afraid to ask for a copy – you have a right to this information.)