How to Pick Your IVF Clinic — Including the Questions They Hope You Won’t Ask

By INCIID — Updated May 2026

Choosing a fertility clinic is one of the most important decisions you’ll make on your journey to building a family. This choice is deeply personal, medically significant, and emotionally charged. There is no one “best” clinic for everyone — the right clinic is the one that aligns with your needs, values, expectations, and life circumstances.

Step 1. Start With Your Goals and Priorities

Before evaluating clinics, spend time clarifying your own goals and priorities. Ask yourself three questions:

What outcomes are most important to me to become a parent? (e.g., biological pregnancy, shared parenting, minimal intervention)
What level of emotional support and communication do I expect?
How do I want to balance time, cost, and medical interventions?

There’s no standard answer — only what is right for your situation. For many patients, an OB/GYN remains an important partner in care — but when pregnancy does not occur as expected, specialized fertility training can make a meaningful difference.

Step 2. Clinic Expertise and Physician Training Matter

Since the mid-1990s, INCIID has consistently emphasized the importance of seeking care from a Reproductive Endocrinologist (RE) when fertility concerns arise. OB/GYN practices are fundamentally built around pregnancy, childbirth, and routine gynecologic care. While OB/GYNs play an essential role in reproductive health and often provide initial fertility evaluations, their training does not include a dedicated fellowship focused exclusively on infertility diagnosis and treatment.

Reproductive Endocrinologists complete an additional subspecialty fellowship in Reproductive Endocrinology and Infertility (REI) after OB/GYN residency. This advanced training focuses specifically on:

Complex infertility diagnosis
Hormonal and endocrine disorders affecting reproduction
Recurrent pregnancy loss
Male and female factor infertility
Evidence-based fertility treatments beyond routine gynecologic care

Seeing a Reproductive Endocrinologist does not mean committing to aggressive treatment or IVF. It means accessing care from a physician whose training is specifically designed to evaluate fertility issues thoroughly and efficiently, helping patients understand their options earlier and more clearly.

Step 3. Understanding Success Rates: Context Matters

All IVF Outcome Data Is Self-Reported

A question INCIID has heard repeatedly over the years is: What is the “best” fertility clinic? These comparisons often rely on data that fertility clinics themselves submit to national reporting systems, such as the CDC’s National ART Surveillance System and the Society for Assisted Reproductive Technology (SART). These organizations collect and publish the information they receive, but they do not audit clinic medical records, independently verify reported outcomes, or evaluate whether reported statistics align with patient-centered definitions of success. Their role is data aggregation and publication — not quality control or outcome validation.

“Success” Is Not Defined Consistently Across Clinics

For most patients, success means a full-term pregnancy resulting in a live birth. However, some clinics emphasize or report success at much earlier stages — a positive pregnancy test, a chemical pregnancy, or early ultrasound confirmation. These outcomes may be counted as “pregnancies” even though a meaningful percentage may end in miscarriage. Without clear differentiation between pregnancy rates, ongoing pregnancy rates, and live birth rates, published statistics can overstate outcomes that matter most to patients.

Fertility clinics operate within a competitive healthcare marketplace where published success statistics influence patient volume, reputation, and revenue. Success data is self-reported and unaudited, meaning clinics may highlight statistics that appear more favorable without this constituting outright misrepresentation. Patients should understand these numbers within the context of financial and marketing pressures, rather than viewing them as neutral, independently validated measures of quality.

The Role and Limits of CDC Fertility Data: Is the Fox in Charge of the Hen House?

Here is the uncomfortable truth that the fertility industry rarely states plainly: the CDC does not collect IVF outcome data. Clinics report it to the CDC themselves. The CDC publishes what it receives. No one audits it. No one verifies it. No one checks whether the numbers are accurate, honestly categorized, or patient-centered in any meaningful way.

The CDC is frequently cited as an authoritative, independent source for fertility clinic outcomes. It is not. CDC ART reports are retrospective, population-level summaries based entirely on clinic-submitted data. The CDC does not verify clinic-reported outcomes, does not audit data accuracy, does not evaluate clinic-level quality, and does not assess whether reported outcomes reflect what patients actually care about — a healthy baby born at home.

This is the fox in charge of the hen house. The same clinics competing for your business are the ones supplying the numbers that consumers use to compare them.

