Choosing an IVF clinic is a major decision in your family-building journey.

The number of clinics across Asia and North America is overwhelming, but not all of them will meet your needs as Asian intended parents. It is crucial to know what matters in a clinic and to be equipped with the best information and questions to ask any prospective doctor.

Ultimately, informed patients are better equipped to advocate for themselves, so education for intended parents - like the information from Building Asian Families - is essential. With our resources, intended parents can make a well-informed decision when choosing an IVF clinic for egg or sperm donation, ensuring the best possible outcomes for their family-building journey.

Here are some of our top considerations for choosing a clinic for your treatment:

Legal and Regulatory Compliance

This is a non-negotiable, first criterion to assess. Check that the clinic complies with local laws and regulations regarding egg and sperm donation. Laws vary significantly by country and region, affecting everything from donor compensation to anonymity rules.

Accreditations and Standards

The clinic should have all the mandatory national licenses and accreditations (you can find this information on our country pages). Beyond this, look for clinics that have gone beyond the mandatory to seek optional international or national accreditations or certifications. For example, many Southeast Asian clinics seek RTAC accreditation, while other clinics in Asia may seek Joint Commission certification.

Laboratory Quality

This should be a top consideration for all intended parents. In IVF, better labs have better results, which may also save you money in the long term. Among licensed and accredited clinics, the quality of the IVF laboratory may vary considerably and is a key factor in driving patient outcomes. Compare key markers of laboratory quality between different clinics, drawing on data that the clinic reports to accreditation bodies or national authorities. Clinics should be able to provide this information to you on request. For example, be sure to ask :

• What proportion of patients use ICSI vs conventional IVF? Many labs use ICSI as the predominant way of fertilizing eggs. But ICSI is expensive, and may be used in cases when it is not necessary. Ask your doctor whether you need to use ICSI if you have good sperm quality and fresh donor eggs.

• What percentage of eggs are fertilized in ICSI or conventional IVF? A good lab should have fertilization rates over 60% for conventional IVF, and over 70% for ICSI.

• What is your blastocyst development rate? A good lab should have over 50% of embryos reaching the blastocyst stage (day 5 or 6).

Medical Expertise and Services Offered

Choose a clinic with experienced reproductive endocrinologists and a comprehensive range of services to meet your needs. Look for board certifications, professional associations and service, years of practice and the quality of their education. Ensure that the clinic is experienced in treating patients like you. For example, if you are seeking treatment using donor eggs or sperm, look for clinics that have experience providing these services. If you are in a same-sex relationship or do not have a partner, ensure that the country and clinic have treated others with the same family situation and will be inclusive. If you have a specific medical condition or need, ensure that the clinic is suitable. Also, ensure that the clinic has doctors who can treat you in your preferred language, or has other staff who speak your language and can assist you during your appointments and by email or phone when you have a question.

Genetic and Health Screening of Donors for Fresh Cycles

If you are seeking a clinic that will manage a donor matching process for you, ask about the process they use to select donors. Ensure that they provide a thorough screening of donors, including medical, genetic, and psychological assessments. Reputable clinics typically accept only a small percentage of donor applicants after rigorous screening. Also, consider whether it is essential to you that you can see pictures of donors and review medical histories yourself, as this is not possible in all countries.

Transparent Costs

Ask about the costs of care in detail to avoid hidden costs and ensure that you are making an informed decision about the total amount you will spend for a cycle. Be sure that you know the difference between base prices and optional additional treatments and procedures that your doctor recommends, such as ICSI and PGT-A. Understanding all of the possible costs will also help you to compare countries and clinics for care, so that you are comparing the costs of the same treatments. For third-party reproduction, you may also need to understand all of the possible costs associated with an agency or egg bank; for example, this may include legal fees, agent compensation, donor compensation, medical insurance and travel costs for your donor, as well as shipping and importation costs of transporting eggs or embryos between cities or countries.

Number of Cycles in a Year

It is crucial to choose a clinic with experience in IVF with donor eggs or donor sperm so that the doctor, laboratory staff, and support staff can meet your needs. However, a high number of cycles is not always predictive of a higher quality of care. While some clinics have many doctors and treat thousands of patients per year, others have only one or two doctors and may have fewer cycles. A smaller clinic that specializes in IVF with donor eggs for older couples, or with experience treating Asian intended parents of your ethnicity, may be a better match for your needs.

Success Rates

A word of caution: while success rates seem like the only thing that matters in the end, comparing clinics on their success rates alone may be misleading. Different clinics in different countries may report success rates differently, so be careful using this as your driving factor of comparison. For instance, some clinics measure success as a positive bHCG test two weeks after embryo transfer, which may not account for chemical pregnancies and miscarriages, while others may be reporting on live births. It is important to understand what each clinic counts as "success" and how it is reported.

Third-party reproduction entails making many difficult choices as you start your family. Whether through your clinic or through referrals to other professionals, ensure that you will be able to access counseling to help you navigate the emotional complexities of the process.