Goldilocks and the Four REs

When I first recognized that I may have a problem conceiving, my husband and I were already one miscarriage deep, less 12 months of our lives. I brought up the subject of my fertility with my gynecologist who did some initial testing and sent a referral in to “his friend from medical school who is a fertility specialist.” That’s how the decision was made regarding whose care I would be under and which clinic I would go to.

Isn’t that so arbitrary?

I didn’t know at the time that the relationship I develop with my Reproductive Endocrinologist (RE) would be an important one. Had I known, I’d have been a bit more involved in the decision-making. Instead, I was mostly excited by speed: my goal was not just to make a baby, but to make one as quickly as possible.

In my journey to conceive, I’ve been under the care of or consulted with four separate REs. And through this experience, I’ve learned that not all REs are created equal. I’m not talking about their training or knowledge, although it most likely also differs from doctor to doctor.

I’m talking about “fit” – the compatibility between you and your RE, and you and your clinic.

Fit differs from person to person – what I need in an RE and a fertility clinic is not necessarily the same as what you need. In fact, what I need today is different from what I needed six years ago at my first consult.

If you are reading this post, new to the infertility experience, or feeling like you don’t have the right ‘fit’ with your current care, I encourage you to think about what you need and to be an active participant in your quest for the right RE. Here are my tips:

Write down and prioritize the characteristics and attributes you want in an RE.

Maybe you care more about compassion and empathy than years of experience in the field. Really think about what is important to you and how important it is to you.

Do your research.

There are local support groups, message boards, and even your own doctor(s) (e.g., family doctors, gynecologists, etc.) who may have insight into the particulars of REs and fertility clinics. They are a great resource.

Make your first consultation an interview.

The purpose of your initial appointment is for an RE to get patient history. However, there is nothing stopping you from using some time in this appointment to get a better sense of the RE and the clinic. Here are some questions you can consider asking in that initial consultation:

• What do you feel makes a positive doctor/patient relationship?
• How would your patients describe you?
• What do you feel are the best attributes of your clinic?
• How do you communicate with your patients? E-mail? Phone? Through nurses or directly? How quick are response times?
• What makes you and your clinic different than others?

Don’t settle.

We’re so rushed in this process to move forward with treatments that we often sacrifice some of the things that are important to us. We accept insufficiencies in care because we don’t want to waste the time to find a different clinic/RE. I’m guilty of this and it is my biggest regret in this journey.

As I mentioned, I’ve been in the care of or consulted with four very different REs at three very different clinics. My first RE was not really  accessible for questions or concerns, and didn’t take the time to explain things to me. But we successfully made a baby with her help, so I am forever indebted to her.

My second RE was very focused on natural solutions, which was not a priority for me, and by the end of our relationship, it was clear that our personalities and approaches were not well-aligned.

The third RE was simply a consult – he was very experienced with a no-nonsense, no sugar-coated delivery, which my husband loved, but at this stage in our journey, I needed a little more ‘sugar’.

And then there is my current RE. My current RE listens to me, remembers details about our journey without having to be reminded, asks insightful questions, counsels rather than instructs or lectures, never makes me feel rushed, values my input, and works collaboratively with me and our specific needs. I feel like he ‘gets’ me, allowing me to be myself when we meet, making for a more productive relationship and for a more customized approach to my care. For me, he is just right.

What is ‘just right’ for you?