This is not a new problem. INCIID has documented it since 1995. As far back as 1986, congressional hearings were held in response to complaints about exploitation and unscrupulous practices in the IVF industry. The resulting Wyden Report led to the IVF Success Rate Certification Act of 1992 — legislation explicitly intended to compel honest disclosure of IVF success rates. In 1994, a national accounting firm was engaged to develop a real audit process for SART member programs. Clinics showed no interest, SART lacked the resolve to enforce compliance, and the effort was abandoned within a year.

By 2002, SART had formally notified all IVF program directors that random onsite reviews would be discontinued due to a lack of financial and human resources. Clinics were instead asked to perform a self-review of ten pre-selected cases and submit the results themselves. That system — self-reporting, self-review, self-certification — is essentially what remains in place today.

For the full history of how IVF reporting accountability has been promised and deferred for decades, read INCIID’s History of IVF at inciid.org/a-history-of-ivf/

CDC fertility data should be viewed as contextual background, not as a measure of clinic quality, a consumer protection tool, or a guarantee of outcomes. It is a starting point for questions — not an answer.
(See also the timeline for data collection and History of Sart Statistics )

Why INCIID Urges Caution When Using Success Statistics

Statistics that are self-reported, unaudited, variably defined, and population-based cannot fully capture quality of individualized care, appropriateness of treatment decisions, transparency of communication, or alignment with patient priorities. Success rates can inform questions, but they should never be the sole factor guiding clinic selection. Everyone’s fertility journey is different.: Different diagnosis, different ages and different histories.
In research and medicine, and even everyday life – people have their own operational definition. So to be very clear, an “operational definition” is simply how something is measured and counted. In IVF statistics, the operational definition of “pregnancy” or “success” is set by each individual clinic — and it matters enormously. A clinic that counts a positive blood test as a pregnancy will report very different success rates than one that only counts live births.

What Patients Should Ask Instead

How does this particular clinic define success? Because as an infertility patient, what you define as success is a live birth.
Do you report live birth rates, not just pregnancy rates?
Do you count pregnancies within your statistics as success even when the pregnancy results in miscarriage? In other words, what is the clinic’s definition of a pregnancy.
Are these outcomes specific to patients like me — my age, diagnosis, treatment history?
Which outcomes matter most to your clinic when evaluating success?

Key Takeaway: IVF success statistics are entirely self-reported, unaudited, and shaped by how individual clinics define and present outcomes. Patients should approach these numbers with informed skepticism and focus on live birth outcomes, transparency, and individualized care.

Step 4. Personalized and Patient-Centered Care

Fertility treatment is not a transaction — it is a journey that unfolds over time and often under emotionally and medically difficult circumstances. Choosing a fertility clinic is much like deciding who will be on board before the ship leaves the dock. A clinic that functions well does not simply point patients in a direction, wish them luck, and wave as the boat pulls away. The care team should be on the ship with them, navigating the journey together.

Patients should feel that their physicians and care team are actively engaged throughout the process, willing to explain risks and options clearly, responsive when plans need to change, and invested in outcomes — not just procedures.

Step 5. Evaluate Whether the Clinic Is Truly Full-Service

Not all fertility clinics offer the same depth or breadth of care. A truly full-service IVF clinic is equipped to evaluate and treat a wide range of fertility diagnoses without requiring patients to seek essential care elsewhere once treatment has begun.

Comprehensive Care for Both Female and Male Fertility

For female patients, full-service care includes advanced hormonal evaluation, high-resolution ultrasound, and evaluation and treatment of ovulatory disorders, diminished ovarian reserve, PCOS/PMOS, endometriosis, uterine abnormalities, and recurrent pregnancy loss.

For male patients, full-service care includes comprehensive semen analysis beyond basic counts, evaluation of sperm motility, morphology, and DNA integrity, and access to urologists or andrologists experienced in conditions such as varicoceles, azoospermia, and ejaculatory disorders. Clinics that delay or minimize male fertility evaluation may miss critical contributors to infertility.

Surgical Expertise Integrated into Fertility Care

A full-service IVF clinic should have direct access to specialists who perform hysteroscopy, laparoscopy, surgical treatment of endometriosis or uterine abnormalities, sperm retrieval procedures such as TESE or micro-TESE, and fertility preservation procedures.

Advanced Embryology Laboratory and Fertilization Techniques

The IVF laboratory plays a central role in treatment success. A full-service clinic should operate a state-of-the-art embryology laboratory with advanced incubators, strict environmental monitoring, highly trained embryologists, and technologies that support optimal embryo development. Modern clinics should offer ICSI when clinically appropriate — and be able to explain clearly when it is and is not necessary.

