Bedside Manner? Not Optional

Just when I was feeling like the Grinch, having decided that I just can't deal with sending out Christmas cards this year because ours won't have anything in it other than "Merry Christmas and Happy New Year" (and my mailbox is crammed with adorable children in Christmas sweaters, halloween costumes and Red Sox t shirts), something good happened.

I found a fertility clinic that is - if this is possible for such a place - wonderful. If you are lucky enough to live near Boston, I highly recommend it - Boston IVF & The Domar Center. If you're not, maybe they can recommend a similar place near you.

To understand why I was so elated after an infertility visit, let's backtrack a little.

About six months after we started trying, I decided that we should get an appointment with a fertility specialist. Everything I had read said that if you have trouble after 6 months and you're over 35, you should probably see a doctor. At the time, I figured that they'd tell me nothing was wrong, not to worry about it, and to give it more time. "You're young, healthy and have nothing to worry about. Enjoy the last of your childless time - vacation, sleep late - go ahead! Drink too much without worrying about a 2 year old bothering you in your hung over state. Go out seven nights a week without worrying about a babysitter! Go for it!" The wonderful doctor would say, pooh poohing me for worrying.

Um, yeah.

It was a lot more like this: Wait 6 weeks for an appointment, take time off from work for an 11 a.m. appointment, wait in waiting room which is shared with obstetrics (there's a GREAT plan, nice work), wait and wait and wait (doctor took me almost 2 hours late) while watching hugely pregnant women and their happy husbands holding hands. When the doctor finally takes you, sit in her cramped office with no windows, as she reads info about you off of her computer screen and asks questions without looking at you.

At my first visit, other than asking me how long we had been trying, Dr. G asked me no questions. When I told her I'd been off the Pill for six months, she said "Well, if it was going to happen, it'd have happened by now."

The whole experience was cold, impersonal and made me feel like I was taking up her valuable time. I realize that this may not have been her fault due to the fact that she was probably way overbooked - the hospital where she works is one of the best in the country and she was recommended as the best of the best - but it was still really sort of a harsh intro to infertility. In addition, I'd asked if my husband should come with me to the appointment, and the secretary had told me "He's not really necessary." Hmmm. Somehow I think the man who is 50% of the equation IS necessary, and if for no other reason, he should have been with me so that we could have felt like a team and so I wouldn't have felt completely alone. Dr. G essentially said the same thing when I asked her if he should come with me for the HSG test (more on that fun little adventure in another entry). But it gets better.

On the way out, she handed me a brochure for a liquid diet (I had asked her if losing weight would help my chances because I'd gained weight after we got married). I looked at her and said, "Well, um, like I said earlier, I have battled an eating disorder in the past and I think a liquid diet is really a bad idea for me..." she responded with "One of my patients has lost 4 pounds a week on it!" Uh huh. Let's see how fast she gains it back.

I left in tears and managed not to completely break down until I was in my car - paying $30 for parking because what should have taken 20 minutes took 3 hours because of the waiting. Great. So now I knew that if I were going to be able to get pregnant, I'd be pregnant already, and I was basically morbidly obese and needed a liquid diet (I am overweight - about fifteen pounds heavier than I should be - but I think telling someone who is a size 12 and weighed 90 pounds for most of her high school years to go on a liquid diet is just a leetle irresponsible).

Before I scare you and depress you and you decide that you can give up because you've been trying for seven months, keep reading.

There is more to the Dr. G story - which I'll share another time, when I talk about the tests you may have to take (hint: she doesn't get any nicer while causing me breath-stopping pain) but here is what your experience could be like:

Call to make an appointment, and actually get a human being on the other end of the line - someone nice, kind and polite. Have her tell you that you have to wait three weeks but you can come in and talk to a nurse if you'd like to see someone sooner. "I'm sure you want to get started, and I understand it's frustrating to wait," your amazed ears hear.

Be told that your husband/partner needs to be with you for the appointment (this is really, really the way it should be, if you ask me).

Arrive for your appointment and find yourself in a nice, quiet waiting room with cool mod furniture, flat screen TVs, coffee and ice waters. Be greeted by friendly receptionist and even nicer billing coordinator (WOW) who speaks english, pays attention to you, gives you no attitude at all and tells you she likes your earrings. No one tells you in a surly tone that you have to go to the first floor to update your hospital card or that your paperwork didn't arrive.

Be taken by a kind, smiling nurse to meet the doctor. Be ushered into his office - where he's actually sitting - and get this: meet him clothed. No paperthin gown; no waiting on a cold table for 45 minutes looking longingly at the Family Circle on the back of the door and knowing that the second you get up to get it the doctor will come in and think you were trying to steal the free Motrin or birth control in the cabinet; no having to get weighed and changed into a paper napkin designed by Larry Flynt while your husband gets to stay clothed and in the warm waiting room.

Instead, a genuine smile, and someone who explains what's going on. After apologizing for giving us "cold, unemotional numbers" Dr. A tells us that 57% of couples get pregnant in the first 3 months, 73% get pregnant in the first 6 months, and 85% get pregnant in the first 12 months (I might be slightly off on these, but that's what I remember). He explains that this means that after 6 months, our chances of conceiving naturally dropped to 2% a month. Just as I am beginning to get depressed, he says,
"But I feel really, really good about your chances. All of the tests you have had so far have been normal, and while that frustratingly means you are classified as having 'unexplained infertility' the good news is that you are young, healthy and can increase your chances five-fold with IUI and Clomid (we'll get to that later, too)."

While 10% a month doesn't seem so great to me (I have never, ever in my life been a C- or F student and in nothing I've ever tried to do have I been in the lowest 15%) at least that means we have a 30% chance in the next three months.

I'll admit that I'm scared about that other 70%...but somehow I don't dread going to Boston IVF the way I did going to the Brigham. The affiliated Doman Center has acupuncture, massage, yoga, nutrition and emotional counseling. They can help us with the Mind aspect, and Dr. A will take care of the Body aspect.

And one last logistical thing. If you are starting Clomid and IUI, know that you could be doing it in a place that is easier...with Dr. G, my husband would have had to give his sample at 7 a.m. and it would not have been ready for me until 11. I would have had to had the IUI between 11 and 12 p.m. - no flexibility. At Boston IVF, I can go in with my husband at any time on the day of ovulation, and the sperm will be ready within 45 minutes. So he can be with me for the insemination if I want, without having to wait around for four or five hours.

This is hard enough. Make sure that you're getting medical care at a place that doesn't make it any harder than it already is.

-L