In a previous article, I talked about the importance of choosing the right Gynaecologist for you. Also important, especially if you are opting for assisted reproduction, is your choice of clinic. In the last decade, there has been an explosion of fertility clinics in Nigeria. Even the little hospital on my parents’ street boasts of reproductive services on its signboard. Before choosing a clinic, it has become increasingly important to critically assess and determine which one is best for you.
There are many factors that influence one’s clinic choice. Some people would prefer to base their decision on the Doctors in the clinic, opting for those who have been in the industry longest and/or have some track record. Some prefer to go with success rate, some opt for location and privacy, and some opt for comfort. The deciding factor differs from one person to the next. I know someone who would not be caught dead in any of the bigger fertility clinics, for fear of running into someone she knew. She instead opted for an unknown clinic hidden somewhere in VI, simply because she believed she would not run into anybody there. Well, she didn’t run into anybody but she didn’t get pregnant either.
As far as decision factors go, success rates are relative, and I don’t put too much emphasis on them. My opinion is that, whilst it’s good to know your clinic has a 95% success rate, there are no guarantees that you won’t fall into the 5%. A lot of people will argue against this rationale, but I have seen quite a number of failed cycles from hospitals with supposedly excellent statistics. And, from my experience, these hospitals tend to push the blame of failure on the couple. In my case, when my 1st cycle failed, I was told point blank that something must have been wrong with my uterus, as they (the hospital) had done everything to ensure a successful cycle. To further buttress my point, the clinic where I had my successful cycle did not (at the time) have as good statistics as the clinic where I had my failed cycle.
There are no hard and fast rules, but below are some general factors that should be given some consideration when you are choosing your clinic:
1) Availability & Accessibility of the Physician
While it’s one thing to choose a clinic based on the track record of a doctor, it’s another thing to commence your cycle with this clinic, and the said doctor is as elusive as a ghost hardly ever there! In the end, you find yourself tossed from junior doctor to junior doctor. Very disappointing if the doctor is the very reason you selected this clinic in the first place. And even if the doctor is available for appointments, reaching him when you have questions or queries could be close to impossible. The difference between the clinics where I had my 1st and 2nd cycles, especially with respect to doctor accessibility, was like night and day. For my 2nd cycle, I went back to my old Ob/Gyn, who was accessible to me 24 hours a day. I could text him at 2am in the morning, and he would respond almost immediately. Yes, this might not be a realistic expectation, but it’s nice to at least have a doctor who is available to talk with you, answer your questions, and respond to queries in a timely manner!
2) Follow-up Processes & Procedures
How a clinic follows up with its patients is absolutely critical. I know this might seem a bit touchy-feely to most, but fertility is such a sensitive subject that yes, it doesn’t hurt having a bit of extra attention. Having a clinic that follows up with you for appointments, tests, and treatment plans makes a difficult experience a bit easier to handle. So, if this matters to you, ask anyone who has used the clinic you are considering what this is like.
3)Available Technology & Range of services offered
As much as you like a doctor, you want to be sure that the clinic in which he operates has the right facilities for your procedure. You need to be sure that they have a good embryology unit, and if you would like the option of freezing embryos you don’t use, you also want to be sure that they are equipped enough to do this. It’s also worth investigating if they are able to offer a wide range of IVF-related services, such as ICSI (Intra-cytoplasmic sperm injection), Blastocyst Embryo Transfers, Assisted Hatching, Donor Eggs, Donor Sperm, etc.
Unfortunately, this is a cold reality. You have to ask yourself if you can afford that particular clinic. A few years ago, you could safely guesstimate how much you would spend for a cycle, regardless of which hospital you chose to use. But today, prices vary quite widely. I have heard some prices, especially from hospitals out of Lagos, that have made my mouth fall to the floor. Maybe because there aren’t other available options around, or maybe because they believe they have so much more to offer. Whatever the case, some hospitals now charge top dollar, with prices even triple the expected average. On the flip side, I recently heard the price of a cycle in an Abuja clinic with fast growing popularity, and I was stunned by how low it was. Essentially, you need to be sure that your wallet can accommodate the hospital you select.
5) Clinic Location & Office Hours
As much as you want to glaze over this as a factor, trust me it is. As much as you love the hospital, you need to be sure that you are fine with driving across town, or hopping on a plane, for all your appointments. If this isn’t a problem for you, then you can move on to the next point. But if dealing with the logistics could be tricky for you, especially where work is concerned, then you might want to think of a Plan B. The same also applies to their office hours. Some clinics are quite inflexible when it comes to their operating hours, and if you are not able to adapt to this, you might need to reconsider.
6) Post Treatment Counseling & Support
You might not be thinking about this now, but trust me it is very important. Whether or not you have a successful cycle, it is important that the clinic you choose has a good counselling system in place. Where I had my 1st cycle, I was treated like the Queen of Sheba when the going was good, but as soon as my cycle failed, I was dropped like it was hot. There was no counselling, no after care, nothing. The truth is that a lot of hospitals in Nigeria do not have provision for this. But if available, is definitely a great to-have.
7) General Clinic Statistics
It’s true that I believe success rates are relative and should not be too much of a factor, but it is also important to know what you are signing up for. It’s important to do your research about the clinic you are considering. If they are known to have abysmal results, then it might be something for you to pause and think about. If 3 out of 5 people have nothing but complaints, it should also be food for thought. To be forewarned is most definitely to be forearmed.
8) Gut Feeling
This, in my opinion, is absolutely critical! You just have to listen to your gut. Make it a point of duty to check out the clinic. You might only be able to speak with front-office staff (as most doctor appointments are by appointment only), but listen to what your intuition says about the place. When I walked into my IVF Clinic number 1, the place just didn’t resonate with me. I felt uneasy and somewhat unhappy. I attributed this to the stress of dealing with IVF, but if I’m to be honest, it ran far deeper than that. Not even the clinic’s white and blue ambience was able to calm me. But I didn’t listen to my gut, I went on to cycle with them anyway, and I ended up deeply regretting it. But don’t take anyone’s word for it. Just because one person didn’t feel right about Clinic A doesn’t mean you won’t either. It might ring better with you than the other person. I referred my friend to my longtime doctor who was behind my successful IVF cycle, and she was so creeped out by him. I still struggle to understand why (because I think he’s awesome), but I respect her decision, and am helping her search for an alternative she will be comfortable with.
It’s not easy, but hopefully you’ll be able to make the right choice about what hospital to use. When I was deciding on my 2nd cycle, I knew there was no way in the world I was returning to the last hospital, but I was torn between my old Ob/Gyn (whom I loved to death, but thought he wasn’t aggressive enough for me) and a major IVF clinic (with an impressive record, and as aggressive as I thought I wanted). The deciding factor for me was being able to return to the familiar and comforting. I chose my old Ob/Gyn because, having been so emotionally battered from the last clinic, I needed to cycle with someone who understood me. And I’m so glad I did.
Good luck all!