How to Navigate IVF: Success Rates, Treatment Add-Ons, and How to Choose the Right Clinic for You
- Dr Natalie Hutchins
- 3 days ago
- 7 min read
Episode Introduction
IVF is one of the most emotionally loaded journeys a person can take. By the time most couples walk into a fertility clinic, they have already spent years trying, months grieving, and countless hours searching the internet for answers. That combination of hope and desperation is, in many ways, what makes navigating the IVF landscape so difficult. Vulnerability and high-stakes decision-making do not make easy companions.
The problem is that the IVF industry does not make it easy to choose wisely. Success rates are presented in formats that are virtually incomparable between clinics. Regulation varies dramatically from country to country, and even within regulated systems, quality of care, laboratory standards, and treatment add-ons fall largely outside the scope of oversight. A clinic can display a headline live birth rate that looks impressive and entirely fail to mention that it only accepts patients with excellent prognosis.
Then there is the question of cost, access, and geography. In many countries, publicly funded fertility treatment is limited, inconsistent, or unavailable. Waiting times can stretch to a year or more, and the eligibility criteria can be opaque until you are already deep in the process. The result is that the people most in need of support are often the least equipped to navigate a market that is, frankly, not well designed with them in mind.
In this episode, I am joined by Emma Whitney, an embryologist and chair of the fertility charity Fertility Action, and Professor Bassel Wattar, a gynaecologist and clinician researcher specialising in reproductive medicine. Together we cover everything from how to read a success rate, to what actually goes on in an IVF laboratory, to which treatment add-ons have genuine evidence behind them and which do not. If you’re thinking about IVF, already in the middle of it, or just trying to understand your options, this episode gives you the tools to ask better questions and advocate more effectively for yourself.
Guest Bios
Emma Whitney is a clinical embryologist and the chair of Fertility Action, a charity dedicated to improving access to fertility treatment and supporting those navigating the fertility landscape. She has extensive experience in clinical embryology, including embryo selection, preimplantation genetic testing, and laboratory quality.
Professor Bassel Wattar is a gynaecologist and clinician researcher with a specialist interest in reproductive medicine. He co-leads a research unit dedicated to evidence synthesis in women’s health and the Clinical Trials Unit at Anglia Ruskin University with a focus on delivering high quality applied clinical research.
What We Cover
00:03:04 Access to IVF: public funding, waiting times, and the postcode lottery
– Why 60% of IVF cycles are now done privately, and how eligibility criteria for publicly funded treatment vary enormously depending on where you live.
00:10:48 The global picture: how other countries fund fertility treatment
– International comparisons showing that some countries offer unlimited IVF cycles as a matter of public health policy, in response to declining birth rates and demographic pressures.
– Why the economic and societal case for funding fertility treatment is largely absent from political debate in many places.
00:13:10 How to choose a clinic: what to look for beyond the website
– The role of specialist matching, multidisciplinary team culture, and continuity of care in predicting a good clinic experience, none of which are visible on league tables.
– How corporate ownership models and rented laboratory arrangements can fragment the care pathway in ways that matter to outcome.
00:16:55 Understanding IVF success rates and how they can mislead
– Why live birth rate per embryo transferred systematically excludes patients who never reached a transfer, and why cumulative and per-cycle-started metrics give a more honest picture.
– How patient selection, including excluding older women or those with low ovarian reserve, can significantly inflate a clinic's published success rates.
00:26:55 The embryology laboratory: the part patients never see
– What makes a high-quality embryology lab, including time-lapse incubation, seven-day working, and embryologist involvement in clinical decision-making.
– How the embryologist consultation works in practice, and what questions patients can ask to understand the lab team's role in their care.
00:38:55 IVF add-ons: what they are and how to evaluate the evidence
– How the add-on designation works, what it means in practice, and why the current regulatory framework for assessing add-ons has significant limitations.
– The distinction between add-ons offered to everyone versus those targeted at specific patient groups, and why that distinction matters for evaluating the evidence.
00:43:21 Preimplantation genetic testing (PGT-A): green, amber, or red?
– What PGT-A does and does not do, including the risk of discarding mosaic embryos that might have self-corrected, and why the evidence base is still contested.
– Why age is the key variable in deciding whether PGT-A is appropriate, and how to have an informed conversation with a clinician about whether it is right for you.
00:51:41 Endometrial scratching, embryo glue, and other add-ons reviewed
– An evidence-by-evidence review: endometrial scratching (limited and contested), embryo glue (minor benefit, no additional cost, now standard in many labs), time-lapse incubation (standard, not add-on).
