Choosing A Reproductive Endocrinologist: What I Wish I’d Known 

I remember taking the call in 2011 from my OB-GYN doctor’s office as I was walking through a crowded office building lobby. It was loud and I was fumbling in my purse for a pen when the nurse said, “We recommend that you see a fertility specialist.” I stopped. I asked her to repeat what she’d said; I was sure that I hadn’t heard right.

But, yes. My FSH levels had jumped since the prior round of bloodwork and instead of trying another IUI with my obstetrician as we’d expected, they were recommending that we see a fertility specialist. The clinic they recommended was just downstairs from their office and they suggested that I call right away.

So, I did. The nurse had made it sound as if my FSH numbers were climbing by the second. I asked the specialist’s office for the next available appointment with any doctor who could see me.

When my husband and I met with him, he briefly explained the IVF process and why he thought it was the right next step for us. He explained that his nurse would meet with me to demonstrate how to administer the medication and to answer questions. The insurance coordinator would talk to us about finances. And then, on the first day of my next period, I was to call and come in to get started. Bada bing, bada boom.

The nurse had made it sound as if my FSH numbers were climbing by the second. I asked the specialist’s office for the next available appointment with any doctor who could see me.

I had no questions because I had no idea what we were talking about.

When I look back on the first year and the first two rounds of our IVF experience I cringe at how ill-informed, underprepared, and disempowered I felt.

Since then, I’ve undergone four additional IVF cycles (with a different doctor) that resulted in two full-term, healthy pregnancies. I’ve also coached many women through their IVF experiences and in choosing the right Reproductive Endocrinologist (RE).

When it comes to choosing an RE, here’s what I know now that I wish I’d known before I began my journey:

Allow Scary or Shocking News to Settle Before You Act  

Rarely is fertility treatment life-threatening. Wait a day, a week, or more to process the information you’ve been given before you decide what to do next. This will go a long way toward your feeling in control of your own care.

You don’t need to get the first appointment with the next doctor available. You don’t need to rush into something that you don’t understand. Pause, breathe, sleep on it, and then determine what you need to know to feel confident moving forward.

Do Your Research  

I can’t emphasize enough the importance of doing your homework. There is so much stress in the unknown. When we don’t feel we have enough information, we don’t feel we can be part of the conversation. You don’t need to know it all, but you need to know enough to feel confident and to trust that you are on the right path.

• Ask your OB-GYN for two or three REs recommendations, and ask the doctor why she recommends them. Check with your insurance company—whether you have coverage and which REs are in your network. Ask friends for referrals. Reach out to people in your area whom have been in your shoes. Resolve lists support groups all over the country. You can also take a look at FertilityIQ which has a database of patient ratings for REs.
• Set up consultations with a few of the REs that seem like the best fit. Check out this pregnantish article on The IVF Process and prepare your questions in advance. Commit to ensuring that you get all of them answered during your visit. Take note of not just the doctor and the protocol they might recommend, but also the clinic atmosphere, the nursing staff, and clinic operating procedures.
• Ask questions about:
  – office hours
  – how to reach someone after hours
  – how patients are instructed about medication
  – how monitoring is handled (and approximate wait times)
  – what procedures the doctor will do herself vs. have a colleague perform.
  – if you don’t have insurance coverage, ask about payment plans, reduced rates, or grants that might be available.
  – if it is important to you, ask about holistic treatment and what the doctor’s opinion is on the benefits of treatments like supplements, diet, acupuncture, therapy, yoga, and the like.
• Explore the process of IVF and the role of the laboratory. This will help you be in sync with what is happening and when. Several outlets have helpful, simple, articles that cover the details of the process and what questions to ask up front and along the way.

Be an Advocate for Yourself  

This is your body, your money, and your family. You can—and should—be a key decision-maker in your care.

This is not the time to be timid or to avoid confrontation because you don’t want to seem impolite. You can be kind while standing up for yourself. Before you start treatment, understand the complete path—including the potential detours—for your cycle. Meet with the insurance coordinator or financial counselor to understand the costs and all of your payment options. Ask for follow-up appointments or calls if you have remaining questions or concerns.

When I look back on the first year and the first two rounds of our IVF experience I cringe at how ill-informed, unprepared, and disempowered I felt.

If you feel you’ve been poorly treated once your treatment has begun, ask to speak with the head of patient services. Having your early consultation research on what was outlined and expected beforehand will help explain your situation with more than emotion, which could be easily dismissed (by you or the clinic).

If you find you are not being listened to, your concerns are not taken seriously, or you don’t fully trust your medical team has your best interest at heart, it probably means it is not—or is no longer—a good fit. Move on.

Build a Circle of Support  

Perhaps not specific to choosing your Reproductive Endocrinologist, but a critical component of surviving infertility is emotional support. Very likely, your doctor or clinic will not be able to provide all the support that you need for the journey. That’s OK—they are great at things few others in your circle can do.

Creating a support team of friends and family, professionals like a therapist or coach, online communities (like pregnantish), or through Resolve or other outlets can help you process your emotions, renew your hope in the face of disappointment, and share experiences with people who have been in your shoes. Your support team may also be able to offer suggestions of other resources that could enhance your treatment.

One of the most important decisions you’ll make in your infertility journey is choosing the care team that will surround you. Protect and empower yourself with information, planning, and support.