Access to Genetic Expertise

A full-service clinic should provide genetic counseling, preimplantation genetic testing (PGT) when appropriate, evaluation of genetic contributors to recurrent pregnancy loss, and guidance on interpreting genetic results within the broader clinical context.

Key Question: Does this clinic have the specialists, laboratory capabilities, surgical expertise, and genetic support needed to address my diagnosis now — and adapt if new factors are identified later?

Step 6. Ask About the IVF Laboratory — It May Be the Most Important Question You Ask

Most patients spend considerable time evaluating physicians — and that matters enormously. But the IVF laboratory is where fertilization happens, where embryos develop, and where the quality of every technical decision directly affects outcomes. Yet patients rarely ask about it, and clinics rarely volunteer detailed information. The laboratory is not a commodity. Two clinics using identical stimulation protocols and the same medications can have meaningfully different outcomes based on laboratory quality alone.

Questions to ask about laboratory quality:

What is your vitrification survival rate? A well-run laboratory should achieve embryo survival rates after thawing of 90 percent or higher.

What percentage of fertilized eggs reach the blastocyst stage? Industry benchmarks suggest 40 to 60 percent of fertilized eggs should reach blastocyst stage under good laboratory conditions. Ask what the clinic’s rate is for patients in your age group.

How many embryologists work in your laboratory, and what are their credentials? Ask whether embryologists are certified by the American College of Embryology or hold equivalent credentials.

What quality control systems does your laboratory use? Leading laboratories use electronic witnessing systems — barcode or RFID tracking — to verify that the right eggs, sperm, and embryos are always matched to the right patients.

What is your laboratory’s air quality and environmental monitoring protocol? Embryos are extraordinarily sensitive to environmental factors. Ask how often environmental parameters are checked and what happens when deviations occur.

A clinic that answers these questions openly and specifically is demonstrating transparency. A clinic that deflects or responds with vague reassurances deserves follow-up questions.

Step 7. Understand the Clinic’s Philosophy on Single Embryo Transfer

Current ASRM guidelines recommend single embryo transfer (SET) for most patients, particularly those under 38 transferring blastocyst-stage embryos. Evidence consistently shows that elective SET in appropriate candidates does not significantly reduce cumulative live birth rates when frozen embryos are available for future transfer — but it dramatically reduces the risks of multiple gestation, including premature birth, low birth weight, and NICU admissions.

Despite this, practice varies considerably across clinics. Some embrace SET as a default. Others continue to transfer multiple embryos more frequently than current evidence supports — whether due to patient pressure, competitive pressure on success rates, or habit.

Questions to ask about embryo transfer policy:

What is your clinic’s single embryo transfer rate? This is a matter of public record through SART reporting.

Under what circumstances would you recommend transferring more than one embryo? Ask the clinic to explain their specific criteria.

If I want to transfer only one embryo, will you support that decision? The answer should be yes, with clear clinical guidance.

What is your policy on freezing remaining embryos? A clinic that routinely freezes high-quality embryos for future single transfers demonstrates a commitment to cumulative success over cycle-by-cycle statistics.

A clinic that pressures you toward multiple embryo transfer without clear clinical justification is not serving your long-term interests — even if it seems to increase the odds in a single cycle.

Step 8. Ask How the Clinic Uses Preimplantation Genetic Testing

PGT-A — preimplantation genetic testing for aneuploidy — is the process of biopsying cells from a blastocyst-stage embryo and analyzing the chromosomes before transfer. Embryos with the correct number of chromosomes (euploid) are significantly more likely to implant and result in a live birth.

PGT-A can be genuinely valuable — particularly for women of advanced reproductive age, patients with recurrent pregnancy loss, or those with a history of failed transfers. But some clinics recommend it universally for every patient, every cycle, regardless of age or clinical history. ASRM’s 2024 guidelines are clear that PGT-A should be offered thoughtfully and selectively. Universal PGT-A adds $3,000 to $6,000 or more per cycle and may not improve outcomes for younger patients with good prognosis.

Questions to ask about PGT-A:

Do you recommend PGT-A for all patients, or selectively? A selective, evidence-based approach is more consistent with current ASRM guidance.

Based on my age and diagnosis, do you recommend PGT-A for me — and why? The answer should be specific to your situation, not a blanket policy.

What is your clinic’s euploid embryo rate by age? This data gives you a realistic picture of what PGT-A would likely reveal for patients in your situation.

What happens to embryos that test abnormal? Are they discarded, or are there options? This is an important ethical and practical question.

