Forewarning; This may read as jaded, bitter, and angry and it likely does have a bit of that laced throughout these paragraphs, but as you read this – Truth Bomb – you might find what I am saying as eerily relatable – or if you are in healthcare, like me, you might read this as a horror story for Canadian medical care.
I want you to understand that mine wasn’t the Spa-like experience you see on TV…. no, instead I got the bargain basement clinic, and lack luster care. A loud blood processing machine hums incessantly to the left of the administration desk, bankers boxes are piled in corners, and the room is lined with unlocked filing cabinets with Client files of past, present, and future visible for everyone to see. The carpet is stained the walls are yellowed, in short, esthetically it isn’t the place you come with a hopeful heart and expect to leave with your dreams come true.
The accessory staff are friendly, though, not one ever greeted me with their name and designation, so even months later I cant tell you if they are nurses or technicians or what have you… but they were definitely the friendly ones, so I held on to that.
I first met with my Doctor in early 2012. My initial reaction from our very brief encounter was that he was pompous, forward, and rude. It is my understanding he acknowledges this about himself and makes no apologies. but does that really make it any more acceptable?
I’ve been argued with over my thoughts and experiences here, so I will say that I understand that being smacked in the face with the truth instead of having it served delicately on a platter is what some clients like, I don’t agree, but I am glad to have cleared that up.
The message I got from that first (I will be gracious) ten minute meeting was loud and clear, he could tell by the hair pattern on my jawline that I had PCOS, and just like that it was added to my forever medical record – a very technical process you know! I left the office strangely self-conscious of my appearance and with a carbon copy prescription for my new medication, and some requisitions for day 21 Blood work.
I want to be very clear here aside from being instructed to take this pill on cycle days 3-7 I was not provided with enough information about this medication in order to provide informed consent to taking it. He didn’t care… and whether he is confident in what he is doing or not, he didn’t care that whether I left feeling confident about this endeavor. Maybe he was overbooked that day, maybe he was tired, maybe he was behind on paperwork – but none of that was my fault and none of that has anything to do with whether or not I should have been given the opportunity to provide informed consent.
I left incredibly angry. I waited a whopping six months for this appointment. I invested what trust I could muster from my broken state into that small token of hope he handed me, and figured what harm could come of this. Truthfully though, I was angry that he didn’t do a work-up, how quick he was to decide that my sole issue was PCOS (which he wasn’t wrong about) but I wanted to rule out the hundreds of other factors that affect fertility – a blocked tube, an inhospitable uterus, a heart-shaped or tilted uterus (which I also have by the way), low sperm motility/quality, hormonal imbalances (also me), endometriosis, polyps/cysts/ or fibroids… the amount of other factors out there is practically endless. Long- story short my diagnoses wasn’t spawned out of due diligence, it wasn’t even really an educated guess, it was an assumption because he had seen hundreds of other women sit in that same chair with the same facial hair pattern and jumped to this conclusion.
In short, I placed my bet on the roulette table and three months later I rolled a winner. There was no sure thing, there was no medical certainty… he got lucky that he was right and he got me pregnant so he could add my name to the list of successes, further proof of his hasty assumption about me.
Here is what happened that my Doctor didn’t disclose with me;
I miscarried the first month because unbeknownst to me (and I later learned from a gynecologist I was seeing) that it isn’t good practice to attempt to get pregnant that first month on medication, because a woman’s body can release immature or damaged eggs. Even after I returned the following month with complaints that “My period was the worst I had in my life” and he informed me that I had miscarried as evidenced by my blood work, he still didn’t share this little piece of valuable knowledge with me.
It took only a quick three months and two visits with my Doctor to finally have a viable pregnancy, but by this point I already knew I wanted my prenatal experience far more informed, empowering, and supported then that of my experiences with Fertility treatment. So, I never told my Doctor or his office that I got pregnant and as far as I was concerned this chapter of my life was closed. My midwives made up for everything this Doctor lacked and more, and restored my faith in our healthcare system.
