Choosing where to do IVF is one of the most important decisions of your fertility journey. The right clinic can make the difference between a smooth, successful experience and months of frustration. But how do you evaluate clinics when you're not a medical expert? What questions should you ask? And when should you consider getting a second opinion?
This guide helps you navigate clinic selection — whether you're choosing your first clinic, evaluating an international option, or wondering if it's time to switch after failed cycles.
What Makes a Good IVF Clinic?
Before diving into specific questions and red flags, understand what actually matters:
The Things That Matter Most
- Lab quality: The embryology lab is where your eggs become embryos. This is arguably the most important factor — and the hardest to evaluate from the outside.
- Physician experience: Your reproductive endocrinologist's skill and expertise matter, especially for complex cases.
- Appropriate patient matching: Different clinics excel with different patient populations. Some specialize in difficult cases; others focus on straightforward cycles.
- Communication and care: You need a clinic that communicates clearly, answers questions, and treats you like a person.
- Evidence-based protocols: Good clinics follow current research and adjust protocols based on individual response.
Things That Matter Less Than You Think
- Fancy facilities: A beautiful waiting room doesn't correlate with pregnancy rates
- Celebrity patients: Marketing doesn't equal medical excellence
- Published success rates: These are easily manipulated and hard to compare (more on this below)
- The latest "cutting-edge" add-ons: Many expensive extras lack evidence
Essential Questions to Ask Any Clinic
When evaluating a clinic — whether for a first consultation or a second opinion — these questions reveal important information:
About Success Rates
"What is your live birth rate per cycle started for patients my age with my diagnosis?"
Why it matters: "Success rate" can mean many things. Live birth rate per cycle started is the most meaningful metric — it includes cycles that were cancelled and accounts for the full journey, not just transfers.
"What is your implantation rate?"
Why it matters: Implantation rate (embryos that implant divided by embryos transferred) is considered one of the best quality indicators because it reflects both lab quality and transfer technique. Good clinics achieve 40-50%+ for top-grade embryos.
"What percentage of your cycles result in multiple pregnancies?"
Why it matters: Lower is better. High multiple pregnancy rates suggest a clinic is transferring too many embryos to boost pregnancy numbers at the cost of patient safety. Top clinics achieve good results with single embryo transfers.
About Your Care
"Will I see the same doctor throughout my cycle, or will I see different physicians?"
Why it matters: Continuity of care matters. Some large clinics rotate patients through multiple doctors; others ensure you see the same RE throughout. Neither is necessarily better, but you should know what to expect.
"What happens after a failed cycle? Will we have a thorough review?"
Why it matters: Good clinics analyze what happened and adjust. Clinics that just say "try again with the same protocol" may not be learning from your cycle.
"How do you customize protocols, or do most patients follow a standard protocol?"
Why it matters: One-size-fits-all medicine doesn't work well in IVF. Good clinics tailor stimulation based on your ovarian reserve, previous response, and specific situation.
About the Lab
"What are your lab's accreditations?"
Why it matters: Look for CAP (College of American Pathologists) accreditation, JCAHO certification, or equivalent. These indicate the lab meets rigorous quality standards.
"What is your embryo thaw survival rate?"
Why it matters: Should be 95%+ with modern vitrification. Lower rates suggest lab quality issues.
"What percentage of embryos reach blastocyst stage?"
Why it matters: Good labs should see 40-60% of fertilized eggs reach blastocyst. Significantly lower rates may indicate culture system problems.
About Costs
"Can I get a complete breakdown of all expected costs, including medications, monitoring, and any likely add-ons?"
Why it matters: Hidden fees are frustrating and common. A reputable clinic should provide transparent pricing. Be wary of lowball quotes that don't include obvious necessities.
"What's included if my cycle is cancelled or I need additional monitoring?"
Why it matters: Understand what happens financially if things don't go as planned.
