Obviously,
you want to choose a good doctor. It’s hard to know from the start who is going
to be good and who isn’t. They all graduated, right? Recommendations help. And
sometimes, it’s just good chemistry. Also, at the beginning, you don’t know how
far into the whole process you’re going to need to go. In my 4+ years of
experience at different clinics and with different doctors, here are my top 5
of what to look for.
1. They care
about me
This may
seem like something obvious, but it’s really not. Like most doctors, fertility
doctors have hundreds if not thousands of patients. Each one has her own
expectations of how much attention she should be receiving relating to the
problem at hand (including myself). And we’re talking about hundreds of very
hormonal women here. I don’t envy fertility doctors, it’s a hard job. So on top
of all that they have to deal with, my good doctors hav often made me feel like I might be their only
patient. They have seen me on short notice, and have squeezed me in between
other patients. They have always been there for me / us, to get us through
tough results, miscarriages, moving countries or clinics, and have cared to
have conversations that don’t just relate to follicles, embryos, linings, and
sperm.
To be blunt,
if you don’t get a cell phone or email, don’t stay with that doctor. On my very
first appointment with my doctor in Israel, Doron, he gave us his cellphone
number. This is before moving over to IVF. I’m talking about the very first
appointment at the fertility clinic - when you’re at the stage of, “you’re
ovulating today, go have sex with your husband.” Nothing major. And to be
honest, that may have happened once - I think we even skipped that stage and
went straight to IUIs and injections because all the other drugs didn’t work,
and I really did need his cellphone. I wasn’t sure if something was supposed to
hurt or feel uncomfortable or if what I was feeling was a normal side-effect
not to worry about. And even more so, once I started IVF, when the hormones
increase and you feel even shittier, there were more questions. The truth is, I
rarely called him, but knowing that I could was comforting enough. And when we
really did need it, it was useful. Coming home from work at 5 weeks pregnant
bleeding, and hearing from him on the phone that I should go to the hospital
because it’s probably a miscarriage (which it was) was super helpful. I may not
have known what to do and would start reading forums and who says what and why
and isn’t it normal to have bleeding in early pregnancy (it is), and I would probably
drive myself crazy. He was also in touch with us the whole evening at the
hospital by text message and during my 2nd miscarriage a few months later where
I was at 15 on the pain charts of 1-10, he was on the phone with Alon when we
needed him. Doron is amazing, and if you read Hebrew, check out his informative
blog here and like his page. When Doron left to open a private practice, I was assigned to some
super old doctor who was very old-school (nothing against old doctors, just
this one fit the stereotype). I called my previous doctor and asked him, off
the record, who should I go to instead. I convinced the next doctor, Amir, to
give us his cell number even though he didn’t give it out, and we would text him
for urgent matters only. Super helpful!!! Now my doctor here, Yaakov, answers
email almost immediately, as if it’s a text message, and it really makes
us feel more at ease. Basically, have a way to get in touch with your
doctor that isn’t just through the receptionist who goes on lunch for an hour
and leaves at 3pm.
3. Being
flexible and extra nice
Clinics
shouldn’t operate like a fast-food chain. Sometimes there needs to be some
flexibility and you want the staff to be extra nice to you. In Israel,
fertility treatments are free, a part of the public health system. IVF cycles
are unlimited (they tried to pass a law to limit it to 8, but there was so much
push-back that they reversed it). Medications are 85-95% off for the first 2
children. And there is a “ceiling” for medication costs per quarter. It’s very
easy to reach that ceiling even with the major discount, and once that happens,
I would get a couple extra prescriptions to have on hand for the next round or to potentially
donate. Also, in Israel you hold your paper file in your hands as you walk
around from blood work to ultrasound to the doctor (if necessary), but if you
want to order a copy of your file it costs money. One of the secretaries said
to me, “there’s a photocopier, just photocopy what you need, no one will say
anything.” And she was right. Now, for my friends in Israel who are in
treatments I tell them to take a photo of their chart every time they go and to
keep track of everything. It gets confusing the more you play around with
different protocols. In Canada, it’s a lot harder to work around things than in
Israel. In general, people play by the rules. When I used to get the regular
ultrasounds done there was a giant tv screen so that I could see what the
technician was seeing and we’d even talk about it. In Canada, I’m not allowed
to see anything - I think I almost cried at my first appointment here, the
technician was so rude (so I thought) and wouldn’t let me see anything.
Eventually I got used to it, but there was one morning where I had sooo many
follicles and after I shared that it’s still so weird for me that I can’t see
the screen, the technician turned the screen around for me saying,
don’t tell anyone. She was super sweet and understood how interesting it is
also for the patient to see what’s going on in her body. To put it simply, just
make sure the people are nice.
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| A hospital in Jerusalem - looks so beautiful from a distance (c) Rebecca Schwartz |
4. Awesome
secretaries and staff
With the
doctors, come the clinics with all the staff, nurses, lab and ultrasound
technicians, and secretaries. It’s not easy for anyone to wake up super early
to get to the clinic. I remember when I was in Israel and would get up at
5:30am. It’s an awful way to start the day. But there were always big smiles to
greet me. And these women would have to get there also before the 7am start to
set everything up. I always felt that these women really cared about me. There
was one secretary in particular, Sarit, who was always there for me, would joke
around, and would try to make everything easier for us. I remember after the
ultrasound technician found no heartbeat they send me down to emerg in the hospital
(that’s their protocol) and as I was checking in with the secretary at emerg
she suddenly appeared in the back and looked at me (who was all teary-eyed) and
motioned at me like “what happened?”, I motioned back waving my finger to
signal that something went wrong and she started crying. I didn’t mean to make
her cry, but she really cared so much about all the women she would see every
day. The secretary at emerg also came out to give me a hug and a cup of water.
These are amazing women who also deal with all the joys and disappointments
that us infertiles go through and can act as a rock for us.
5. Think
outside the box
When getting
started with fertility treatments it makes sense to be on a similar protocol to
everyone else. You’ve got to start somewhere. But doing the same thing over and
over again is insane, and my best doctors have brought forth new and different
treatments. In Israel, one of my doctors wanted to try this treatment that no
one else was really doing at the clinic and I had to run around the hospital
and pharmacies trying to get the right approvals, and in the end got it. He had
seen it work on other women’s linings to help thicken it, and honestly, it
didn’t work on mine, but he was creative and always thinking of different ways
to help my situation. You want to be with someone who isn’t lazy and tries new
things and can get creative. Be with a doctor who is patient and will answer
your questions. Someone who can look at your history every so often with fresh
eyes, and isn’t afraid to talk to doctors at different clinics for new
approaches. My current doctor never rushes us, will bring in diagrams to
explain things we don’t understand (even if we’re asking for a 2nd or 3rd
time), and has lots of patience. If you don’t understand something, your doctor
needs to explain it to you. At the end of the day, you’re left with yourself
and your doctor might go somewhere else, so try your best to understand what
you’re doing and why.
I have been
very lucky over the past 4 years to be with excellent doctors who feel very
strongly about making Alon and I into a larger family and we are very thankful.
Hope this list is helpful for those of you currently on your journey or
starting your journey.
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