What is the cost of PGT-A, and is it included in your quoted treatment price? Hidden costs are one of the most common sources of financial surprise in IVF treatment.

A clinic that recommends PGT-A to every patient without individualized discussion is prioritizing protocol over personalization.

Step 9. Find Out Who Will Actually Perform Your Procedures

At a large fertility clinic or academic medical center, the physician you meet during your consultation may not be the physician who performs your egg retrieval, embryo transfer, or other procedures. In high-volume clinics, procedures are often distributed among multiple physicians, fellows in training, or advanced practice providers — sometimes without patients being clearly informed. Patients deserve to know this upfront, not discover it the morning of their retrieval.

Questions to ask about who performs your care:

Who will perform my egg retrieval? Will it always be the same physician, or does it rotate?

Who will perform my embryo transfer? Is there any way to ensure continuity with my primary physician?

If I am seeing a fellow or trainee during any part of my care, will I be informed in advance?

Who should I contact if I have questions between appointments — my physician directly, a nurse coordinator, or a patient portal?

What is the typical response time for non-urgent questions?

Clinics that answer these questions clearly and without defensiveness are demonstrating respect for patient autonomy. Continuity of care matters — not just medically, but emotionally.

Step 10. Understand the Clinic’s Philosophy on Fresh vs. Frozen Transfer and Freeze-All

The decision about whether to transfer an embryo in the same cycle as egg retrieval (fresh transfer) or freeze all embryos and transfer in a later cycle (frozen embryo transfer, or FET) is one of the most consequential protocol decisions in IVF. Neither approach is universally superior. The right decision depends on your ovarian response, hormone levels, endometrial thickness, whether PGT-A is being used, your risk of OHSS, and other individual factors.

Research published in 2025 found that natural cycle frozen embryo transfer was associated with higher live birth rates and lower rates of pregnancy complications — including hypertensive disorders — compared to artificial cycle preparation for ovulatory patients.

Questions to ask about fresh vs. frozen transfer:

What is your clinic’s default approach — fresh transfer or freeze-all — and why?

Under what circumstances would you recommend a fresh transfer versus freezing all embryos?

If I have a high AMH or produce many eggs, do you routinely recommend freeze-all to reduce OHSS risk?

What endometrial preparation protocol do you use for frozen transfers? Natural cycle, modified natural cycle, or artificial cycle? How do you decide which is right for a given patient?

A clinic that applies a one-size-fits-all transfer protocol without explaining the individualized reasoning is not practicing the kind of personalized care that leads to the best outcomes.

Step 11. How to Actually Read SART Data

SART publishes outcome data for most IVF clinics in the United States at sartcorsonline.com. It is a useful starting point, but requires careful interpretation.

What SART data shows:

SART reports outcomes by age group, cycle type (fresh vs. frozen), and whether a patient’s own eggs or donor eggs were used. The most meaningful metric is live birth rate per intended egg retrieval — not pregnancy rate, but the percentage of cycles that result in a baby coming home.

What SART data does not show:

SART data is entirely self-reported by clinics. It is not audited or independently verified. It is typically published one to two years after the treatment cycle occurred. It does not capture patient selection bias — clinics that turn away difficult cases will report better statistics than clinics that treat everyone.

The patient selection problem:

A clinic that accepts only patients with good prognosis will naturally report higher success rates than a clinic that takes on complex cases, older patients, or patients who have failed elsewhere. Higher reported success rates do not necessarily mean better care. They may mean more selective patient acceptance.

How to use SART data effectively:

Always compare clinics using your specific age group. A clinic’s overall success rate is nearly meaningless — what matters is the live birth rate for patients in your age bracket with your diagnosis.
Look at both fresh and frozen transfer data. A clinic with excellent frozen transfer rates may be practicing a more modern, conservative approach.
Ask the clinic: What is your live birth rate for patients with my specific diagnosis and age? Can you show me your SART data for that group?
Use SART data to generate questions, not to make final decisions. A clinic with slightly lower reported rates that explains why may be a better partner than one with higher numbers but less transparency.

Step 12. Ask About Artificial Intelligence in Your Care

Artificial intelligence is being used more often in fertility treatment — for embryo selection, sperm analysis, time-lapse imaging, and predicting success rates. Most patients have no idea it is happening, and most clinics do not volunteer the information. You have the right to know whether AI is being used in your care, how much weight it carries in clinical decisions, whether it has been reviewed for bias, and whether you can decline AI-based recommendations.

Is AI being used in my care?

