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It Is Important to Seek More Than One Fertility Doctor's Opinion

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Second opinions

A blog by Rhonda Levy, May 29, 2014

Over the last two decades, I have had the opportunity to interact with some of the most renowned luminaries in the field of reproductive medicine. From this privileged vantage point, I have been struck by the certainty and passion with which they articulate their positions, and the sincerity with which they express their beliefs.

At first I interacted with these physicians as a patient, and then in my role as a consultant. I learned in both these capacities that there is often a lack of consistency in their views, and a significant degree of conflict and debate. One might imagine that views might differ country to country, state to state, or even city to city. However, the truth is that views differ fertility clinic to clinic within a single urban center. For example, in New York City, which boasts some of the most renowned fertility clinics in the world, a patient might be advised to proceed in a completely different manner by two equally respected fertility clinics. At one clinic the patient might be told that it is best to transfer her embryos on day three of their development, while in the other clinic she might be told that her embryos will be more likely to implant in her uterus if transferred on day five. At one clinic the patient might be told that it is in her best interest to have the chromosomal makeup of her embryos analyzed via pre-implantation genetic screening in an effort to identify chromosomally normal embryos for transfer. At the other clinic she might be advised against the screening of her embryos prior to transfer. New York City is not the only American city in which opinions differ clinic to clinic. This phenomenon exists in virtually every US city. And these are just two examples of a multitude of ways in which highly respected fertility clinics within a single city differ quite dramatically in their medical opinions.

This lack of consensus puts the patient in a very difficult bind. When faced with diametrically opposed views about the treatment approach most likely to lead to the best possible outcome, how is the patient to know what to believe?

In order to help my clients solve this problem, I encourage them to consider the following:

  1. Understand from the outset that there is a lack of consensus within the medical community on many different fronts. Every fertility clinic has its own culture, attitudes and beliefs;
  2. Do not rely on only one physician's opinion regarding how you should proceed. Before proceeding with treatment, arrange consultations with physicians at at least two different fertility clinics. Ask many detailed questions to ensure that you truly understand the rationale behind the approaches they each suggest.
  3. Do not leave either consultation until you have a strong understanding of why the physician is suggesting that you proceed in a certain manner. If you do not understand something when it is first explained to you, ask for the explanation to be repeated. New scientific information can be overwhelming for physicians let alone patients, so do not feel inhibited about asking the physician to explain him or her self a second time.
  4. Certain aspects of each physician's explanation will likely resonate more with you than others. Once you truly understand why each physician believes what he or she believes, your instincts will help you decide which approach feels most "right" for you.

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