How To Get What You Want From Your Fertility Doctor
Unfortunately it wasn’t the first time I heard this story in my office. Melissa reported her IVF had failed. Women going through infertility are the fiercest most tenacious people I’ve met, so naturally she wanted to discuss what was next. She explained the doctor recommended another round, but this time a cheaper version called “mini IVF”. She was floored that this option existed because he hadn’t explained it to her previously. Melissa blamed herself for not asking enough questions.
We call upon professionals because we are not the professionals. We may be good at what we do professionally, but we are not reproductive endocrinologists. And even if you are one, when you’re a patient you get to be treated like a patient. That should mean getting all the information up front, but unfortunately that is not reality many times. Doctors may assume that you’ve already googled your condition to death, but even if you have, you still get to ask your professional the questions you want.
I have a firm belief that going through infertility has opportunities for benefits later in life. You learn things about yourself and your life that you might not ordinarily learn til much later in life. Here is a helpful acronym I teach my clients when dealing with healthcare professionals (including me!)
You’re going to see your fertility doctor because you want to get pregnant and you believe they can help you. He or she is going to suggest a course of action, at any stage. Be it IUI, IVF, egg donor, sperm donor, or embryo donor. Throughout these options are many recommendations about medication amount and timing. You’ve been through a lot to get here and just want someone to tell you what to do. But you will rest better knowing you can ask these questions.
The acronym is B.R.A.I.N.:
An example would be that your doctor wants you to take progesterone before IVF. You would say “What are the benefits of taking progesterone?” and she would tell you “it helps to thicken your uterine lining to prepare for the embryo to implant after transfer.” If you want to know more about her answer, ask.
Ask your doctor “What are the risks of doing this procedure?” I often see women who go through laparoscopic surgery for endometriosis prior to conceiving. If you ask about the risks, you will find out more about what to expect, including pain, recovery, and that the outcome doesn’t necessarily mean 100% removal of the scar tissue or guarantee of pregnancy.
Had Melissa been able to ask about alternatives to traditional IVF, she would have found out about the “mini IVF” and paid much less money. It is not her fault that she didn’t know to ask, but trying to conceive can be a time to empower yourself by asking questions.
Some decisions in TTC can be risky, complicated, and expensive. It’s easy to get swept away by the energy of the white coats in the room and feel pressured to make a decision. Ask for a few minutes alone to talk to your partner or call a friend so you can process your thoughts and feelings more freely before you come to a conclusion.
Use all the information you have to negotiate a plan. You might ask “is it better to try another round of IVF immediately after an endometrial scraping or should I wait a cycle?” Or “what are our chances of conceiving if I don’t have my uterine septum removed?”
Remember that while you are dealing with extraordinarily well trained specialists, no one cares about your outcomes as much as you do. Essentially you are hiring them to serve you, and every consultation you’re having with them means you get to ask lots of questions. There are no stupid questions, and even if you've asked it before, you can ask it again. Your reproductive endocrinologist is at your service.
Allison Ramsey is a licensed professional counselor and fertility counseling specialist in the Asheville area. She’s a member of the American Society for Reproductive Medicine, and completed their certificate training in mental health counseling for infertility. Contact her to start feeling better.