Navigating Infertility Doctors: Tips on finding your Reproductive Endocrinologist (Episode 2)
Posted on April 11, 2008
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Reproductive Endocrinologist Jeffrey Fisch , M.D.
Welcome to episode 2 of the Twin Peas Podcast. This episode features 4 great tips to help you select the best fertility doctor for you!
In today’s episode, I discuss how my husband Dave and I navigated finding an RE (Reproductive Endocrinologist) for our IVF treatment. I recommend talking with more than one doctor. Each RE has different opinions about how to approach treatments. Also, talk to other people to find out if the doctor you are thinking about using has a good reputation. Some doctors are known for good and some for bad practices.
In this podcast, I mention Dr. Jeffrey Fisch at the Sher Institute of Reproductive Medicine in Las Vegas, Nevada. Check out the website for SIRM at www.haveababy.com.
Did you miss anything I said? Don’t worry, there’s a full transcript waiting for you — just click the following link!
TRANSCRIPT of episode 2:
Navigating Infertility Doctors
Choosing an infertility doctor, i.e., Reproductive Endocrinologist (RE) might be one of the most important decisions of your life. Your selection may impact whether or not you become pregnant. In this episode, I’ll describe how we chose our doctor and give some tips that we learned that might be helpful to you in your search.
We found three doctors in our local area by asking our others for recommendations. By opening up with everyone we knew we were able to get the names of two of the top local doctors as well as a referral for one doctor with a questionable reputation. Since we didn’t know which doctor might be the best one for our situation, any information was good information to have at the start of our search.
With a few doctor’s names in hand, we did some research on the doctors by visiting their websites and asking people about their experiences. Did they become pregnant, what they liked about the doctor, what they didn’t like about the doctor or their staff, etc. We looked at their success rates, costs of treatments, and payment plans. Most of the doctors we looked at were competitive in most areas such as success rates and costs. No RE’s were covered under our health insurance policy so the choice was ours to make.
We decided to scheduled appointments with two of the three doctors we researched. The first RE was great. He gave us a lot of information about our options based on our medical status and discussed how long each procedure might take and when we could schedule an IVF treatment. He even got us started that same day on a Clomid Challenge because the timing was just right in my monthly cycle. During his exam, he noticed that I was lactating. Odd for a woman who hadn’t yet delivered a baby to be lactating! Come to find out my Prolactin levels were elevated so my body mistakenly thought I was breastfeeding.
We kept our scheduled appointment with the second RE just-in-case we ended up liking him better. We already knew what to expected, to some extent, and we were excited to get our opinions on a second doctor so that we could start our treatments. After more than 60 minutes of waiting in the lobby without any communication from his staff, we left. Dave is not a patient person and he was counting the hours he was missing work, especially since we had liked Dr. #1. Dr. #2’s office called us to try to reschedule, but they weren’t as flexible as we needed them to be to squeeze us in, so we told Dr. #2 no thanks.
We were all set to move forward with Dr. #1. We completed our application and we were about to schedule our first IVF cycle when a friend of mine contacted me with life changing information. The doctor we were about to use was part of a multiple-practitioner office. My friend, Kelly, informed me a woman she knew used the same RE’s clinic, but not the same doctor -keep in mind, and experienced two failed IVF attempts. The news really only mattered to me because our condition was almost an exact replica of this woman and her husband. This same woman went out of town, to Nevada, to become pregnant and did become so with twins at this clinic. So, I needed to learn more.
Not really wanting to repeat the process of completing another application or hassling with an out-of-town treatment I almost ignored the well meaning advice from Kelly to check out this new clinic. But, after checking out their website I was hooked. Some of the information I’d been longing to find in other places was right in-front of me. Something told me it would be worth a telephone interview with a doctor from this clinic.
