Maybe we’re all masochists, but according to a Gallup poll, 90% of us want to have a child. The other 10% probably caught OneDirection on tour this summer.
Normally, conceiving a child involves a steamy shower, a bottle of rose, and Enya’s greatest hits. But when you are infertile, or sub-fertile, the majesty of conception is supplanted by teeth-gnashing anxiety (on-par with developing cancer, according to a Harvard study), skyrocketing expenses (one round of IVF depletes two years of household savings) and mating acts so unnatural even Seaworld would boycott in protest.
In the ‘60s and ‘70s, most couples got pregnant in their early 20s. (Maybe concerns over drug use and tight pants were overblown?) Today that age is approaching 30, and in Northern Europe, headed to 35. The trends seem as inexorable, and universal, as our genes are stubborn and unable to keep pace. Caught in the crosshairs are 10 – 20% of couples who will rely on medication, surgery and maybe another person’s body, to get the family of their dreams.
I’m no IVF expert, but I’ve stayed in quite a few Holiday Inns – all next to fertility clinics my wife and I have visited over the years. My advice for anyone who is considering fertility treatment, is to find the best doctor for you, as quickly and as thoughtfully, as possible. The doctor who matches your needs carries the expertise, resources and comportment to help you survive the process. The others abscond with your time, money and hope. But making the distinction is far easier said than done. Most cities have an unwieldy number of doctors to choose from (for instance, New York has upwards of 200), and nearly all have idiosyncrasies that are imperceptible at first, but will prove to be game-changers in time. It can be months until you know if you’re in the right hands and thereafter changing course can feel all but impossible.
For most of us, picking a fertility doctor looks a lot like how a first-time entrepreneur chooses a VC. Decisions are made on a short-fuse, wrought with emotion, swayed by unsubstantiated-claims of success (“we’re top decile!”), insensitive to economic implication and clinched on brand cache alone. Ninety percent of patients we talk to don’t bother to interview a second doctor and yet most run out of patience with their first doctor well before they run out of hope or money. Our data shows most patients will ultimately leave their first clinic.
Nobody flunked this test with flying colors worse than me and my wife. With our first doctor, we were eager to get going and sped past countless omens and tepid references. During our first egg retrieval, this doctor instructed my wife to leave in her progesterone IUD and we received a follicle count so low that the only explanation was early menopause. That oversight cost us three months of agony and $20,000. What a barrel of laughs.
When we were in the market for doctor #2, we ran a tighter ship and went with a guy who had better references and even once appeared on basic cable. For this doctor we made three trips. The first to his clinic on the east coast, for three weeks. The second, at discharge, to hyponatremia, which is not a lovely Greek island. And the third to our local emergency room, where we learned our fertility clinic’s nurses had misread my wife’s chart and ordered her to “pound water like crazy”, inducing 15 pounds of weight gain (non-cupcake aided) and potentially fatally diminishing her sodium levels. When we finally got Dr. Basic Cable on the phone, we reminded him his job was to help us add members to our family and hopefully that cleared up the confusion.
Having been through all of this, I’d argue that after selecting your spouse, choosing a fertility doctor is the most important “people” decision you may ever make (43% of patients say this is the most important event in their lifetime). This is serious business, as according to one study, over half of female fertility patients regard the process “as the most upsetting experience in their lives”. But perversely (or relatedly) the resources available to choose a doctor range from the highly-incomplete (Yelp!), to the intellectually-inaccessible, (government data) to the shamelessly-misleading (too many count). You have never seen a more dire “I-Need-This-To-Work-Out-But-Have-No-Idea-What-The Hell-I-Am-Doing” scenario since Senior prom. Or the 2016-2017 New York Knicks.
My wife and I have been bothered by this for years and in the summer of 2015, we decided to do something about it. We are part of a generation that values gray matter over scar tissue, but in the case of fertility treatment, there is flat-out no substitute for experience. To harness that insight, and to help it proliferate (this topic is still very taboo), we built a website called FertilityIQ FertilityIQ, for fertility and IVF patients across the U.S. to assess their doctors and clinics. Since this is just a tad more important than finding the cheapest bikini wax on Yelp!, we take the comically-inefficient step of verifying with each reviewer that they were an actual patient of the caregiver they assessed. We try to pair the comprehensiveness of TripAdvisor, with the intelligence sorting of Amazon, with the old-school veracity of Consumer Reports. All in a field where lives are on the line.
Amidst all this, in July, 2015, we started getting reviews on a specific doctor near San Francisco. The people who provided the assessments thought this doctor's attention to detail was superb, and so we set up a consultation. This doctor listened closely, ordered a diagnostic/procedure to be performed, and ultimately we were able to conceive naturally. It's hard to say for certain where we'd be without that doctor's help, or without the 11 people who wrote in to assess him, but today we remain ever grateful to those who care enough to help this process go better for others.