Red Flags: When to Be Concerned
Some warning signs should make you pause and consider other options:
🚩 Major Red Flags
- Same protocol after repeated failures: If they keep doing the exact same thing without explanation, they're not learning from your cycles
- No post-cycle review: Refusing to discuss what went wrong or adjustments for next time
- Pushing donor eggs prematurely: Recommending donors after one failed cycle with your own eggs (for younger patients) without adequate justification
- Unrealistic success promises: "We guarantee you'll get pregnant" or success rates that seem too good to be true
- High-pressure sales tactics: Pushing you to sign up immediately, discouraging second opinions
- Hidden fees appearing after you've started: Significant costs that weren't disclosed upfront
- Dismissing your questions: Making you feel stupid for asking or not taking your concerns seriously
- High multiple pregnancy rates: Rates above 15-20% suggest aggressive multi-embryo transfer practices
- Defensive responses to questions: Getting upset when you ask about success rates or protocols
⚠️ Yellow Flags: Worth Noting
- Very long wait times: May indicate overwhelming volume and less personalized care
- Difficult to reach: If getting answers is hard before you're a patient, it won't get easier
- Pushing expensive add-ons: Especially unproven ones like intralipids, PRP, or extensive immune testing for everyone
- No mental health support offered: Shows less holistic approach to care
- Reluctance to share specific data: Evasive about their actual success rates
Understanding Success Rate Statistics
Published success rates are notoriously difficult to interpret. Here's why you shouldn't rely on them alone:
Why Clinic Comparisons Are Misleading
- Patient selection: Clinics that turn away difficult cases will have higher rates than those specializing in complex patients
- Age mix: A clinic with mostly young patients will outperform one treating primarily 40+ women
- Reporting variations: Different definitions of "success" and different time periods
- Cycle start vs. transfer: Rates "per transfer" exclude cancelled cycles, inflating apparent success
- Multi-embryo transfers: Transferring 2-3 embryos boosts pregnancy rates but increases multiple pregnancy risks
SART/CDC Warning
The CDC and SART explicitly state that their published data should NOT be used to compare clinics directly. Patient populations differ too much for meaningful comparison. Use the SART Patient Predictor Tool (sartcorsonline.com) for personalized cumulative success estimates based on your specific factors.
Better Metrics to Consider
| Metric | Why It's Useful | What to Look For |
|---|---|---|
| Live birth per cycle started | Most comprehensive outcome measure | Ask for your specific age/diagnosis |
| Implantation rate | Reflects lab and transfer quality | 40-50%+ for good-quality embryos |
| Multiple pregnancy rate | Lower is better (safer) | <10% indicates responsible practices |
| Embryo thaw survival | Lab quality indicator | 95%+ with vitrification |
| Blastocyst rate | Culture system quality | 40-60% of fertilized eggs |
When to Consider Switching Clinics
How do you know when it's time to try somewhere else?
Consider Switching After:
- 3+ failed cycles without clear explanation: Especially if protocol hasn't been meaningfully adjusted
- Consistently poor communication: Can't get questions answered, feel dismissed
- Loss of trust: You don't believe they have your best interests at heart
- Repeated errors: Scheduling mistakes, medication mix-ups, dropped communication
- Feeling like "just a number": No personalization, assembly-line treatment
- Significant unexplained cost increases: Fees appearing that weren't disclosed
💡 The 40% Rule
Research shows pregnancy rates decrease by about 40% after 4+ failed IVF attempts at the same clinic. This doesn't mean success is impossible, but it does suggest that if the same approach keeps failing, a fresh perspective may help.
Getting a Second Opinion
A second opinion is always reasonable. You don't need to justify wanting one.
