After struggling to conceive for about a year, I scheduled an appointment with my OB/GYN to see if anything was wrong. She couldn’t find anything unusual and so referred me to a private fertility clinic in New York City for additional testing.
We had been using an ovulation predictor kit, but I traveled a lot for work so we didn’t always get it right. While we were starting to worry that there might be a larger issue, we still felt that our chances of conceiving naturally were pretty good.
We hoped that the additional testing would give us a clean bill of health and alleviate some of the stress we were feeling, which, in turn, would help me get pregnant. For us, going to this specific clinic was opening Pandora’s box and rather than bringing us closer to our goal of having a child, it set us back.
My story is about two faces of the same industry: one honest, compassionate doctor that I call Dr. Jekyll and one money-hungry, unethical doctor that I call Mr. Hyde. There are many Dr. Jekylls out there and unfortunately there are also many Mr. Hydes.
I hope my story will give some insight into the infertility machine and help you to identify early on whether a doctor is a Jekyll or a Hyde, however, you can also skip the story and go right to suggestions on How to Find Your Own Dr. Jekyll.
If you are new to the fertility game, I recommend you first read my post, “What is the Best Treatment for Unexplained Infertility: Clomid, IUI, and IVF?” It will explain the procedures and acronyms used in this post and will hopefully help you laugh at a situation that isn’t terribly humorous.
My experience with Mr. Hyde:
We arrived for our first appointment with Mr. Hyde to a crowded waiting room, in a swanky office, and waited over three hours to be seen. After our consultation we were given a tour of the premises so we could see, “where the magic happens.”
We didn’t feel comfortable with Mr. Hyde, but my OB/GYN, who had interned in his office, warned us that his bedside manner was, “a bit abrupt.” She had also told me that, “if anyone can get you pregnant, it’s Mr. Hyde.” We were very impressed with his statistics and with his offices. If all these couples were waiting three hours to see him, he had to be good, didn’t he?
When preliminary testing didn’t turn up anything unusual, I was diagnosed with unexplained infertility and Mr. Hyde prescribed an Intrauterine Insemination (IUI) with injections. We were surprised, we had never heard of unexplained infertility and thought that if we didn’t have any problems we would just continue trying and it would happen eventually.
Mr. Hyde told us that if we had been trying for a year we definitely had a problem and our chances of conceiving naturally were very slim. He then explained IUI to us and told us about his success rates. It was January and Mr. Hyde said he saw no reason why we shouldn’t have a baby by the end of the year, if we followed his protocol.
We latched onto that and jumped into our first IUI with enthusiasm. It wasn’t easy, I had to give myself daily injections and travel regularly from Brooklyn to Midtown for 7am monitoring. The waits were outrageous and the office staff were rude. Any question was met with long sighs or silences, and on a number of occasions I saw the receptionists shouting at patients for making one mistake or another or for complaining about the long waits.
On my first round of IUI I ovulated early, which I found out later meant my chances of conceiving that month were close to nil. Mr. Hyde neglected to advise me of that and instead insisted that I rush my husband in so I could do the IUI post ovulation. Had he not done the IUI, he couldn’t have billed me for it. Not surprisingly it didn’t work and so we tried again with an additional injection to prevent early ovulation.
I spent an awful lot of time in Mr. Hyde’s office, and no one made an attempt to learn my name or take an interest in my case. I was just shuffled through the system, along with so many other women. On the mornings I had to go in for monitoring, I would wake up angry in anticipation of what I was about to endure.
When the second round of IUI failed, Mr. Hyde said I would need to have an exploratory surgery to check for endometriosis. I was not happy about the idea, and questioned it, but he assured me that it was necessary and that if there was endometriosis he might be able to remove it so I could conceive.
The medication had taken effect and I lived life on an emotional roller-coaster. Flying high for part of the month with the hope of a pregnancy and then crashing low with each failure. Every time I crashed, Mr. Hyde had one more treatment up his sleeve to tempt me with. Each one more expensive and more invasive than the one before.
