I don’t do this but hardly ever, but I’m going to complain about a blog.
Some of you might read it: Infertility Blog by Dr. L1cc1arbi (sp). If you don’t read it but want to have something to refer to after you’re done reading her, you can find it at infertility blog (one word) dot blogspot dot com.
If you do decide to read the post by Dr. L., yes you will see I submitted my response anonymously. That’s why I didn’t provide any links.
He had a post recently which contained an article written by one of his former patients that will be published in a book to be released in a couple of months. This patient basically states to find the best IF treatment centers go online to sart dot org and do a comparison of success rates for the clinics near you.
For the uninitiated, this sounds like excellent and sage advice. If I’m lucky, I will find 2-4 clinics within my area; I can follow those links, and BAM! have my comparison for success rates for all the different kind of procedures each clinic provides. FYI: the Centers for Disease Control and Prevention publishes the same info to which I add this side note: anyone else find it particularly insulting that while the CDC tracks infertility treatment under the heading of Disease Control and Prevention, most insurance companies, family members and friends still consider ART elective and having children a "lifestyle choice"…I’m just saying….
The problem with the "comparisons" is there is no control group or requirements that detail anything more than the patient’s age when submitting data. My SIL tried to convince my husband we should get a consult with the clinic in Denver because their success rates are impressively sky-high Here’s what most people don’t know: many of these physicians maintain higher success rates by excluding women who have hormone levels over/under their "acceptable" ranges.
Admittedly, my clinic had us go through CD3 FSH testing (elevated levels of follicular stimulating hormone indicate limited reserves of eggs), a HCG (hysterosalpingogram to check for tube-blockage and uterine anomalies) and a SA (sperm analysis). These tests were not performed in order for us to be accepted as patients with my clinic, but to provide the most efficient treatment plan possible depending on our level of infertility, even if that meant referring us to other options including foster parenting or adoption.
That’s what a physician is expected to do when treating an Illness or Disease.
Instead you have these clinics who place limitations on who they accept and suddenly and effectively they have taken the word Disease and made it a mockery by declining treatment to someone who truly needs it. On the other hand, if he takes on this difficult patient, he risks lowering his standings with SART.
Imagine if an Oncologist was allowed to do the same. "Oh, your cancer has spread into your central nervous system and liver. Yeah, well, the possibility of remission is rather slim so you will have to seek treatment elsewhere as you don’t pass my minimum level of success." I’d have my pitchfork at the ready if I heard of something so shameful and disrespectful to another person’s illness just for the sake of a bottom line and reputation.
The better advice to couples about selecting their RE is really no different than how you should select any medical specialist: by both your physician’s suggestion and opinions and by word of mouth. I didn’t know of the CDC or SART reports before I made my final choice of the two clinics available in Nebraska. It’s no coincidence that the clinic that came highyl recommended is also the clinic that has the higher success rate overall. It’s too easy to "doctor" the stats to make a reproductive clinic more appealing on paper. Go with the recommendations. Go with your gut. And if you walk in the door and something doesn’t feel right, walk out. It’s your time. Your dollars.
Sometimes it’s easy to ignore the flaws when you’re looking at your RE and the staff through baby-colored glasses, but if you can’t stand your doctor; or trust him/her to have your best interests at heart; or if you feel they are taking you on (or rejecting you) because of how you fit into their fiscal spreadsheet, move on. That’s my advice.