When a Second Opinion Makes Sense
- After failed cycles to get fresh perspective
- If you're uncomfortable with recommended treatment
- For complex diagnoses (severe male factor, DOR, multiple failures)
- If you're considering expensive add-ons
- Before major decisions (donor eggs, surrogacy)
- Anytime you want reassurance or another viewpoint
How to Get a Second Opinion
- You don't need to tell your current clinic — though you can if you want
- Request your records: Get copies of all test results, cycle reports, embryology reports
- Many clinics offer free or low-cost consultations — especially for second opinions
- Virtual consultations are common — you don't necessarily need to travel
- Come prepared: Have specific questions and concerns ready
What to Ask During a Second Opinion
- "Based on my history, what would you do differently?"
- "What do you think went wrong in my previous cycles?"
- "What tests or evaluations might we be missing?"
- "What would your recommended protocol be?"
- "What are my realistic chances at your clinic?"
Evaluating International Clinics
If you're considering treatment abroad — in Colombia or elsewhere — additional factors matter:
What to Look For
- International accreditation: JCI (Joint Commission International) is the gold standard
- ESHRE membership: European Society of Human Reproduction and Embryology
- ISO certification: Quality management standards
- English-speaking staff: Clear communication is essential
- Transparent pricing: All-inclusive quotes without hidden fees
- Coordination with home doctors: Will they share records, communicate with your local provider?
- Track record with international patients: Experience managing the logistics
Colombia-Specific Considerations
Why Colombia?
- Healthcare quality: WHO ranks Colombia #22 globally for healthcare systems
- Cost savings: 50-70% less than US prices for comparable quality
- Accessibility: Direct flights from 12+ US airports (3 hours from Miami)
- Major hubs: Bogotá, Medellín, and Cartagena have established fertility centers
- English availability: Major clinics have English-speaking staff
- Success rates: 45-60% at top clinics, comparable to international standards
- Altitude advantage: Bogotá's high altitude reduces Zika-carrying mosquitoes
Questions for International Clinics
- "How do you coordinate monitoring with my local doctor?"
- "What's included in your package price, and what's extra?"
- "How will we communicate during treatment?"
- "What happens if I need to extend my stay?"
- "Can you provide references from other international patients?"
- "What's your embryo shipping/storage policy if I can't return immediately?"
The Consultation Checklist
Use this checklist when evaluating any clinic:
Before Your Consultation
- Research the clinic's background and physicians
- Gather your medical records and previous cycle reports
- Write down your questions
- Note any specific concerns or priorities
During Your Consultation
- Ask about success rates for your specific situation
- Inquire about the doctor you'll be working with
- Ask about lab accreditations and quality metrics
- Request complete cost breakdown
- Ask about communication and follow-up processes
- Discuss what happens if treatment doesn't work
After Your Consultation
- Review the financial quote for completeness
- Assess how your questions were handled
- Note how the staff treated you
- Consider if you felt heard and respected
- Compare with other consultations if applicable
- Trust your gut feeling
Want Help Evaluating Your Options?
We can connect you with Colombian fertility clinics for second opinions and help you understand how their approach compares to your current treatment.
Get Free ConsultationTrusting Your Instincts
Beyond all the metrics and questions, your gut feeling matters. Pay attention to:
- How you feel in the office: Comfortable? Rushed? Dismissed?
- Whether your questions are welcomed: Good doctors appreciate informed patients
- The staff's demeanor: Are they kind? Helpful? Or cold and transactional?
- Whether explanations make sense: You should understand your treatment plan
- Your confidence level: Do you trust this team with your care?
You'll be working closely with this team through an emotionally challenging process. The relationship matters.
The Bottom Line
Choosing an IVF clinic is significant, but it doesn't have to be overwhelming. Focus on:
- Lab quality and physician experience — the fundamentals
- Communication and care — you need to feel supported
- Transparency — about success rates, costs, and processes
- Personalization — treatment tailored to your situation
- Your instincts — trust how you feel about the clinic
Don't hesitate to get second opinions. Don't stay with a clinic that isn't serving you well. And remember — the "best" clinic is the one that's best for your specific situation, not necessarily the one with the highest published success rates.
Read more: After a Failed Cycle | IVF Cost Guide | Understanding Fertility Tests