The interview with Dr. Jeffrey Fisch changed our lives. After looking at my test results, Dr. Fisch made a comment that he thought I might have a pituitary tumor because of my excess prolactin. What? Dr. #1 never mentioned anything about a pituitary tumor. In fact, he downplayed my prolactin levels after receiving my blood work reports. A pituitary tumor is a non-cancerous brain tumor and they are very common in women. Dr. Fisch recommended an MRI to confirm a tumor because he would need to know this information to determine how to treat my prolactin during an IVF cycle.
We talked with Dr. #1 about my possible tumor and he didn’t really think an MRI was necessary and he didn’t think he would treat my elevated prolactin during an IVF cycle. We followed the advice of Dr. Fisch and schedule an MRI. Mainly because Dave and I wanted to know if I did in fact have this odd non-cancerous tumor that can cause blindness or severe headaches. The MRI showed that I did indeed have a small tumor.
With results in hand, Dr. Fisch told us he would treat my prolactin levels to minimize any possible problems during an IVF cycle. Dr. #1 still said he wasn’t going to let the levels impact his decision not to use any medication. However, before making our final decision on which doctor to use, I perused the cost of their plans and the terms they used to describe a successful procedure. Dr. #1’s office used a 23 week pregnancy as a success milestone. Dr. Fisch’s office, on the other hand, doesn’t deem a procedure successful unless it ends with a live birth.
We decided to go with Dr. Fisch because he seemed to be a more thorough doctor and because the goal of his clinic was for us to end up with a baby, not just a pregnancy. Using an out-of-town doctor wasn’t the most convenient choice, but since he diagnosed my tumor over the phone with a few test results in hand, I figured it would be worth the hassle.
Some of my recommendations to you: 1) get more than one opinion on your medial status or your results because their might be one doctor who is more competent than another, 2) find out as much information you can about your options based on your infertility so that you can talk intelligently with an RE about what treatments might be best for you, 3) research the doctor to determine what they deem a success, is it a pregnancy or is it a child, 4) ask others their opinions on which the doctor’s they’ve used. I was part of a support group meeting where a woman made the decision to change her doctor based on the comments from the other women in the group about their doctors. The opinions of others can make a difference.
Dr. Fisch practices at the Sher Institute of Reproductive Medicine (SIRM) in Las Vegas. SIRM has offices nationwide. I’m not advocating they are the only RE clinic to use, but their website, www.haveababy.com is full of great information. Patients travel from around the world to use their services.
Good luck in choosing your doctor. It is a tough decision and one to be taken seriously, especially when it’s your dime.
In my next episode, I’ll talk about how to manage some of your relationships during your infertility journey.
Text copyright 2008 Twin Peas LLC, Music copyright 2008 Disc of Light Media.
» Filed Under Doctors, Infertility, Podcast, Resources
Comments
2 Responses to “Navigating Infertility Doctors: Tips on finding your Reproductive Endocrinologist (Episode 2)”
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Kelly, I’m very excited that you are getting involved with our True Harmony Health Project 2008. I have recently joined True Harmony, and my experience prior to that was in the field of infertility. I just finished reading a few of your blogs, and I was able to relate to many of the stories, especially from Episode 2.
I’m so glad that you did you research and were able to find Dr. Fisch. Sadly, as you know, many women aren’t as motivated as you were. It is an expensive and daunting experience and it is a shame that in some cases a couple’s insurance (if they are lucky) or financial situation will determine who they can and can’t see.
I have worked with more than one RE and each has his or her own style of practice. The physician/patient relationship is so important. Establishing trust and confidence with the patient and LISTENING is so important. As you point out, fertility is not just a physiologic issue – there is so much more that needs to be addressed. Unfortunately, it seems to get lost at times in the hustle bustle of the RE office. Personally, I felt that I did not have enough time to spend with my patients and many of them exited from their initial visit with the doctor confused and many times upset or even angry. Getting information to women before they have their initial visit should definitely increase the chances of them having a more positive experience with whomever they chose.
I look forward to meeting and working with you.
Mary Ann Shostek, PA-C
Thanks for your comments Mary Ann. I’m looking forward to working with True Harmony!