– Why immune treatments for recurrent implantation failure, including intralipids, IVIGs, and steroids, currently lack robust randomised trial evidence despite being widely offered.
01:00:13 Going abroad for IVF: regulation, risk, and what to ask
– How regulatory standards for IVF clinics and laboratories differ significantly between countries, and why some popular destinations for fertility tourism have minimal oversight.
– Practical advice on accessing reliable information about overseas clinics, including the value of seeking referrals from clinicians who have direct knowledge of the labs they recommend.
What You Will Learn
• Why is publicly funded IVF so difficult to access, and does it depend on where I live?
• What happens if I am on the waiting list for IVF and I age out of eligibility before I am seen?
• How do I choose between IVF clinics when they all look similar online?
• What does an IVF success rate actually mean, and how can it be misleading?
• Why do different clinics show different types of success rate, and which is the most honest?
• Should I be asking to meet the embryologist, not just the consultant?
• What is a high-quality embryology laboratory and how would I know if a clinic has one?
• What is a treatment add-on in IVF and how do I know whether it has real evidence behind it?
• What is PGT-A (preimplantation genetic testing) and should I have it?
• What is the risk of discarding a viable embryo through genetic testing?
• Does endometrial scratching improve IVF success rates?
• What is embryo glue and is it worth having?
• Is there any evidence for immune treatments like intralipids or IVIGs in IVF?
• Is IVF abroad safe, and how do I know if a clinic in another country is properly regulated?
• What should I ask a fertility clinic before I commit to treatment?
• Where can I find free, reliable support and information about IVF?
Key Takeaways
• Success rates on clinic websites are not straightforward. Always look for live birth rate per cycle started, ask about age banding, and find out what patient groups the clinic accepts. A high headline number may reflect careful patient selection, not superior care.
• The embryology team matters as much as your consultant. Ask whether you can speak with an embryologist before treatment begins, and find out whether the lab operates seven days a week. These details are not on the regulatory website, but they are worth asking about.
• Most IVF add-ons are offered ahead of the evidence. Before agreeing to any additional treatment, ask what the current evidence shows, whether it is targeted at your specific situation, and what the additional cost is.
• Knowledge is your best protection. The IVF market, wherever you are, is not perfectly regulated. Educate yourself, seek peer support, consult more than one specialist if you can, and make use of the independent resources that exist.
Further Resources and Support
Regulatory Bodies and Official Information
• HFEA (Human Fertilisation and Embryology Authority) — UK regulator of IVF clinics; includes a clinic search tool with independently reported success rates and a guide to treatment add-ons.
• HFEA Clinic Finder — Search and compare licensed clinics in the UK, including reported success rates and available treatments.
• HFEA Treatment Add-Ons — Independent evidence ratings for common IVF add-ons, updated regularly.
Charities and Peer Support
• Fertility Action — UK fertility charity co-chaired by episode guest Emma Whitney; provides free peer-to-peer support groups monitored by qualified psychologists, plus advocacy for improved access to treatment.
• Fertility Network UK — The UK’s leading patient-facing fertility charity, offering information, emotional support, and community for people at all stages of the fertility journey.
• Resolve: The National Infertility Association (USA) — Advocacy, education, and support for people experiencing infertility in the United States.
• ESHRE (European Society of Human Reproduction and Embryology) — Professional body for reproductive medicine; publishes evidence-based patient guidance on a range of fertility topics.
Mental Health and Emotional Support
• British Infertility Counselling Association — Directory of counsellors specialising in fertility, pregnancy loss, and assisted conception, for patients in the UK and internationally.
• Mind (UK) — Mental health charity with resources on managing grief, anxiety, and the emotional impact of fertility treatment.
Miscarriage and Pregnancy Loss
• Tommy’s — Research and support charity for pregnancy complications including miscarriage, stillbirth, and premature birth; includes guidance for those experiencing recurrent pregnancy loss.
• Miscarriage Association — UK charity providing support and information for those affected by pregnancy loss at any stage.
• Sands.org.uk — Support and information for anyone affected by the death of a baby, including a helpline, online community, and local groups.
Disclaimer
The content of this podcast episode and these show notes is intended for general informational and educational purposes only. It does not constitute medical advice and should not be used as a substitute for professional medical guidance, diagnosis, or treatment. Always consult a qualified healthcare professional about your individual circumstances before making any decisions about your fertility care. The views expressed by guests are their own and do not represent the official position of any regulatory body or institution.
