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If Your Fertility Doctor Is the Pilot ...

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a blog by David Kreiner, M.D., F.A.C.O.G., East Coast Fertility, August 9, 2011

To read more of Dr. David Kreiner's The Fertility Doc blogs, CLICK HERE.

“Scuza,scuza , Signore e signori we are experiencing technical difficulties...”

While I sit uncomfortably detained aboard an Al Italia jet on the tarmac at the Sicilian airport waiting for the mechanics to determine if they can repair the mechanical troubles, my mind drifts to the plight my patients experience while they go through their fertility treatments.

Frustrated with Lack of Control

Frustrated, with no control over my situation, I reflected upon what it must feel like for my patients who must place their trust in people more experienced than them who routinely deal with those issues that are so significantly impacting them.

Like my pilots and their support staff, the fertility doctors, nurses and their staff have dealt with problems identical to or extremely similar to the ones my patients face on a daily basis. As such, I felt that I should trust that the pilots and maintenance staff would only proceed with the flight once they were assured the problem was satisfactorily repaired and that the plane was safe.

However, I figured that if we were to be delayed for takeoff, then I could take out my IPad and make myself more comfortable during the wait. Immediately, I heard from the flight attendant, in angry Italian, scolding me to turn off my electronics. Actually, I did not understand, but several other passengers quickly added in English to shut off my IPad. Did I not hear the prior instruction to turn off the electronics?

I did not understand the reasoning behind this as we were obviously delayed for takeoff. I was frustrated with my lack of control and understanding. I would have felt more comfortable if I understood what was going on and even better if I were able to participate in the process in some way.

I am sure that my patients must also have this great desire to understand and obtain some control. I believe that many do — often by gaining more knowledge on the subject through the Internet, our orientation sessions, and directly through questioning the fertility doctors and nurses.

The fact was for me I had no knowledge on our problem with the plane and was therefore utterly helpless other than to offer my complete cooperation. My patients, on the other hand, do have opportunities to obtain some control and an ability to assist on their own behalf in achieving their goal of a pregnancy.

What Can Fertility Patients Do to Improve Their Success?

Listening carefully to instructions and following them religiously, such as obtaining and administering fertility drugs at the correct dosages and times, is essential.

It is also important to patients' ultimate success if they arrive to monitoring visits, egg retrievals and embryo transfers at stated times. Patients’ responses to fertility drugs vary over time and are considered when their doctors interpret their hormone levels. The egg matures over the course of time passed from the hCG shot, but if this time is extended too long, a patient may ovulate before the egg retrieval is performed, and the egg is lost.

How else can patients improve their outcome? Studies have shown that stress reduction through support groups, mind body programs, massage and especially acupuncture improve success rates essentially by improving a body’s ability to respond in a healthy fashion to the fertility process.

As my reflections on the unique ability of my patients to impact their fertility were now complete and committed to paper (my IPad safely turned off and stowed away), over an hour later we finally pulled away from the gate and safely took flight. One hour later we landed in Rome, excited to move on to the next leg of our trip. I thought as I reflected on my successful journey how I wished for my patients to be as successful in theirs.

Yet as we are about to deplane, I hear “Signore e signori I am very sorry ...” The pilot announced that the bus transportation to the gate had not yet arrived, and it would be another short while.

“I apologize for the inconvenience." Yes, this is very familiar.

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