How Do You Know if an IVF Clinic's Lab is Good? Here Are 14 Questions to Ask

Choosing a fertility clinic is a significant decision. While the expertise and bedside manner of the Reproductive Endocrinologist (REI) is what most patients focus on, there's another important aspect that often remains hidden in plain sight: the IVF laboratory.

The lab is where your embryos will be created, nurtured, and stored – so it's essential to ensure they have the expertise, technology, and track record to optimize your chances of success. 

In this article, I’ll share key questions you can ask to ensure your chosen clinic has a lab that can maximize your chances of success.

First off, why is a good IVF lab important?

Within the controlled environment of the lab, highly skilled embryologists meticulously handle your eggs, sperm, and embryos, employing cutting-edge technologies and adhering to rigorous protocols. This is where fertilization takes place, where embryos develop, and where critical decisions are made that can significantly impact your chances of achieving a healthy pregnancy.

A high-performing IVF lab will impact the chances your fertility treatment is successful. Even the most experienced and compassionate REI cannot compensate for a lab that lacks state-of-the-art equipment, meticulous protocols, or a team of highly trained embryologists.

You may never see the lab, but it still plays an enormous role. It's where your eggs and sperm are carefully prepared for fertilization, where delicate procedures like intracytoplasmic sperm injection (ICSI) are performed, and where your embryos are nurtured and monitored during their crucial early stages of development. The lab's environment, technology, and expertise directly influence the quality and viability of your embryos, ultimately affecting your chances of a successful pregnancy and a healthy baby.

By asking the right questions and understanding the key factors that contribute to a lab's success, you can ensure that your embryos are in the best possible hands, increasing your chances of achieving your dream of parenthood. So let’s take a look at some of the questions you can ask:

Embryologist qualifications and staffing:

1. Education: What are the educational backgrounds of the embryologists? Ideally, they should have master's degrees or higher in reproductive science or a related field. Some states, such as New York, New Jersey, Florida, and California, have specific requirements for the laboratory director.
2. Experience: How many years of experience do the embryologists have? Inquire about their specific experience with procedures relevant to your case (e.g., ICSI, PGT-A). 

The lab supervisor should have documented completion of training in and performance of a minimum of 60 ART procedures under supervision with attestation from the training laboratory. 

3. Staffing levels: How many embryologists are on the team? The American Society for Reproductive Medicine (ASRM) recommends 2-3 embryologists at minimum for clinics with under 150 annual cycles. That number goes up to 4-5 for clinics with 301–600 annual cycles. It’s also good to ask whether the lab director is on site or not.
4. Communication: How often will I receive updates on my embryos' development? Will you hear from the lab or your fertility doctor? Clear and frequent communication is helpful to feeling informed and involved in your IVF journey.

Lab technology and procedures:

5. Disaster preparedness: How are the embryos stored? Every ART laboratory needs to maintain an up-to-date disaster preparedness or emergency plan which includes robust protocols for power outages or disasters, such as backup generators and alarm systems. 
6. Incubators: What type of incubators do you use? The most advanced labs use "desktop" incubators with 5% oxygen levels, which mimic the conditions of the fallopian tube and promote embryo development. Avoid labs that use "big box" incubators with 20% oxygen.
7. Cleanliness: How often are the incubators and other equipment cleaned and maintained? Rigorous hygiene practices are essential to prevent contamination and ensure embryo health.
8. Air quality: What measures are in place to control air quality within the lab? IVF labs should have specialized air filtration systems to remove particles and pollutants.

Note: Questions 6-8 are not necessary to ask if your clinic has good success rates, as you can assume they are doing the little things right. However, they could be helpful if the clinic is new or does not have known success rates.

Lab performance and outcomes

9. Certification and accreditation: Is the lab certified? The Society for Assisted Reproductive Technology (SART) requires its members to have an embryology laboratory that is accredited by either the College of American Pathologists (CAP) or The Joint Commission (TJC). 
10. Fertilization rates: What percentage of the eggs fertilize? A good lab should have a fertilization rate between 65-70%. 
11. Blastocyst development rate: What percentage of embryos reach the blastocyst stage (day 5 or 6) in your lab? A good lab should have a 50% blastocyst rate.
12. ICSI or insemination: Does the lab do 100% ICSI or do they use conventional insemination? Every clinic has their own protocol, and most are 100% ICSI.
13. Success rates: Can you provide data on the clinic's IVF success rates, specifically for patients with similar characteristics to me? Ask about live birth rates, pregnancy rates, and implantation rates. You can also refer to SART.org for this data.
14. Research involvement: Does the lab participate in any ongoing research or clinical trials? Participation in research can indicate a commitment to staying at the forefront of IVF technology and techniques.

The IVF lab isn't just a sterile environment filled with microscopes and petri dishes; it's the birthplace of your dreams, the silent partner working tirelessly to bring your hopes for a family to fruition. By taking the time to investigate and understand the inner workings of the lab, you empower yourself to make informed decisions about your fertility treatment.

Remember, your journey to parenthood and the choice of an IVF clinic should reflect your individual needs and priorities. Don't hesitate to ask the hard questions and seek out detailed information. A good clinic will be proud of their lab and willing to share answers to all your questions! I’m wishing you the best of luck on your journey!

Read more:

• What are Some Tips on How to Find the Best Fertility Clinic?
• IUI vs. IVF: Can Success Rates Help Me Choose?
• Does Insurance Cover IVF? (Please Say Yes!)
• How Common is Donor Egg IVF?