Choosing a fertility clinic is one of the most important decisions you'll make on your path to parenthood. The right clinic can mean the difference between success and failure, between feeling supported and feeling like a number. And if your current clinic isn't working, knowing when and how to switch — or at least get a second opinion — can change everything.
This guide helps you evaluate clinics, understand success rates, recognize red flags, ask the right questions, and know when it's time for a fresh perspective.
What Makes a Good Fertility Clinic?
Beyond success rates (which we'll discuss in detail), several factors contribute to a clinic's quality:
Medical Excellence
- Experienced reproductive endocrinologists: Board-certified REIs with years of experience
- Skilled embryology team: The lab is where the magic happens; experienced embryologists matter enormously
- Modern equipment: Up-to-date incubators, microscopes, and laboratory technology
- Quality control: Lab accreditation (CAP, JCAHO, ISO certification)
- Evidence-based protocols: Treatment approaches based on current research
Patient Experience
- Communication: Responsive to questions, clear explanations, accessible staff
- Continuity of care: Seeing the same doctor throughout, or at least consistent team
- Wait times: Reasonable time to get appointments and start treatment
- Support services: Access to counseling, support groups, financial counseling
- Transparency: Clear pricing, honest about success rates and limitations
Practical Considerations
- Location: Frequent monitoring means many visits; proximity matters
- Hours: Early morning and weekend availability for time-sensitive procedures
- Cost: Pricing that fits your budget; financing options if needed
- Insurance: In-network with your plan, if applicable
Understanding Success Rates
Success rates are the first thing most people look at — and the most commonly misunderstood metric in fertility care.
Why You Can't Simply Compare Clinic Success Rates
The CDC and SART publish clinic-specific success rates, and it's tempting to pick the clinic with the highest numbers. But this approach is flawed:
⚠️ Patient Selection Bias
Clinics that accept harder cases (older patients, poor prognosis, repeated failures) will have lower average success rates. Clinics that turn away difficult patients will look better on paper. A clinic with 60% success might actually be better than one with 70% if the first accepts everyone while the second cherry-picks.
SART explicitly warns against using their data to compare clinics. The CDC data comes with similar caveats. These databases are useful for understanding national trends, not for picking your specific clinic.
Better Metrics to Ask About
Live Birth Rate Per Cycle Started
This is the most meaningful number. It counts everyone who began treatment, including those who canceled or didn't make it to transfer. Pregnancy rate or clinical pregnancy rate can be misleading because they don't account for miscarriages.
Implantation Rate
The percentage of transferred embryos that implant. This is arguably the best quality metric because it reflects embryo and lab quality. Ask for this number specifically for patients your age.
Multiple Pregnancy Rate
Lower is actually better. High multiple rates suggest the clinic transfers too many embryos to boost success numbers, which increases risks for mothers and babies.
Embryo Thaw Survival Rate
Should be 95% or higher with modern vitrification. Lower rates suggest lab quality issues.
Age-Specific Results
Always ask for success rates broken down by age. National averages for live birth per cycle started:
| Age | Live Birth Rate (Per Cycle) |
|---|---|
| Under 35 | ~44-50% |
| 35-37 | ~36-40% |
| 38-40 | ~22-27% |
| 41-42 | ~10-15% |
| 43+ | ~3-5% |
Your clinic's numbers for your age group are more relevant than their overall average.
The SART Patient Predictor Tool
SART offers a tool at sartcorsonline.com that provides personalized cumulative success estimates based on your specific factors. This can give you a realistic sense of your chances over multiple cycles.
Red Flags to Watch For
Some warning signs should make you think twice about a clinic:
đźš© Major Red Flags
- Same protocol repeatedly: Doing the exact same thing after it failed without any adjustments
- No post-cycle review: No meeting to discuss what happened and why
- Pressure tactics: Pushing you to make quick decisions, add expensive add-ons
- Unrealistic promises: Guaranteeing success or quoting rates that sound too good to be true
- Hidden fees: Surprise costs that weren't disclosed upfront
- Poor communication: Can't reach anyone, calls not returned, questions dismissed
- Defensive responses: Doctor reacts poorly to questions or requests for explanation
- High multiple rate: Routinely transferring multiple embryos to inflate success numbers
- Premature donor recommendation: Suggesting donor eggs without adequate own-egg attempts (unless age clearly warrants)
- Feeling like a number: Assembly-line treatment with no individualization
Green Flags That Indicate Quality
âś“ Signs of a Good Clinic
- Individualized protocols: Treatment plans tailored to your specific situation
- Clear explanations: Doctors take time to explain reasoning and answer questions
- Post-cycle reviews: Automatic debrief meetings after every cycle
- Protocol adjustments: Willing to change approach based on your response
- Transparent pricing: Clear cost breakdown upfront, no surprises
- Responsive communication: Staff returns calls, portal messages answered promptly
- Continuity: You see the same doctor (or small team) consistently
- Support services: Access to counseling, financial guidance, support groups
- Single embryo transfer focus: Prioritizing singleton pregnancies when appropriate
- Willing to discuss limits: Honest about when to consider other options
Essential Questions to Ask
Before committing to a clinic, ask these questions:
About Success Rates
"What is your live birth rate per cycle started for patients my age?"
Not pregnancy rate, not per transfer — per cycle started. This is the most honest number.
"What is your implantation rate for my age group?"
This reflects embryo and lab quality most directly.
"What percentage of your patients my age achieve live birth within 3 cycles?"
Cumulative success rate is often more relevant than per-cycle rate.
About Your Care
"Will I see the same doctor throughout my treatment?"
Continuity matters. At minimum, you should have a primary RE who knows your case.