Is AI used at any point in my treatment — for example in embryo selection, sperm analysis, or predicting success rates?
Is it used for everyone, or only in certain situations?

How does AI affect decisions?

What decisions does AI help with, and what decisions are made by clinicians?
How much weight does AI have compared to human judgment?
Can my doctor override or disagree with the AI recommendation?

What data is the AI based on?

What kind of data does this AI use?
Does the data reflect patients like me?
What information about me is not included in the AI’s analysis?

What are the limits?

What is this AI tool good at — and what is it not good at?
Does it predict implantation, pregnancy, or live birth?
How do you explain uncertainty or margins of error to patients?

Bias and fairness

Has this AI tool been reviewed for bias?
How does the clinic make sure it does not disadvantage certain patients?

Communication and choice

Will someone explain AI results to me in plain language?
Can I ask questions or say no to AI-based recommendations?
What happens if my values or preferences differ from what the AI suggests?

Download INCIID’s full patient guide: Questions to Ask Your Clinic About AI in Fertility Care at inciid.org

Step 13. Financial Transparency and Support

Financial considerations are often one of the most significant — and least openly discussed — factors in fertility care. Patients should expect clear, upfront information about the cost of diagnostic testing and treatment options, medication expenses and potential variability, what insurance does and does not cover, and payment plans or referral to external resources. Clinics that avoid or minimize these conversations can leave patients feeling unprepared, pressured, or forced to make decisions without fully understanding the financial implications.

INCIID is a charitable nonprofit organization, and financial access has long been central to its mission. Through national scholarship initiatives and long-standing partnerships — including with EMD Serono — INCIID provides limited access to fertility medications at no cost each year for eligible patients. In 2026, INCIID plans to revive its full IVF scholarship program, expanding opportunities for individuals and couples facing significant financial barriers to treatment.

Step 14. Logistics and Practical Fit

Practical details can make or break your experience. Is the clinic easily reachable for appointments? Does it offer flexible scheduling? How does follow-up communication work — phone, portal, text? Are emergency contacts available? A clinic that aligns with your lifestyle and logistics reduces stress during a physically and emotionally demanding process.

Step 15. Patient Experience and Reviews

Reading reviews and patient stories can offer insight into how a clinic operates daily. Look for patterns: Are concerns about communication common? Do patients feel supported emotionally? How does the clinic handle complications or unexpected results?

INCIID encourages patients to share thoughtful reflections on their fertility care experience. Patients are welcome to name the clinic where they received care so long as comments focus on experience, communication, and support — rather than outcomes alone. Comments should focus on your experience rather than allegations, avoid naming individual staff members, and avoid medical claims about competence or negligence.

Step 16. Alignment With Your Values

Choose a clinic that feels right on a human level. Your comfort, trust, and sense of partnership matter. A clinic may have stellar credentials and success numbers, but if you walk away unsure or uncomfortable after your consultation, that is important data too. When possible, meet with more than one clinic — and trust your instincts as part of your decision.

Step 17. Second Opinions Are Not Just Acceptable — They Are Encouraged

One marker of a patient-centered clinic is how they respond when you mention that you are seeking or have sought a second opinion. A confident, ethical clinic will welcome second opinions. A clinic that discourages them, responds defensively, or implies that seeking one is a sign of distrust is sending an important signal about their culture.

Second opinions are particularly valuable:

When you have received a diagnosis that significantly changes your treatment path — such as diminished ovarian reserve, recurrent implantation failure, or a recommendation for donor eggs.
When a treatment cycle has failed unexpectedly and you want to understand what happened and whether a different approach might be warranted.
When you feel uncertain, unheard, or unsupported by your current care team.
When a clinic recommends a protocol that differs significantly from what you have read or heard from other sources.

INCIID’s advisory board and professional directory connect patients with experienced specialists across a range of fertility subspecialties. Seeking a second opinion is not disloyalty — it is informed self-advocacy. A good fertility specialist will tell you the same thing: get the information you need to feel confident in your care.

Step 18. Your Decision Is Personal and Evolving

Selecting a fertility clinic is not a momentary decision — it’s the beginning of a long and nuanced journey. Take the time to gather information, ask thoughtful questions, and reflect on what feels right for you. There is no single checklist that fits everyone, but these modern considerations help you evaluate clinics in a holistic, patient-centered way.

Download the Fertility Clinic Checklist at inciid.org

Download Questions to Ask Your Clinic About AI in Fertility Care at inciid.org

Search the INCIID Professional Directory at inciid.org/professionals

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