Choosing a clinic abroad: questions to ask and red flags to watch out for

I’m going to do something unusual for someone working in this sector: give you the tools to assess a clinic without my help, including those I don’t recommend. If you’re familiar with these criteria, you’ll make a better choice, whether you use a consultant or not.

Check for accreditation first

In Greece, every licensed clinic must appear on the list of units accredited by the National Authority for Medically Assisted Reproduction. This list is public. A clinic that isn’t on it should not be considered, regardless of its other credentials. In Spain, you can check via the national register; in Belgium, via the list of licensed clinics.

The twelve questions to ask in writing

1. What is your live birth rate per transfer, for my age group and my specific medical indication, over the last twelve months? Why the wording matters.
2. Does this figure include cycles involving donor eggs? How many cycles does it represent?
3. A detailed, line-by-line quote, with an explicit list of what is not included.
4. What is your policy in the event of cycle cancellation, a lack of eggs or a lack of embryos? What is the refund policy?
5. How many embryos do you transfer, and why in my case? This is the issue.
6. What tests do you require beforehand, and how long are they valid for?
7. How do you select the donor, and what genetic screening do you carry out?
8. How long do you store the embryos, at what cost, and what does the consent form cover?
9. Who is my point of contact, in which language, and what is the usual response time?
10. Who should I contact in an emergency after I return, on which number, and at what times?
11. Will I receive a full report on the cycle, in a language I understand?
12. Will the doctor who speaks to me via video call be the one performing the procedure?

A reputable clinic will answer all twelve questions in writing, directly and without taking offence. This is the real test, more so than the answers themselves.

Warning signs

• A success rate that is advertised without any definition, or one that is abnormally high for your age. If it’s over 60 per cent using your own eggs at the age of 42, something isn’t right.
• A guarantee of pregnancy or a full refund in the event of failure. No one can guarantee a birth; such offers conceal an inflated initial price.
• Time pressure: ‘there’s one place left this month’, ‘the price goes up next week’. Biology doesn’t work on a ‘special offer’ basis.
• A refusal to provide a written quote, or a quote that changes between the video call and your arrival.
• A catalogue of donors with photos. This is illegal in Greece and Spain, where donation is strictly anonymous. A clinic that offers this is not complying with the law it otherwise claims to follow.
• Additional techniques offered as a matter of course — time-lapse, embryo glue, assisted hatching, immunotherapy — without any justification based on your medical history.
• No questions about your medical history before proposing a treatment plan and a price.
• An intermediary paid by the clinic who does not tell you this. Always ask who is paying whom.

Regarding online reviews

These are useful for assessing the welcome, communication and organisation – in other words, the aspects a patient can actually evaluate. They say nothing about the quality of the laboratory, which is, however, the decisive factor. Be wary of pages full of nothing but praise and forums where the same three clinics crop up in every reply: commercial partnerships exist, and they are not always disclosed.

The criterion nobody mentions

Continuity. A treatment journey lasts for months and involves times when you’ll need a response within a few hours: an ultrasound result to be passed on, a dose to be adjusted, unexpected bleeding. A clinic that’s excellent in the lab but unreachable for ten days will leave you in a difficult situation at the worst possible moment. Test this before signing up: send a specific question and see how long it takes for a reply to arrive – and whether they actually reply at all.

To be transparent, this is also the very reason for my work. But that’s no reason not to check it for yourself — and if a clinic responds directly to you without an intermediary, so much the better: my role is to ensure the process runs smoothly, not to convince you that it’s impossible without me.

Frequently asked questions

Source: https://fertilitegrece.com/en/blog/choosing-fertility-clinic-abroad/ — Triada Baloukoudis, IVF patient coordination in Greece. General information, not medical or legal advice. Printed on