The decision to have a baby is a big (and exciting!) one—and it’s the first of many you’ll make during your fertility journey. The next major choice you’ll have to make is who you’ll turn to for treatment.

Fertility treatment can be draining emotionally, financially, physically, and mentally, so having the right doctor and clinic is crucial. Not only do they need to have the best medical options available, but they should also have deep experience in treating patients who identify as lesbian, gay, bisexual, trans, queer, questioning, two-spirited, or other sexual orientations and gender identities. Of course, success rates are a key measure to consider, but it’s a journey. A clinic that communicates well, practices empathy, and personalizes care is critical. 

There are tons of clinics that post rainbow flags on their websites—a promising sign—but of course, you’ll want a doctor and clinic that can practice those values in person. Here, Bird&Be chief medical advisor Dr. Dan Nayot highlights the factors to consider when finding an LGBTQ-friendly fertility clinic—all to help make your big decision a little easier. 

Get referrals from sources you trust.

You can hit up Google to find clinics near you, but nothing beats a recommendation from someone who’s been there. Many of us tend to keep hush-hush about family planning, but often, those who’ve been through successful fertility treatment are happy to share any information that would help others along. If you know an LGBTQ family that lives close to you (a nearby clinic is handy—fertility appointments can be frequent and short-notice), ask if they had a positive experience at their clinic and with their doctor. They’ll likely be happy to open up and let you know how comfortable and supported they felt throughout the process. 

Go deeper into the clinic’s LGBTQ2 training and policies.

Once you have a doctor or clinic in mind, you’ll want to do your own research too. You can start on the clinic’s website, but you may have to phone to get more information, which isn’t a bad idea. A voice conversation can help you get a feel for the clinic—listen to your gut if you don’t get a good vibe or feel uncomfortable during the chat. 

You’ll want to confirm that the staff is trained in inclusivity, and also ask about policies that put that training into action. Are change rooms and washrooms gender-neutral? Does the staff understand the correct use of pronouns? Can any partner be in the room for consults and procedures? Are consent forms relevant to your situation?

You can also ask what percentage of the clinic’s patient population identifies as LGBTQ. Ideally, the clinic will have ample ongoing experience treating LGBTQ patients—this offers peace of mind that all the training and policies are practiced day in, day out. 

Make sure the clinic meets your reproductive needs.

You might not have your exact fertility plan in place this early on (and that’s totally OK), but for any elements you are sure of, check that the clinic is equipped to support you with the right services. For example, what egg and sperm banks do they work with? Do they accommodate direct donation from a known donor (like family or a friend)? When a third-party donor or carrier/surrogate is involved, there are complex legal implications involved. Can the clinic recommend an attorney to help counsel you on your options and draft the required documents? How does the clinic support mental health throughout the journey? Are there financing options available?

If IUI or IVF might be part of your treatment, you’ll also want to ask about the lab’s technology. Do they perform conventional IVF or Intracytoplasmic Sperm Injection (ICSI, pronounced “ick-see”), a newer technique that leads to higher fertilization rates? What sperm selection technologies do they routinely use? More broadly, what are the clinic’s success rates across various procedures? Make sure you are given estimates based on your clinical scenario, not in general.

You might also want to consider the clinic’s location and waitlist. Ideally, your clinic will be close to you and with a short waitlist, but there may be tradeoffs worth making to find the best clinic for you.

Come to your first appointment with questions.

A comfortable patient-doctor relationship goes a long way during what can be an emotional and challenging journey. Consider your consultation an opportunity to start building that connection. Your doctor will likely have a lot of questions for you—but it’s important that you get your questions answered too.

It helps to plan out what you want to ask in advance. You’ll likely be taking in a lot of new info, and it’s easy to lose track of questions on the fly. Here are a few to consider:

• Is the clinic able to accommodate your specific family building plans (for example, direct donor sperm, an international surrogate, etc.)?
• What ancillary services are available to help with the journey, such as counselors, naturopathic doctors, and/or legal counsel?
• What are the costs of different treatment options?
• What timelines might you be looking at and how frequent will appointments be along the way?
• What experience does the doctor have working with LGBTQ patients?
• Has the doctor recently worked with patients in your same scenario? If so, what went well in the process and what didn’t?
• How does the clinic handle egg and sperm donors?
• How much control will you have over the surrogacy process?
• Are there any regional/local regulatory issues to consider (agencies, cross-border laws, direct donation, sex selection, etc)?

Make a move if you need to.

Whether it’s after your first appointment or later in the process, remember that you’re not locked in and you have options. If at any point you don’t feel right at your clinic, you can request a referral elsewhere (to a different doctor at the same clinic or another clinic altogether). You’ll want to make sure to get copies of all your medical records, and any notes you can make about each step of your process so far will help make sure you get the best care at your next clinic. A transfer might slow down your journey slightly, but sometimes a fresh start can pay off in the long run.