A Tale of Two Clinics

There are two large fertility treatment centers in the large metropolitan city in the neighboring county. The first is affiliated with a large teaching hospital, and the second is a private fertility clinic. Their ranking in most areas is the roughly the same, and the price of treatment is also similar. I am insured by two excellent PPO insurance carriers, (who probably won’t be sending me holiday cards this year) but neither plan offers fertility coverage.

My initial fertility work up and first round of IUIs were done at the large teaching hospital, mostly because my primary care doctor belonged to the IPA affiliated with the hospital. There are a lot of good things to say about that center- the staff physicians were excellent, the lab was excellent, and a wide range of specialists collaborated with the center to provide ancillary tests and analysis. As I progressed through treatment, however, I encountered some issues that were so serious that my husband and I decided to leave the large hospital and pursue treatment at the private center. Specifically:

Teaching hospitals have a dual purpose: to treat patients and to train physicians, (also to conduct research, more on that in another post) and those activities generally amount to the same thing, as far as patients are concerned. You know the doll who gets yanked off the shelf for the community CPR class? Congratulations, you’re that doll. And while I am the first person to appreciate that physicians have to start somewhere, my personal experience, as a CPR doll was, how to say not exactly, exquisite. Here were two problems that could have been avoided:

- I researched my Reproductive Endocrinologist (RE) a lot, and luckily enough, she accepted me as a patient. So far, so good. However, she was not the clinician who performed most, or any, of the actual procedures, and probably more importantly, she was not the physician who monitored my progress. Or, at least, not until I developed multiple cysts after several months on Clomid- cysts that should have been monitored prior to every procedure, and were not.

- There’s a new commercial for a pregnancy test (I have no idea if it’s a new pregnancy test), with the byline “1 in 4 woman can misread a traditional pregnancy test.” Ok. Fair enough. I suppose that under the right circumstances, 1 in 4 people can misread nearly anything, so I’m not going to deconstruct that statement. But the Ovulation Predictor kits suggested by my RE….good lord. Now that was rocket science. I need to devote an entire post to explain why this was so. But in any case, it is for this reason that the private clinic doesn’t use them at all, instead relying on ultrasound monitoring to appropriately time IUIs. Also, the private clinic uses ultrasound monitoring to look for the development of cysts. Also the private clinic uses ultrasound monitoring to ensure that CLomid hasn’t decreased the ovarian lining to a thickness that would not be conducive to implantation. For those three reasons, my IUIs at the teaching hospital were pretty much pointless. I think I should devote another blog post to why exactly one probably doesn’t want to go through pointless IUIs, with the adroitly named TomCat catheter.