Knowing when to trust your doctors - and when not to
Photo by Walter Otto on Unsplash
Ok we’ve talked a lot about the process of getting pregnant, but not the people who make that happen. One thing that I’ve found absolutely appalling about this entire process is that the fertility industry is basically the medical version of the wedding industry. It really feels set up to prey on women when they are at their most vulnerable.
I’ll say upfront I’m very pro-medicine and science, pro doctors, pro vaccines, so my disdain for fertility clinics does not extend beyond this very specific field of healthcare.
My experiences with two large Toronto fertility clinics has been rough so I thought I’d share some of the red flags I encountered with my doctors so you can go into things with more open eyes than I had.
Clinic #1: Starting from scratch
My first clinic I chose for location. It was in the west end, affiliated with a large downtown clinic, and easy to get to. In hindsight, my bar should have been higher.
I did both my IUI tries at this clinic and I do wonder if I’d gone back to IUI instead of IVF at my second clinic whether I would have had a better experience. Ah hindsight.
There were a few red flags at this clinic I encountered:
Warning #1: Vanishing doctors
My first doctor was a woman who actually had her name on the door. I met her twice before she literally disappeared. Yeah, that’s right. Without a word or explanation she vanished like a poof a smoke. Did she retire? Move to another clinic? Get eaten by a polar bear? I’ll never know. One day another woman showed up to utterly botch my first sonohysterogram and that was that. I thought she was a nurse since she never introduced herself, but when I came back in for my results, lo and behold she was in fact my new doctor. They were clearly running a tight ship over there.
Warning #2: Lies and misinformation
I was routinely given the wrong information at my first clinic so I urge everyone to do their own research. You need to be the expert because you never know who will lie to you and who won’t. Before she disappeared, my first doctor told me I needed to get fertility counselling to proceed. Fair enough. I got an appointment for January and expressed my concerns about needing to wait two months and missing my December window. My doctor assured me it was no problem and we’d proceed with December anyways since my January appointment was booked. Yay! So I worked towards December as normal with her and when I went to book my IUI, the receptionist told me it was illegal (it wasn’t) without my counselling appointment first and refused to book me. Queue the vanishing doctor. I was delayed 2 months due to a straight up lie. Not that there was ever a consequence for that.
Warning #3: Hidden fees
HIDDEN FEES ARE EVERYWHERE! Do your research and ask clinics their prices upfront before you choose one. Between my first and second IUI rounds the cost went up $500 with no warning. The clinic insisted they needed to pre-wash the sperm sample. When I pointed out I’d already paid extra to buy a pre-washed sample at their insistence, they just shrugged and charged me anyways. I told them point blank I wouldn’t return for a third try here if this didn’t work. They could not have cared less. It’s all about quantity, not quality, in the fertility world. As long as they can book the next poor woman into the spot, all is fair.
Warning #4: Careless doctors
Everything was more painful at this clinic. My sonohysterogram nearly had me passing out it was so painful. The doctor kept blaming me for being tense as she poked at my insides ineffectively. I thought she was right and it was something I did until I had a second one done that was a breeze. It was 100% the clinic but again, they don’t care about anything but numbers so why bother with patient comfort?
Clinic #2: Changing fertility clinics
I hit my boil point with the first clinic and decided to switch. Changing fertility clinics is not an easy process so I highly recommend doing your own research before jumping from one to another as it will delay your fertility journey. My switch cost me about 4 months. I was directed to one of the most popular clinics in the city, this time right downtown. I got on the wait list around February and luckily got an appointment moved up to the next month (originally it was going to be a 3 month wait). Huzzah! I thought.
I had a phone appointment with the highly recommended doctor I was looking to transfer to. She sounded great on the phone and explained I’d need to redo some of the tests from the last clinic, including the dreaded sonohysterogram, so she could get a better idea what was going on. I agreed and we started the process. The red flags I ran into at this highly regarded clinic include:
Warning #1: Female patients are FORCED to have male doctors
Yeah. You read that right. This clinic has far too many patients to offer appropriate medical care and one of the ways that bites women is being forced to have male doctors for incredibly intimate exams. I flat out refused to go to the male doctor who was booked to do my sonohysterogram and was told too bad so sad. If I wanted a woman, I’d have to delay my test a month and hope a female doctor was available. When I said fine push it back a month they give me the surprised Pikachu face. I then made it extremely clear that under no circumstances would I let a male doctor be any part of my fertility team. I was warned that my stance might result in losing an IVF round later on since they can’t guarantee anything.
Please TALK TO YOUR CLINIC about the use of male doctors and for what tests if you don’t want them on your team. If having a man poking around your business is a red flag for you, better to know before you jump clinics. Losing a round you’ve invested thousands in is no small matter and I was horrified by this trap when I learned about it far too late.
Warning #2: Vanishing doctors (again)
I made it through my tests and was ready to hop back onto the IUI train. But then my doctor disappeared without a word. Again. The doctor I had waited for and specifically selected. She was the only reason I’d picked this new clinic. Then poof, she was gone. And then this well known clinic left all her patients waiting for THREE MONTHS before moving us to new doctors. Talk about incompetence.
