We see a number of patients who have failed IVF cycles elsewhere, so we have a fairly good idea of what makes some clinics bad.
Here's a short list of features which can help you identify a poor quality IVF clinic
1. Clinics which depend upon outside embryologists to do their procedures for them. IVF is a demanding process and your embryos need the full-time loving care and devotion of an experienced embryologist. A full-time embryologist spends a lot of time honing his skills and optimising the conditions in his IVF lab to ensure high pregnancy rates. This is not something a "visiting embryologist" can do. Thus, these clinics will very rarely freeze spare embryos , and your supernumerary embryos are usually discarded - or donated ( without your content or permission) to another patient.
2. Clinics run by over-busy doctors who travel a lot and are not available in one location. This is a problem for many reasons. These doctors are so busy shuttling from clinic to clinic, that they simply cannot provide the needed care and attention to their patients. While this may not be an issue for many young patients ( who are good ovarian responders), this can be a major problem for patients with poor ovarian reserve or those who develop OHSS. Another problem is that these clinics will often treat patients in batches. This means they will group all their patients together, and do about 10-15 egg collections in one day ! While this works fine for young women this not a good option for difficult patients ! After all, when you have 25 women cycling at one time, how can you possibly ensure that all 25 women will grow eggs at exactly the same time so that they are allready for an egg pickup on the same day ? When there are too many patients , care gets regimented and fragmented, and there is more scope for errors.
3. Clinics with too many assistants. Because there aren't too many good IVF clinics, the good clinics are all very busy. To maximise their patient through-put and revenue, the senior doctor employs assistants. This means that often the history is taken by a junior - and patients rarely get a chance to bare their soul or establish a rapport with the senior doctor. As the treatment progresses, most of the instructions are relayed to the patient by a nurse or an assistant. Once you've paid your fees and signed up for the IVF treatment, you rarely get a chance to see the senior doctor again !
4. Clinics which do not provide medical documentation or records. This is a major problem because IVF clinics want to "hang on" to their patients. They are worried that their patients may desert them or go to another doctor, which is why they treat the patient's medical records as their personal property - and refuse to give even a copy to the patient. A good clinic should routinely give you a treatment summary as well as photos of your embryos - and if they do not, then you should be very concerned !