Everyone seeking infertility treatment will want to be sure that they are receiving ‘quality care’. But what exactly is quality, how is it measured and how can you go about comparing quality between different infertility clinics abroad?
Before you can begin comparing quality of the services offered by different infertility clinics, you need to decide what this means to you personally. Some people focus on comparing quality of the clinical infertility treatment they receive, others on comparing quality of the environment in which that treatment is given. For some, comparing quality of the service that they receive throughout their visit to an infertility clinic is the most important factor, whereas others focus on comparing success rates in conceiving and producing a live birth between different clinics.
You need to consider how important each of these quality factors is to you, so that you can go about comparing the quality of infertility clinics in a meaningful way.
There are a number of internationally recognised standards that are used when comparing different infertility clinics on the basis of their quality of service. The most well known of these is ISO9001. The American-based Joint Commission International also provides accreditation to an internationally accepted standard. However, it is worth remembering that these standards are often based on quality of systems, management processes and other business factors, rather than the more personal criteria that you may find more important when having infertility treatment.
In addition to these quality and accreditation standards, this site also adopts the Good Practice Score as a method of measuring certain criteria of participating clinics relating to aspects of equity in cross-border reproductive care, patient information, donors, surrogacy and embryo transfer.
Within their own countries or regions, infertility clinics can also apply for accreditation and registration with federations, associations and societies, such as the European Foundation for Quality Management, or the Quality Council of India. The International Federation of Fertility Societies can help you find the relevant organisation for your chosen country.
It should be noted, however, that the standards that infertility clinics need to achieve to receive accreditation with these bodies vary, from strict quality checks and regular inspections to simply filling in a form and paying a membership.
You should always research in depth organisations claiming to accredit infertility clinics to see which quality accreditations carry genuine credibility and kudos and which are just meaningless certificates.
In the majority of countries, a basic standard of quality is regulated by the ministry or department of health, and all infertility clinics in these countries should be registered. Again, the level of inspection and testing required for registration will vary from country to country, so you should check out the details to see exactly what national registration means and what reassurances it gives you when comparing quality.
For example, the Human Fertilisation and Embryology Authority (HEFA) in the UK strictly monitors standards, success rates, multiple birth rates and more, with regular pre-arranged visits and spot checks. HEFA will take away the licence of any infertility clinic in the UK that continually falls short of its high standards. In some countries, the standards prescribed, and the application and inspections of those standards, may not be as thorough.
The EU Tissues and Cells Directive was created in 2004 to establish quality standards across the European Union. This should mean that all infertility clinics adhere to the same standards when it comes to certain quality criteria. As with much EU legislation, however, it has not been implemented uniformly across all member states and differences remain when comparing quality standards between countries.
For some people, the quality of an infertility clinic is simply a matter of results. You may consider comparing quality purely by comparing success rates, either as confirmed pregnancies or as successful live births. If so then there are several factors that you need to consider in interpreting the statistical data that are given to you, and many questions that need to be asked to verify that the data are really relevant to you. (See our related articles on success rates and comparing success rates).
Another clinical measure that can be used when comparing quality is infection rates. Reputable infertility clinics should be able provide data on infection rates, including for MRSA. A low infection rate will indicate a high quality of cleanliness and safe clinical techniques amongst the staff.
Comparing quality means much more than simply comparing clinical or business standards. All healthcare choices should be based on the treatment experience as a whole, rather than just the medical treatment itself, and this is especially true when you factor in the highly emotional and stressful aspects involved in infertility treatment.
There are therefore many other aspects to consider when comparing quality of overall care at infertility clinics abroad. These include factors such as:
Comparing quality means comparing all of the clinical and experiential factors as a package, from your initial contact to your final follow up. You may not find an infertility clinic that is perfect on every count, but with some careful consideration and thorough research, you should be able to find an infertility treatment centre that you are happy with, somewhere in the world.