What I looked at when I was deciding
I ended up at NYU Langone Fertility Center. That decision was based on location, reputation, and the fact that they had the data and accreditation I was looking for. This page isn't about why that was the right choice for me — it's about the framework I used to evaluate it, which is what might be useful to someone else.
The experience this site documents is entirely based at NYU Langone. Other clinics — Extend Fertility, Spring Fertility, Shady Grove — are mentioned here only as reference points for the types of questions worth asking, not as endorsements or comparisons.
This page is informed by Natalie Lampert's The Big Freeze, which makes a strong case that the lab matters more than the doctor, and that most patients never ask the right questions about either. That framing shaped everything on this page.
Lab quality — the thing that matters most
A fertility clinic is only as good as its embryology lab. The physician is important, but the lab is where the eggs actually go — where they're evaluated, frozen, and stored. Lab quality differences explain most of the variation in outcomes between clinics, and most patients never ask about it.
Ask about
Lab director experience
How long has the lab director been in this role? Experienced, stable leadership correlates with consistent outcomes. High turnover is a flag worth following up on.
Ask: Who runs the embryology lab and how long have they been there?
Verify
Lab accreditation
Labs should be accredited by CAP (College of American Pathologists) and/or CLIA (Clinical Laboratory Improvement Amendments). This means they've been externally reviewed. Assume nothing — verify directly.
Ask: Is the lab accredited, and by which organizations?
Look up
SART data
The Society for Assisted Reproductive Technology (SART) publishes outcome data for member clinics at sart.org. It's not perfect data — reporting is voluntary and definitions vary — but it's the best publicly available comparison point.
Look up the clinic at sart.org before your first appointment.
Reading SART data — what it means and what it doesn't
SART data shows success rates by age bracket and procedure type. It's useful for comparison but has real limitations worth understanding before interpreting it.
It's self-reported. Clinics report their own data. Methodology differences between clinics mean direct comparisons require caution.
It reflects past performance. The data lags by one to two years. Staff changes, lab upgrades, or declines in quality won't show up immediately.
Patient mix matters. Clinics that take harder cases — older patients, lower ovarian reserve — will have lower success rates by definition. A clinic with slightly lower numbers but a broader patient population isn't necessarily worse than one with higher numbers and a more selective intake.
Egg freezing and IVF data are different. Look specifically at egg freezing (oocyte cryopreservation) outcomes, not IVF outcomes — the processes and patient populations differ.
Use SART as a starting point, not a conclusion. The questions on the Questions to Ask page get at the same information more directly from the clinic itself.
Storage technology — TMRW and what it means
Traditional egg storage uses liquid nitrogen tanks with manual handling — eggs are stored in straws, tanks are monitored periodically, and human verification happens at each step. This is the standard approach and works well in well-run labs.
A newer system called TMRW (Tomorrow Fertility) stores eggs in individually tracked, automated containers with real-time monitoring and digital audit trails. The primary benefit is reduced risk from human handling errors and equipment failures — each egg has its own tracked container rather than being pooled in a shared straw within a tank.
NYU Langone does not currently use TMRW — eggs are stored in traditional liquid nitrogen tanks onsite or at their partner CryoFuture. Whether TMRW matters enough to change a clinic choice depends on how much weight someone puts on the specific failure modes it addresses — there's reasonable debate on this.
The more important question is: what monitoring and verification systems does this clinic have in place, regardless of the technology? A transparent, detailed answer is a better signal than any specific technology brand.
I had no idea how much of the fertility industry is owned by private equity until I read The Big Freeze. A clinic can be branded under a well-known physician’s name and be part of a larger PE-backed network. That matters for how the clinic is run, what incentives shape decisions, and what happens to your eggs if the network is acquired or restructured. It’s one question most people never think to ask. Ask it.
Ownership structure — what patients often don't know
This is the thing most people go into the fertility industry completely unaware of: a significant and growing number of fertility clinics are owned by private equity-backed networks, not by the physicians whose names are on the door.
The largest network is Prelude Fertility, which owns dozens of clinics across the US. Other significant players include CCRM, Kindbody, and others. NYU Langone Fertility Center is part of the NYU Langone academic medical center — not a PE-backed network — which is one of the factors that went into choosing it.
Why does ownership matter? Private equity ownership can affect staffing decisions, laboratory investment, patient volume, and the financial incentives that shape how a clinic operates. None of this means PE-owned clinics can't provide good care — many do. But it's information worth having when making a choice, and it's often not disclosed upfront.
A simple way to check: search the clinic name with "Prelude," "private equity," or "owned by" to find any network affiliations. Ask the clinic directly if you want to confirm. The answer to "who owns this clinic?" is a legitimate question to ask.
From my research
The private equity angle was something I only found out about from The Big Freeze — I had no idea before reading it. The fertility industry has undergone significant consolidation, and the idea that a clinic could be independently branded but PE-owned wasn't something I thought to look for before starting. Worth knowing earlier than I did.
What I'd tell a friend
Ask who owns the clinic. Directly. Before you commit to anything. It's a legitimate medical question and a good clinic answers it without hesitation. If the answer involves a network you haven't heard of, search the network name plus 'private equity' before your next appointment.
What surprised me
How little the clinic's website told me about what actually mattered. Beautiful waiting rooms, impressive bios, vague language about individualized care — none of it told me about lab accreditation, director tenure, or ownership structure. Everything that actually distinguished clinics required asking directly or looking up independently.
Refund and guarantee programs — what they actually require
Some clinics — most notably Spring Fertility and Shady Grove Fertility — offer "refund" or "guarantee" programs that return fees if the process doesn't result in a live birth. These programs are marketed prominently. The details matter significantly.
Eligibility requirements are real and restrictive. Most guarantee programs have strict age cutoffs (often under 38), AMH minimums, AFC requirements, and BMI limits. Many people researching these programs won't qualify once they read the eligibility criteria carefully.
What's included and excluded varies. Some programs cover only the egg freezing cycles; others extend to embryo transfer. Medication costs, anesthesia, and storage are typically excluded.
The refund isn't the goal. Enrolling in a guarantee program and hoping for the refund means hoping the process doesn't work. The guarantee is a risk-sharing mechanism for people who qualify and want to reduce financial downside — not a reason to choose a clinic.
If a refund program is being considered: read the full eligibility requirements, ask what's included and excluded, ask what the success rate is for patients who enrolled versus those who didn't, and understand exactly what conditions trigger a refund. The details are always more complicated than the headline.