We consented to the surgery and while I was in recovery, Mr. Hyde told my husband that there was very little endometriosis but that if he wrote that on his report our insurance wouldn’t pay. He said that he would report that I did in fact have endometriosis so we would not be unnecessarily out of pocket. We thought he was doing us a favor, but we found out later that he was covering himself since he had just performed an unnecessary surgery.
I was put on birth control pills so that we wouldn’t have to wait another cycle to start the next procedure. I didn’t tolerate them well and felt sick the entire time I was on them. We had another consultation with Mr. Hyde and again waited for over three hours to be seen. We were told that since both rounds of IUI hadn’t worked he didn’t believe that additional rounds would be successful. Our best chance of conception was In Vitro Fertilization (IVF).
We had some reservations about IVF in general but especially some ethical concerns regarding freezing extra embryos. When I spoke to Mr. Hyde about this, he told me that I would be stupid (yes stupid) not to freeze any extra embryos. He kept telling me that it would be penny wise, since I wouldn’t have to pay for their storage, but dollar dumb, because if the first IVF didn’t work I’d have to start at the beginning again.
He couldn’t understand that this was an ethical decision for us and not a financial one. It was the first time we went against anything Mr. Hyde had recommended, and he made it clear that he was unhappy with our decision and thought we would regret it.
He also recommended that we have Intra Cytoplasmic Sperm Injection (ICSI) done. We were hesitant, so he suggested, “we do a little experiment.” He would do ICSI with half the eggs and put the remainder of the eggs and sperm together to see which worked better.
We agreed to this and, despite all the stress surrounding it, the IVF worked. I got pregnant and I was over the moon. All of my numbers looked good and I was confident that I would finally become a mother and all this unpleasantness would soon be behind us.
At my seven-week ultrasound there was no heartbeat, I had miscarried, and I was absolutely devastated. The day Mr. Hyde performed the Dilation and Curettage (D&C) to remove the embryo, he told me that I would need to go back on birth control pills so that we could try another round right away.
I asked why he wanted me back on the pill when it made me so sick, and I was about to tell him that I needed some time to grieve before I could think of trying another round of IVF, but he cut me off and barked, “because that is what I’m prescribing.”
After that appointment, I never returned to see Mr. Hyde. I was devastated by the miscarriage and angry at the lack of compassion, or even civility, I received at Mr. Hyde’s office. We decided that we couldn’t emotionally or financially commit to any more procedures.
We took a long break from medical infertility treatments and focused on getting my health back. I was exhausted and depressed after all the medication, procedures, and disappointments. During this break I turned to alternative therapies, you can read about those experiences at “Does Acupuncture Really Work for Unexplained Infertility; What are the Benefits of TCM Treatments?” and “Mayan Abdominal Massage: Arvigo Therapy.”
My experience with Dr. Jekyll:
About ten months later, my husband was offered a job in Zambia, Southern Africa, that we decided to take, and with that decision returned the panic that if we didn’t do something now we might never have children of our own.
This time we were cautious and researched a number of clinics before we settled on Dr. Jekyll. Dr. Jekyll was offering a half price special on IVF that certainly influenced our decision but more important was his honesty and sincerity. He took one look at my records from Mr. Hyde and said, “well the problem is obvious, you have severe endometriosis.” When I explained the conversation after the exploratory surgery, he shook his head and told me that he would need to read my medical records, “between the lines.”
He then asked what symptoms I was having to warrant the surgery. I hadn’t had any symptoms, and Dr. Jekyll explained that surgery often negatively impacts fertility and shouldn’t be done unless there are clear signs of endometriosis.
He questioned why ICSI had been done to fertilize our eggs, so we explained Mr. Hyde’s experiment and that we had no viable embryos from the eggs that were not fertilized with ICSI. He told us that this was not an experiment because only the very best eggs could be used for ICSI since the first layer of the egg needs to be stripped away. This meant that the remaining eggs were inferior and couldn’t have produced better embryos.
He then asked why we never tried Clomid or an IUI with Clomid, we shrugged and said it was never offered to us. We then heard that IUI with injections is usually done to see if a patient would be a good candidate for IVF.
