In an Attempt Not to Bias Readers, the Doctor Character Doesn’t Get Named until the End. Also: Sorry, This is a Long One

Scene: midday Monday at the offices of The Fertility Institute at Posh Hospital; a slightly nervous couple waits to speak about IVF with a doctor they have never met

Doctor: Hi, nice to see you. (shakes hands) So, why hasn’t this worked yet?

Andrea: That’s what we’d like to know.

Doctor: Well, we can’t tell. You’re young. All your numbers look great. You’ve had a number of mature follicles every cycle. Your sperms counts are fine. But IUIs only give a 17-18% chance of pregnancy. IVF, for patients your age, has a 70% success rate. So I really want to push things. I want to increase your dosage and get as many eggs as we can.

Andrea: But…

Doctor: Then I’m going to say we do IVF with ICSI. (spelling it out and speaking slowly while writing on a chart) That’s intra… cytoplasmic… sperm… injection…

Andrea: Yes, we know. We’ve actually done two IVF cycles with ICSI at a previous clinic. (thinking to herself, “It’s all in that fat stack of patient records you’re holding; have you glanced at those?”)

Doctor: Oh. (glancing at papers) I see that.

Andrea: When we did IVF before, we only…

Doctor: (back to the chart he’s writing out) So we’re going to run a bunch of tests first, to make sure we don’t miss anything and we have the best chance of making this work. We’ll do a Clomid Challenge Test, to determine the best dose of medications for you. We’ll do some bloodwork to check for antibodies that would fight against pregnancy, and for blood-clotting disorders. We’ll do one test – and this one isn’t covered by insurance – to check for enzymes in your endometrial lining that would support a pregnancy.

Andrea: Okay, all those tests sound fine. But you should know, we don’t want to freeze or discard any embryos. We want to fertilize a small number of eggs and transfer all the viable embryos.

(silence)

Doctor: Boy, kids. That really, I mean really lowers your success rates to almost nothing. I mean, I understand, I respect where you’re coming from. But if you don’t give me any out, I can only let you fertilize three eggs. What if they all fertilize? Three embryos is the most I’d be comfortable to transfer, and I can’t take the risk of you having more than that.

Andrea: Well, when we talked about all this with Dr. Owlish, he told us that only one out of every five eggs has the genetic material to turn into a viable pregnancy. So he suggested we fertilize 6-8 eggs.

Doctor: Hmm, Dr. Owlish is usually more conservative than me. I can’t let you do more than three. What if we end up with four embryos, and you have quadruplets? They’d probably have all sorts of disabilities. They wouldn’t be able to take care of themselves, you wouldn’t be able to train them. I would haunt you for the rest of your lives. Your lives would be a living hell.

Aaron & Andrea: … Um, we know the concerns, but our history…

Doctor: I know my numbers. I can’t do more than three.

Andrea: Look, we don’t want high order multiples, either. But we fertilized four eggs at our previous clinic, and we only ended up with two embryos for a day 3 transfer for our first cycle, and one embryos that barely made it to blastocyst for a day 6 transfer for our second cycle. So doesn’t that show…

Doctor: I know my numbers. We’re better than your previous clinic. We have much higher pregnancy rates.

Aaron: But doesn’t our track record have an influence?

Doctor: Every cycle is different. I know my numbers.

Andrea: So why, if we know fertilizing four of our eggs in the past did not result in four embryos to transfer, would it be different here?

Doctor: Better eggs. Better lab.

Andrea: Well, have you worked with patients who only fertilized three eggs before? What were the results?

Doctor: It runs the gamut. Some end up pregnant. Some don’t make it to transfer. We don’t have many patients who restrict us this way. I respect your position, but you have to respect that I know my numbers. I can’t do more than three. You might be able to find another doctor in this area that would work with you, that would let you fertilize more eggs, but they don’t have the success rates that I do. I’m sorry, kids; I know this isn’t what you want to hear.

Andrea: (this is going nowhere; let’s change the subject) So, we run all these tests during one cycle?

Doctor: Yes. (standing up to leave) So call on day one and we’ll get you started.

Aaron & Andrea: Wait! Dr. Owlish also suggested donor embryos?

Doctor: Hmm, that’s really rare. Nobody wants to do that.

Aaron & Andrea: more questions…

Doctor: more non-answers… Good luck! (exit)

(end scene)

So, how do you interpret the conversation? We were less than pleased. Whether he’s right or wrong about the number of eggs we should fertilize (and I’m inclined to think he’s wrong, because we know what happened with four eggs fertilized), he is not the kind of doctor I feel comfortable working with. Though this was the first time we met, he didn’t do any introductions and he never addressed us by name. He didn’t really listen to anything we said, and he seems far more concerned with his precious numbers than with the individual patients sitting in front of him. I’m trying, with mixed success, not to be angry at this doctor. I’m glad that my confidence is not in doctors but in God, who does hear me. Our plan, at this point, is to go ahead with all the tests (doesn’t hurt to gather more information) while researching other doctors in the area and considering our next steps.

Oh, and I think the blog nickname for this particular medical professional will be Dr. Ego.

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22 Comments

Filed under infertilization

22 responses to “In an Attempt Not to Bias Readers, the Doctor Character Doesn’t Get Named until the End. Also: Sorry, This is a Long One

  1. Lauren

    I’m almost disgusted by this man. I think you hit the nail on the head in that it seems he’s most concerned with his numbers. And he definitely isn’t concerned with taking your beliefs or preferences into consideration. Sorry you had that experience. Maybe continuing the look for other doctors is a good idea.

  2. GLouise

    Oh man…

    What an experience! I would probably keep looking, too.

  3. Stacey

    Wow. Good name choice for Dr. Ego. Sorry you guys had to sit through that.