"Who performs the egg retrieval and embryo transfer?"
Is it your doctor or whoever is on call? The RE performing transfer matters.
"What happens after a failed cycle? Do we have a review meeting?"
Good clinics automatically schedule post-cycle consultations to analyze and adjust.
About the Lab
"Is your lab accredited? By whom?"
Look for CAP (College of American Pathologists) or JCAHO accreditation.
"What is your embryo thaw survival rate?"
Should be 95% or higher. Lower rates indicate potential lab quality issues.
"How many embryologists do you have, and how long have they been with you?"
Experienced, stable embryology teams produce better outcomes.
About Costs
"Can I get a complete cost breakdown including all possible fees?"
Medications, monitoring, retrieval, transfer, ICSI, PGT-A, freezing, storage, FET — everything.
"What's included versus additional costs?"
Is ICSI standard or extra? What about assisted hatching? Embryo freezing?
When to Consider Switching Clinics
Loyalty is admirable, but sometimes a change is needed. Consider switching or at least getting a second opinion if:
After Multiple Failed Cycles
The probability of IVF success decreases after 3-4 failed cycles. If you've had 3 or more failed cycles without explanation or meaningful protocol changes, a fresh perspective may help.
Studies show pregnancy rates decrease about 40% after 4 or more attempts. This isn't a reason to give up, but it is a reason to reassess strategy.
Communication Breakdown
If you can't get answers to your questions, feel dismissed when raising concerns, or simply don't trust your doctor's judgment anymore, the relationship isn't working. Your fertility care is too important for a broken doctor-patient relationship.
No Protocol Adjustments
If your clinic keeps doing the same thing after failure without any changes, they're not learning from your cycles. Good medicine involves adaptation.
Significant Errors
Repeated scheduling mistakes, medication errors, miscommunication about critical timing — these aren't just inconveniences. They can affect your outcome and indicate systemic problems.
Your Gut Says So
Sometimes you just know. If you've lost confidence in your clinic, that matters. You need to trust your medical team during this vulnerable time.
How to Get a Second Opinion
Getting a second opinion is standard medical practice. Good doctors expect and welcome it. Here's how to approach it:
You Don't Need Permission
You don't have to tell your current clinic you're seeking another opinion. Your medical records are yours — you're entitled to copies. Most patients don't mention it until/unless they decide to switch.
Gather Your Records
Request copies of:
- All test results (AMH, FSH, ultrasounds, semen analyses)
- Cycle reports (stimulation protocols, response, embryology reports)
- Surgical records if applicable
- Any imaging (HSG, SIS)
What to Expect
Second opinion consultations typically cost $200-$500. Many clinics offer free virtual consultations for new patients. Come prepared with questions and your records.
A good second opinion will offer:
- Independent review of your history
- Assessment of what's been tried and what might be different
- Honest prognosis from their perspective
- Suggestions for additional testing or protocol changes
đź’ˇ Virtual Consultations
Many clinics now offer telemedicine second opinions. This is especially useful for exploring international options or clinics far from home. You can gather perspectives from multiple experts without travel.
Evaluating International Clinics
If you're considering treatment abroad — including Colombia — additional factors come into play:
Accreditation and Standards
- JCI accreditation: Joint Commission International — gold standard for international hospitals
- ESHRE membership: European Society of Human Reproduction and Embryology
- ISO certification: Quality management standards
- Local medical board credentials: Doctors licensed and in good standing
Communication
- English-speaking staff (or your language)
- Responsive to international inquiries
- Clear process for remote consultations
- Coordination for local monitoring if needed
Logistics
- Experience with international patients
- Travel coordination assistance
- Clear pricing in your currency
- Embryo shipping policies if needed
Colombia-Specific Considerations
Colombia offers several advantages for international patients:
- WHO healthcare ranking: Colombia ranks #22 globally — ahead of the US (#37)
- Flight access: Direct flights from 12+ US airports, approximately 3 hours from Miami
- Major fertility hubs: Bogotá and MedellĂn have multiple established clinics
- English availability: Most major clinics have English-speaking staff
- Cost savings: 50-70% lower than US costs
- Success rates: 45-60% clinical pregnancy rates, comparable to international standards
- Safety: Major cities like MedellĂn and Bogotá are safe for medical tourists
Considering a Second Opinion?
We can connect you with Colombian fertility specialists for a free consultation to review your case and discuss your options.
Get Free ConsultationMaking the Final Decision
After gathering information, trust your assessment of:
Medical Competence
Does the clinic have experienced doctors, skilled embryologists, and a track record of success for patients like you? Are they up-to-date on current best practices?
Communication Fit
Do you feel heard? Are your questions answered? Can you reach someone when you need to? Do you trust this team with something so important?
Practical Alignment
Does the cost work for you? Is the location manageable? Do their hours accommodate your schedule?
Your Instinct
After all the research, how do you feel? Your gut reaction matters. You're going to be vulnerable with these people during one of the most stressful experiences of your life. Choose a team you trust.
The Bottom Line
Choosing a fertility clinic deserves careful consideration — it's not a decision to make based on advertising, convenience alone, or even just published success rates. Look at the whole picture: medical expertise, lab quality, communication, cost, and how you feel about the team.
Don't be afraid to ask hard questions. Don't be afraid to get second opinions. Don't be afraid to switch if something isn't working. This is your journey, and you deserve a clinic that treats you as a partner, not just a patient.
The right clinic won't guarantee success — nothing can. But it will give you the best possible chance while supporting you through whatever comes.
Read more: After a Failed IVF Cycle | Understanding Fertility Tests | IVF Cost Guide