At this point we finally realized that, not only had Mr. Hyde taken us for a very expensive and heartbreaking ride but he had also ordered an unnecessary operation that could only have decreased my chances of conception. He was, however, able to bill us for it.
He ordered ICSI when there was no clear reason for it and lied to us about his “little experiment”, but he was able to bill us extra for it.
He didn’t offer us Clomid because he wasn’t interested in a lower cost, less invasive treatment for us. He couldn’t have billed as much for it as an IUI with injections, and he wanted to get us onto IVF as soon as possible since that is where he can make much more money.
He became angry with us when we decided not to freeze any extra embryos because he wasn’t able to bill us for it. After everything we had been though, it infuriated us to realize that Mr. Hyde had used our desire to have a child as emotional blackmail to get as much money out of us as he possibly could.
Dr. Jekyll is a professor and is salaried, so he doesn’t stand to gain anything by ordering unnecessary tests or procedures. He offered us an array of choices from trying Clomid, to IUI, and IVF. He explained our chances of success with each option so that we could weigh that up with the financial cost as well as the emotional and time commitment costs.
Dr. Jekyll told us to think of our options as a menu and that we could make the selection that suited us best each month. He even said that with unexplained infertility taking a month off to try naturally is a valid option. It doesn’t carry the same success rates as IVF, but it can be successful and shouldn’t be taken off the table.
Since time was an issue for us, with the upcoming move, we decided to give IVF one last shot. It worked and my oldest daughter is the result of that procedure. I never waited for more than 20 minutes to see Dr. Jekyll, despite the fact that he had a very busy office. The nurses and doctors all made an effort to learn my name, and I was treated with respect and dignity. It was an entirely different experience from what I found at Mr. Hyde’s office.
I most certainly would have been devastated if this last attempt hadn’t worked, but I can honestly say that I wouldn’t have been angry at Dr. Jekyll. Every experience we had at his clinic further solidified our belief that he had our best interests at heart, and we never felt pressured into anything we weren’t comfortable with.
How to Find Your Own Dr. Jekyll:
I have to take some responsibility for ending up with Mr. Hyde. There are many things I should have done, and didn’t, so I’m going to list them here for you in hopes you can go straight to Dr. Jekyll, or at least minimize any time wasted with Mr. Hyde.
If you are reading this post and haven’t yet started treatment, you are already a step ahead of where I was. Know what your options are and understand what the current standard of care is. That way you will recognize early on, possibly even at your first consultation, if you are with a Mr. Hyde. One of my mistakes was getting my infertility education from Mr. Hyde. I should have done my own research.
Get a referral
If possible, start with a doctor that has been recommended by someone you trust. My OB/GYN referred me to Mr. Hyde, so this isn’t always going to work but it is better than going in blind. In my opinion, a referral from a current or former patient will tell you a lot more than a referral from a doctor who might have ulterior motives for referring to a specific specialist.
Understand the statistics
I was impressed with the statistics I’d heard about Mr. Hyde’s office. The success rates seemed very encouraging. Later I found out a pregnancy was considered a success, even if it didn’t end with a live birth. Fertility statistics are self-reported and can be manipulated. There is a great blog, Fertility Success Rates, where you can learn a lot about how statistics are reported and how to interpret them.
Know how your doctor makes money
There have to be many private clinics that make their money honestly with their patients’ best interests at heart, however, after my experience with Mr. Hyde, I took a lot of comfort in the fact that Dr. Jekyll worked at a teaching facility and was on a salary. He made the same amount each month regardless of what treatment I chose, which meant there was no financial incentive for him to recommend something that was not in my best interest.
Trust your gut
Nothing felt right about Mr. Hyde. I didn’t like him, I didn’t like the clinic, and I didn’t feel like I was an active participant in my quest toward motherhood. I thought about walking away and starting over constantly, so why did I stay for eight months? I didn’t trust my gut and that has always gotten me into trouble. I never should have stayed past that first consultation. I rationalized that there was no guarantee that another doctor would be any different, but the reality is that there are so many choices in this ever-expanding field. Trust your gut and if something doesn’t feel right move on. There is a doctor out there who is right for you and his name is NOT Mr. Hyde!