  4. lifemoreabundant

    I’m so sorry.

    Isn’t it frustrating? And if your area of the country is anything like mine, it’s not like there are lots of these specialists around. There’s only one RE within 100 miles of my home.

    I felt like a car being examined by a mechanic, not a human being trying to reproduce another human being.

  5. Alex and Jill

    Ugh…new doc now. I wouldn’t want him ‘caring’ for me and my embies. I’m sorry you had to go through that!

  6. Anonymous

    yeah or Dr. Hard of Hearing….

    oh brother…

    wileywomb

  7. Shiloah

    How frustrating, maddening, exasperating, irritating and offensive. I wish I had been a wasp on the wall so I could have flown down and stung him on the a**, or somewhere even more sensitive. You are in my prayers, friend.

  8. Courtney

    wow. I’m so sorry you had to go through that appt. I definitely agree that you might as well let him do the testing while you look for another RE. big hugs.

  9. Sarah Kay

    Oh Andrea,
    When I was writing my book, I invented a conversation with a doctor who treated me like a real person! Most of the time I just wanted to throw my shoe at them. So when I finally found a doctor that I liked, I gave him a copy of my book!

    Thank you for sharing–I know you’re encouraging other’s who think that they must just be dumb or something b/c their doctor won’t talk to them. Thank you for your transparency, you’re both constantly in my prayers.
    Sarah Kay

  10. Anonymous

    When I first read your post I was filled with frustration/sinful anger toward your doctor. Hence, I couldn’t comment. Today, the Lord has helped me to see that he is just another sinner in desperate need of a loving Savior. I will pray for Dr. Ego. (and since I know his real neme, I will pray for him by name.) God is at work in the midst of this trial friend. He is absolutely unable to be anything but faithful. It goes against His very nature to do anything other than be faithful!!!!!!! What a hope we have to cling to!!!

    Love you!
    Aleece

  11. Katie

    Wow, Andrea. When I first read this post, I honestly couldn’t think of something to say in response. I can’t imagine how extremely tempting that conversation must have been! As He promises, I’m praying that God will use even this for His good and His glory. Even when dr’s are hurtful and unkind, Jesus is still your compassionate High Priest!

  12. annikadurbin

    That’s so ridiculous! I can’t believe he wasn’t more sensitive. Shame, shame, Dr. Ego! (Excellent choice of nickname, by the way) You all are right to question his attentiveness in the future…I’d be looking around, too! Praying for you all.

  13. Infertile Friend

    Sorry Dr. Ego was so awful but I fully belive there are more like him out there than good ones! I do love Dr. H – too bad you don’t live closer to Alabama! I’m with you on the cost/benefit analysis of acupuncture/herbs. The nurse called my husband and he told her which questions he had for Dr. H so hopefully she will actually call him back. I’m just too emotional to deal with that right now!! I have heard the Method products are great – I think I’ll look for some glass cleaner and shower cleaner the next time I’m at Target. As for putting our hopes on acupuncture I know that its God that is going to give us a baby and He doesnt’ care if we do acupuncture or not so I hope Dr. H realizes that too. I mean if my eggs are as bad as they say then acupuncture really is just a pacifier – that is my husbands favorite line!

  14. Me

    As a nurse I have worked with more than my fair share of Dr. Egos. Unfortunately, sometimes MDs with GREAT credentials have ROTTEN bedside manner and sometimes MDs with GREAT bedside manner have ROTTEN credentials.

    I will be praying as you and Aaron make this decision about a new RE. I really liked my RE, until he said I was old! LOL

  15. gracechild

    Doesn't sound like the sort of person I would like to deal with but then again, the IF medical world is full of egos so what's another one in the basket? Well my very conservative RE transferred 6 embies after studying my previous cycle. Do you want to wait a few cycles for Ego to change his mind or do you want to go with gut & find new doc or swallow tongue & put up the the freak. I know… options in IF are so "attractive" sometimes. (sorry if this is a bit of a sarcastic ramble.. bad hair day)

  16. Vacant Uterus

    NO. New doc now. That was so incredibly rude! I agree, I think he was more cocerned with boosting his numbers and abiding by his own agenda than respecting you as a patient. Plenty of people are interested in donor embryos! (Um, me?) Plenty of people have beliefs similar to yours. This isn’t about him, it’s about you and God. If he can’t get that, it’s time to walk and try someone new.

    And. You are not *kids*.

  17. Happy Not-So-Newlywed

    Oh my goodness- that sounds so frustrating! Talk about a superiority complex! I really hate doctors- don’t they realize that we are technically their clients? We pay them for a service, so they should be trying to please us! And the fact that he didn’t even know anything about your history before he came in just makes it worse!

    I hope you are able to find someone who will actually be helpful! Good luck.

  18. Hope

    UGH…I felt my face get redder and redder the more read (ok that sentence was strange – but you know what I mean).

    Where do these doctors get off? I think it takes a special breed of docs to work with the infertile. He needs to be a pathologist and do autopsies and such…grrr ok that was harsh

  19. Faith

    That’s just so frustrating! I’m sorry you had to go through it. Good luck as you research new docs . . . .

  20. Katie

    Wow, friend. I know that you really are busy when your blog is staying so quiet! We miss your posts (which, thankfully, are generally a million times more frequent than mine!).

  21. Anonymous

    Hi Andrea,

    How are u doing? Long time – no posts…Busy? Miss u n ur posts.

    Take care,
    D

  22. Arpee

    Hi! Found you at Mel’s (Stirrup) Blog Roll.

    Anyhow, you have gone through a lot already -7 iui’s and 2ivf’s and 3rd RE now! I am amazed by your tenacity!

    BTW, do you have insurance coverage for your IF treatments?

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