This is a guide to help you through choosing a doctor, whether for the first time or considering and looking into a new doctor. *This post assumes that you are already in the care of a primary care physician or internist and an OB/GYN you see regularly. Please remember your overall health remains the priority.
Before you begin calling doctors offices or asking friends for references, you and your spouse should talk and consider what you want in a physician. Here are some things to consider:
Male or female (do you have a preference?)
His/her background in fertility and/or a specific diagnosis or issue
Consider the driving distance, time and possible additional cost of choosing a doctor
OBGYN vs. Specialist (Reproductive Endocrinologist)
Do you need a second option from another OBGYN?
Do you need or want a referral to a RE Specialist?
If you aren’t sure about a standard RE or the typical treatment path of ART (Assisted reproductive technology - IUI/IVF), consider looking into a physician with multiple treatment paths or offering differing methodology for instance NaPro technology is now offered in more specialist clinics.
Bedside manner and personality
Is it more important for you to connect with the doctor/specialist or his/her staff? Or both
Once in the office, watch how they interact with their staff, you and your spouse.
Are they kind?
Do they take the time to listen?
Are they respectful?
Make a list of questions for potential doctors about their protocol during and after different treatments. Contact Us, if you need help and guidance about where to start with the ethical questions for help & resources. Resource: The Infertility Companion book.
Ask how flexible they are whenever it comes to decisions that need to be made that might not line up with your beliefs.
Smaller practice vs. larger practice
Access to technology and labs
Multiple doctors and opinions
Reputation/ track record
Where does this rank on your list of priorities in a physician?
How will you gauge their success rate?
Consider asking your current doctor for referrals and friends for recommendations.
Examine the percentage of success rate, not necessarily the number.
Note live birth rates as well as pregnancy rates
Compare their success rate to the national average
Western medicine and/or holistic approach
What is most important to you?
Is there any area on which you'd like to focus?
Once you have an idea of what you want, move forward in making your selection. Remember, no physician or staff member will be perfect, but you are your own best advocate, so seek out the best help available. Here are some questions to ask the physician:
Background and training
How long have you been practicing?
Are you affiliated with a hospital or university?
What is your training in regards to fertility?
Do you have a specialization?
How many patients have you treated with ____? (Either insert your own diagnosis, desired treatment or “unexplained infertility”)
Are (they) willing to completely diagnose before they treat?
What is the timeline for moving forward with a new patient?
Are there multiple treatment options?
Note how attentive they are to you and your spouse: your questions, concerns, medical history, goals.
Will you be comfortable and confident in the care of this person?
How do the nurses and other staff treat you? The doctor?
Initial meeting and/or examination
Note exactly what is included in each treatment.
Assisted reproductive technology (ART)
Call your insurance representative and ask about specific fertility coverage and in-network specialists
Ask the doctor/staff about billing, coding and payment plans, as some bill patients directly and make the patient responsible for submitting to insurance
Ask if they can bill as many services as possible to your insurance. There are many services that are done that may not be specific to “infertility,” such as blood tests, examinations, ultrasounds, etc. Many Reproductive Endocrinologists may have a set price for each type of treatment, but if they can receive some reimbursement from your insurance company then this could potentially offset the out of pocket total that you end up paying.
Helpful links: Though this is not an exhaustive list, we hope and encourage you to find and read credible, accurate, helpful information. PLEASE do not perform a blind Google search.
American Society for Reproductive Medicine (ASRM): Written for medical practitioners, this site also contains the latest info on fertility, including facts, treatments and research. http://www.asrm.org/
Society for Assisted Reproductive Technology: An affiliate of ASRM, this site has patient-specific pages covering all aspects of assisted reproductive technology (ART). http://www.sart.org
American Fertility Association: This site offers an extensive online library, webinars, coaching and online expert services, a resource directory, daily news, and other resources. Membership is free, though you must register. http://www.theafa.org/
Centers for Disease Control & Prevention, Fertility Clinics success rate reports (Note: it takes up to two years for CDC to receive reports from clinics). http://www.cdc.gov/art/ARTReports.htm
State Infertility insurance laws: http://www.asrm.org/insurance.aspx
Society for Male Reproduction and Urology: The mission of SMRU is to promote the advancement of the understanding of male reproductive physiology and management of male infertility by providing a forum for the dissemination of both basic and clinical research data and support of educational programs. http://www.smru.org/
Waiting in Hope Resources:
An infertility community is a great place to beginning asking for references especially if you don't have friends or acquaintances walking or who've walked through infertility. Join a community, a local support group, somewhere to begin asking the hard questions, hear others decisions to help or guide you as you pray through your own decisions. Disclaimer please be selective with your community and group you choose. You will be best supported if you know what you need during this time, like a positive place of hope and help. Not just mourning and complaining, which will not be life-giving and encouraging during this season.
Remembering your path will not look like Sally's we are all different and God is leading each of us down different stories. Seek the Lords will for you and His desire for your ways. Knowing with confidence if you are truly seeking after Him, He will guide and not let you go down the wrong path. He is sovereign and powerful overall, even our decisions and especially sovereign over any doctors opinions, diagnosis, and medicine. It is no match for an all-powerful God. "With man this is impossible but not with God all things are possible with God" (Matthew 19:26). Isaiah 46:8–11
Please join the Waiting in Hope online community, Waiting in Hope Chats or one of our local support groups to find hope, encouragement, and purpose during this season. We would love to get to know you.