This next time around I did everything in my power to try to avoid revisiting this local clinic. I requested to see a Gynecologist and spent a lengthy amount of time with this new Doctor trying the oral medications again. When we weren’t getting anywhere on the oral medications I visited my GP and requested a transfer to a fertility specialist that I had assumed would be a better experience than my last. Low and behold it was the same fertility Docs office that called me, and I battled with the decision to return to his clinic.
Its funny how these things go, fertility completely destroys you, so by the time you crawl into his office you are ready to accept any and all flaws as long as there is a glimmer of hope that you might get pregnant. My husband came to our intake appointment, and perhaps he was a little more demanding a presence than I was, but our Doctor actually (briefly) seemed better. This time around (and because I had more history and a few more miscarriages under my belt) he did order the full work-up I had been hoping for all these years.
I cant remember the complete details, but I remember a lot of confusion regarding when to take my oral medications and when to skip taking it. I distinctly remember my Doctor telling me not to take it during the month that I had my sonohystogram, but when I returned the following month he was frustrated with me for not taking it after all. It threw off my cycles and put us behind again. At one point my husband pleaded with the Doctor to give me something to battle the monthly migranes I started getting with my oral meds, and his only response was to go back to my GP and get him to prescribe me something, then provided me with a list of particulars about what to tell my GP to prescribe. I was very unclear about why my fertility Doctor couldn’t just prescribe it himself given that it was to counteract the medications he was giving me. When my husband canvassed him on the idea of me taking a sick leave from work to facilite my attending the clinic as often as I had to Our Doctors careless and unconcerning response was “What for? She isn’t sick”. Actually Yes Doc. Infertility is an illness, just like any other!
My first cycle monitoring followed shortly after, where I discovered a very unfriendly member of the medical team. I can only assume she was the ultrasound tech, though, she never told me. She never spoke to me at all actually! She just stood in that room day in and day out performing internal ultrasounds on me without ever really acknowledging my existence. Even during my first cycle I went in and bled on that bed nervous that maybe I shouldn’t be there doing this while I was still menstruating, I tried to strike up a conversation about it because I didn’t really want to go through with it that day – but I got no answers for her.
I didn’t see my Doctor after that. Month after month went by and his staff arranged my progression to injections, then adjusted my dosages when everything failed. During one cycle, I produced a large number of follicles, and while I longed to have a conversation about what my options were to do with them, they called me at home and told me not to come in until the beginning of my next cycle. I would have been more than willing to extract and donate those follicles and be empowered once again by helping other struggling couples, but that wasn’t an option not even a topic of conversation for me there.
After my third cycle attempt that required a closer monitoring program and day to day adjustment of my dosing, It was finally time for my IUI. My husband came in to leave his sample, and to my horror the staff prepared the sperm wash at the administration desk while simultaneously preparing another one for another couple. I was mixed with disbelief but more so a level of desperation that clouded my judgement as I am sure happens with most if not all of the clients that come through that clinic. I went into that room, with my faith held high in their abilities as professionals, despite having witnessed questionable practice. Then as I laid on that sterile bed in the breezy and cold room, I was in no state to notice that she didn’t even verify my identity before administering the IUI.
Aside from all that, she also prepared my bill which typically signifies a cycle completion and provided me with the instructions for follow-up for the IUI (Start taking your progesterone in 2 days – test in 2 weeks – call us if its positive) but completely failed to inform my husband or I to return the following day for a second IUI. When I didn’t return the next day and they called me at home no one acknowledged responsibility for this mistake, they simply implied that I had been told and had forgotten. It was insulting to say the least, and also a heartbreaking turn of events as we worried that we missed a crucial step in another very expensive monthly cycle.
As icing on the cake, a couple weeks later I received an intake package from another fertility clinic, one that manages IVF that I had been referred to by my current fertility Doctor. I hadn’t even had an actual appointment with my Doctor for months and at no point had I had a conversation with him about wanting to pursue IVF or given consent for him to send my referral and file details to this new clinic.
I’ve been worried sick about my experiences, I am left feeling powerless, and assured more than ever that I should be seeking fertility medical care elsewhere. I have been navigating avenues for reporting what I have experienced and sharing with you today because we all deserve better in our medical care experiences. I pray your fertility journeys are peaceful and empowering, and if you feel yourself relating to my story I implore you to speak up or look for alternative medical care.