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Dear DR. Smith,
I have heard over and over that the IVF doctor is only as good as his lab. The lab is what handles the eggs and sperm right so how do you know if a lab is good? When i ask of course they say yes they are an A lab
Measured: A being Good, B being average and C not good.
What questions should i ask or is it listed someplace ??
Thanks Ginna
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Aha! That's the rub.
In the ol' days, US IVF labs were unstructured and had no oversight. Now, we have State (Department of Health) and Federal (Center for Medicare and Medicaid Service, Center for Disease Control, Food and Drug Administration) oversight. All IVF laboratories are subject to periodic unannounced inspections by any one of the agencies. Accordingly, IVF laboratories are held to the highest standards of care in the nation. Laboratories must maintain the proper controls to prevent laboratory errors and have an extensive quality control/quality improvement program in place and adhered too. They must be staffed by appropriately trained and credentialed indivduals to ensure the quality of care. All laboratories must be certified by at least one agency in order to operate. Look for the accreditation certificate on the wall. Not posted for patients to see? Bad sign. So... The ol' days are gone and from an accoutability point of view, we all have to toe the line.
O.K. So what separates the men from the boys? Experience and the willingness to adopt new protocols and improve the standard of care as advances in the field occur. Labs that do not change with the times cannot offer the same quality of care as those constantly evolving. A simple way to assess the competency of a laboratory is by getting a list of the laboratory procedures offered (i.e. ICSI, AH, blastocyst culture, PGD). If they are not up to date in their procedures, this is not a god sign. The explanation the "we don't do that because..." doesn't cut it. Furthermore, ask about the experience and credentials of the Lab Director and staff. The Lab Director must be Board Certified (HCLD) in embryology (and preferably andrology too) to be adequately qualified to direct an IVF lab. Ask to see the certificate. Although I'm biased, I think labs directed by PhD's are better than those directed by MD's. The senior staff should have several years experience in IVF procedures and also have certification appropriate for there function in the lab (although not absolutely necessary). Sometimes this information is posted on their website.
If you encounter any hemming and hawing about giving you this information, move on.
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