Fertility Friday - Dear Fertility Doc, Do You Have a Soul?

As I’ve recounted in my fertility journey, the process to conceive using assisted reproductive technology (ART) can be daunting. Between appointments, hormones, needles, and working towards something you know might not work, the road is fraught with uncertainty. Even more challenging is when your doctor is robotic.

The first doctor we went to seemed nice. He broke the news to us about our fertility challenges (conception not impossible, but we would need some help) and recommended we do IVF right away. I decided to take some time, do research, and try natural stuff. When that didn’t work, we moved onto our first IUI. The doctor scheduled it on a Friday, since their office wasn’t open on Saturday. He did that the second time, too. In hindsight, what kind of fertility office doesn’t schedule a procedure for the best date according to one’s cycle? I have not worked with another clinic that would rush a treatment like that. Additionally, they did not take a blood sample to see if I actually ovulated before they proceeded.

Leading up to the IUI, the doctor asked me how I was feeling on Clomid so far. I told him I felt fine, a bit emotional, but I wasn’t sure if that was due to the drugs or the entire process itself. He flashed a fake smile and nodded, moving onto the ultrasound. HE SAID ABSOLUTELY NOTHING.

I was livid! How could he push aside my emotions like that?

I left his office having made up my mind: after this treatment, I would no longer work with him. Naively, I was convinced that he was one of the only fertility doctors around with seemingly no bedside manner. I was wrong. I don’t expect these doctors to be counselors, to sit with me for 30 minutes while I hash out my fears, doubts, and emotions.

However, EVERYTHING would have been different if he would have said something like,

“I know this process can be difficult. Do you have someone to talk to about it? If not, I can recommend some therapists.” I would have felt validated and would have entrusted my money, my body, and the future of my family to this man. Instead, I left feeling like a crazy person and decided to leave his practice altogether.

It would behoove any fertility doctor to have some referral partners like family or couples therapists that they could recommend to their patients. I have seen fliers for acupuncture, even though a lot of fertility doctors will tell you there’s no data to support the effectiveness of it. Because it’s all about data. I have seen fliers for financing. I have seen nothing for therapy or working through the stress and emotional weight of this journey. In my experience, fertility doctors seem to get uncomfortable when you even broach the topic of emotions.

I tried another doctor. He was nice, but I wasn’t feeling a connection. Maybe my expectations are skewed. Am I irrational to want to feel a connection and trust with a doctor who wants to take thousands of our dollars in the hopes that his science experiment will change our lives forever? Are these doctors selling hope or data? Trust or science?

Then, another doctor offered to do a presentation to the fertility support group of which I am a part. I went, and I was compelled by some things he discussed. He seemed to be on the cutting edge of research, and was very data-driven. He was a teacher as well as a practitioner. Although extremely arrogant, I liked what he had to offer and decided to schedule a free consultation. My expectations had changed a bit. I no longer anticipated a doctor who was in touch with my feelings, and I didn’t expect him or her to identify and validate my difficult emotions. I wanted results.

Since I’ve been working with this practice on IVF #1 and now our FET, they have changed lead doctors 4 times. I still like the practice, and they have our frozen embryos there, so we’re committed to staying with them as we see this transfer through.

Last Monday was our final ultrasound and blood work before determining if the FET for next Monday is a go (it is!). We arrived on time and proceeded to wait over 30 minutes before anyone came out to tell us what was going on. I’m extremely patient in these types of situations. After all, I’m late sometimes and I understand when an office runs behind for a myriad of reasons. Finally, a nurse came out and said there was a problem with the ultrasound machine, so they’re running behind.

When our turn was up (45 minutes later), the lead doctor came into the exam room with another doctor. I figured she was either training to practice at the office or she was a resident, but who knows because she was not introduced to us. She then stuck the wand inside of me as if I were a dummy she was practicing on, awkwardly jolting it around while she talked with the lead doctor. Am I invisible? I would think that as that doctor, you would want to introduce yourself and explain what you’re going to do before wanding a patient. Kind of like taking me to dinner first before we do it.

I have no problems yelling out in the exam room when I feel uncomfortable. When I did that, stranger doctor stared at me blankly like I was crazy.

Afterward, I asked the nurse who drew my blood who the female doctor was that accompanied the lead. She confirmed that she was a resident.

Dear Fertility Doc, follow these tips to get more referrals, make more money, and I don’t know, prove that you’re human:

  • Make your patient feel comfortable.
  • Recognize that infertility diagnosis are unsettling and strong emotions result from them. Have a plan to refer your patients to appropriate practitioners that can help them talk through these feelings, since feelings are obviously not your thing.
  • A little goes a long way. Say you're sorry if you're wrong, or running late. Give a person space to feel. Don't make a patient feel stupid or crazy because they reacted differently to a procedure than other patients. Refer back to tip #1.
  • Check in with your patient on each visit. Ask how she is REALLY doing. Let her talk for a minute. Make sure she's getting the support she needs. REFER BACK TO TIP #1. This will yield you amazing results in your practice.

I’m not sure if doctors learn about bedside manner or just how to treat people how they would want to be treated in medical school (if they possibly missed these lessons growing up), or if that is just part of every individual physician’s personality.

Does something get lost along the way from the initial desire to help people to working in an industry that makes hefty promises to those wanting to be parents?

Maybe I’m missing a part of the equation. I’m sure there are details that I’m not aware of, and that there are practices that offer up more holistic services like nutrition and counseling. I know that doctors work a lot, and are under pressure to perform.

These are just my experiences. My unsolicited advice to you if you are in the market for a fertility doctor is to ask as many questions as you want, and make sure you feel comfortable. If something feels off, trust your instinct.

In any business, the same simple things ring true: excellent customer service, making people feel comfortable, and being nice always win. Doc, I know you really want to figure out how to make us a baby, but don’t forget to stop along the way and be human. It’s good for the soul.

B Well,