Warning #3: The hard IVF sell
When I did finally get to meet my new doctor I was about 6 months delayed from my fertility plan at that point and very pissed off.
With very little consulting, my new doctor pushed me hard to switch from IUI to IVF. I told her I didn’t think I needed to do that yet and to look at my test results. Again she harped on my age and painted a very scary scenario of me never being able to have children if I kept delaying and hoping IUI would work.
She then danged the “free” IVF round the Ontario government offers women. If I switched to IVF, I’d have this funded round within two months. It was a very attractive sales pitch. She did it perfectly.
In hindsight, I wish I’d stuck to my guns about the IUI. There was no reason I couldn’t have tried 2-3 more times and saved myself over $10K in the process.
Warning #4: Beware the IVF machine
What I think happened is that fertility doctors and clinics make far more on IVF than IUI. This new clinic breezed by IUI as if it wasn’t an option at all and pushed me full force towards IVF. I deeply regret letting that happen, but once you start on the process, you immediately spend so much money you’re really stuck in it. It feels easier to keep moving forward than to face the sunk cost of your treatments and return to IUI.
So here’s my advice, if you are headed for IVF, be really sure it’s the right step for you. Don’t listen to your doctor telling you horror stories. Talk about your test results with your GP to get an opinion outside of the fertility circuit and do research. Then make an informed choice and pick a clinic that will respect that.
I very much felt like a number throughout this entire process. Just one more sad clog in the giant IVF machine.
Warning #5: When medical care is fobbed off on others
My doctor was barely involved in my IVF cycle. Once she got me roped in, nurses took over my primary care with the help of a terrible app – iMine IVF. With IVF, you go into the clinic often for blood work and ultrasounds to track your progress. Then a nurse updates you on where you are in the cycle at the end of each appointment.
In place of telling me instructions face to face or teaching me about things like HOW TO STAB YOURSELF WITH NEEDLES, this clinic opted to load all those instructions into the glitchy app. Some modules would include videos on how to use your needles properly, but almost all the videos cut off before the end, leaving you wondering where or how to actually finish the application. Often I taught myself with YouTube videos.
Again, I just felt like I was being moved through the IVF machine. No one cared about my personal results or plans. It was very much a one size fits all situation. This resulted in me only having 2 viable eggs collected so I can’t even look back and say this process worked or was necessarily worth it. If I had to do it again, I wouldn’t stay at this clinic.
Warning #6: Hidden fees
That “free” funded round was a great song and dance to get me to sign on the dotted line, but heed my warning, do not fall for the woman in the white coat offering you candy.
I was told my funded round would cost about $5K for medications and “extras.” The doctors knew full well that was a lie. My medications alone were closer to $10K and those extras were about $5K on their own. Hell, the recommended embryo genetic testing I didn’t even do is $4K on its own, something the doctor was well aware of.
Talk to other women who have been through the process. Interview clinics before you sign up for them and ask point blank about costs beyond medication. These clinics have no obligation to tell you the truth upfront unless you make them.
Warning #7: A general lack of support
My clinic had far too many patients to provide adequate support to us all. They even mentioned this decision as a point of pride in their emails, saying they had the option to limit their clinic list, but decided IVF should be available to all women so they would take everyone. Everyone who could afford the exorbitant fees, of course. There was no mention of any program in place to help those who didn’t have the finances to pay their costs. So in reality, all they were admitting to was wanting to take as many women as they could cram in so they could cash those pretty, pretty checks.
And being their patient absolutely felt that way. Questions were ignored. Requests to speak to a doctor were ignored. If you took up a minute of extra time during your check-ins you were made to feel like you were delaying all the other women in the clinic trying to get through their results and off to work for the day. It was an awful patient experience and I’m so glad I never have to see that clinic or those doctors again.
Bottom line
So what did I learn from this weird and stressful process I sort of fell into? Here are my tips:
Do your research and interview multiple clinics before committing to one. Ask about medication fees, hidden fees, fertility extras such as testing and storage, and how they handle patient care. If you hear the word “app” run for the hills.
Be realistic about costs. Do you have $15K to drop on an IVF round right now? If so, cool beans. If not, come up with a plan or look for funding options. Once you start the process, it’s very hard to pull out of it because of the increasing sunk costs of the treatment. Remember to budget more than you think you’ll need in order to cover the hidden fees that WILL pop up.
Decide yourself if you want to stay with IUI or move to IVF and don’t get swayed by your doctor. They want you in IVF. It’s better for them if you agree. Make the decision for yourself and inform your doctor, not the other way around.
Don’t be intimidated by a white coat. All it means is opportunity, not competency. Doctors are human and you have every right to grill them about your medical care before you commit to a procedure. Ask questions and if they get exasperated with you, move on to a doctor who wants you to take your time and feel comfortable with your informed decision.
Look online for resources. There is so much information about IVF out there now. Spend a weekend and educate yourself as much as you can so you have a better understanding of what you’ll be doing to your own body.
At the end of the day, the reality is women wanting to be a mom alone need some scientific help. You have to go to a clinic and you have to face these issues. But forewarned is forearmed. So ask questions. Do research. Interview women who have been through the process. And pick the clinic, and doctor, that’s right for you.