Sunday, February 22, 2015

Dear Doctor(s)

To the Team of Doctors at "Babies Guaranteed":

My acupuncturist suggested I might write you a letter to advise you on my thoughts of the quality of your care.  Lawyer that I am, I'm going to start with a lengthy draft and then eventually edit down.  This whole letter will probably be all of five sentences if I ever send it to you.  So, here we go with the first draft!

I was an intermittent patient at your clinic (factory), beginning when I was desperate to have my Asherman's Syndrome diagnosed.  I was an unfortunate soul who never had her period return, even many months after a D&C for a missed miscarriage (which turned out to be a partial molar pregnancy).  Many hormone tests and a painful provera prescription later, I found my way to you on the advice of the OB who performed the D&C and told me that Asherman's Syndrome "simply doesn't happen from a single D&C."

Dr. Y, you may remember me as a cute young thang, I didn't look any of my 38 years, I was the lawyer who you advised to "stop reading things on the internet"?  If that doesn't jog your memory, I am the chick who learned my cervix was sealed shut like a brick wall during an HSG performed by your Physican's Assistant (a very nice lady by the way, give her a raise).  And then I had my scarring removed by a truly great RE in Boston (yes, flying to Boston felt like a much better decision than having you treat me, given that you told me cases of Asherman's hardly ever existed). Remember when I returned to you for a post-surgical follow-up and you unnecessarily dilated my cervix?  Oh wait, I am also recalling you panicked that I was pregnant afterwards, that was a nice touch (as a lawyer who in fact reads the internet, and follows the protocols of my doctors,  I was pretty careful to not get pregnant while waiting the required monitoring period for cancer after a partial molar pregnancy).

With all of this highly competent treatment  I ran from you like the wind and hoped to never return.  And it was a nice reprieve..... until two more miscarriages.  Then I realized that maybe I should return to your clinic (factory) because you're one of  the only games in town that offers IVF with PGS.  So back I went, two years later, only this time to see Dr. B on the advice of a friend (who had her own ridiculously awful experience with Dr. Y).

Dr. B your soft-spoken demeanor is kind and gentle, though that belies your ability to push a hard-sell for the expensive donor egg.  Surely you sold cars - perhaps jaguars? - in a past life.  Still, it was nice of you to nevertheless move me forward in the process and see if perhaps my sad-sack ovaries were worth a shot at the very expensive (but insurance covered) attempt at IVF.

And that's when I got to really interact with you Dr. K.  Wow, I must be grandiose in my description of you:  You are quite the asshole.  You cracked some mighty fine jokes during my HSG.  You even later sent me into a state of panic over a misdiagnosed scarred fallopian tube (I later learned from another doctor that you didn't ram that catheter in me all that well).  But I digress.  I know that it isn't a pleasant task, to call a woman at her office in the middle of a work day in order to tell her that she might as well be in menopause because her FSH skyrocketed over 18.  I mean, hell, I imagine women cry for hours when you call them.

But Dr. K, I must tell you this:  the way in which you conveyed terrible information to me (high FSH) was truly, devastatingly harmful.  Because you then told me that my high FSH was likely responsible for my earlier miscarriages.  Even though my FSH was under 10 when I had those miscarriages.  And only later did I learn that high FSH isn't instructive in the field of reproductive endocrinology at all, except for the purposes of ascertaining a good responder for IVF.

So in other words, you told me I could no longer be a patient of your clinic unless I was to consider donor egg IVF, because with my own eggs, I was a poor candidate.

But then you had to go farther.  You had to tell me, I quote, "Odds are high I will never get pregnant and carry a healthy baby with my own eggs."

I am now 40 (soon to turn 41 in a few weeks).  I've taken a lot of hits.  People have said mean things to me.  I work in a politically loaded field, I am used to it.  But never in my life has anyone said anything so destructive to me.  That happened to be a load of crap, based on the opinion of the Director of Fertility at one of our nation's largest teaching hospitals.

I would like to tell you about my daughter, Celine.  She is no longer with us.  But she was a healthy baby.  One of my (gasp) healthy eggs met my husband's healthy sperm (and if you'd check out his lack of health habits, trust me you'd gasp for reals).  And we created a healthy baby.  Who was sadly struck by lightening. (Well, actually I think she was struck by some fucked up shit resulting from my MTHFR mutation that y'all never even wanted to test me for, but I digress again).

So, anywho, here I am again.  Pregnant, possibly for the second time after a tfmr.  Under the care of a new RE, one who thinks I have had "shitty luck"  (her words, by the way).

I want you all to know that I have panic atttacks.   I'm fairly sure I had one ten minutes ago. In fact, I have a nice case of PTSD from my experiences.  I generally think every pregnancy I have is doomed (and will continue to have, because, well, I'm fairly sure that you also misdiagnosed my early menopause).  Your words haunt me, despite the fact that I know they are untrue.  In fact, your words might have been a tad unethical.

I am writing you this letter because I want  you to think about the care that you give to women who are at their saddest, their most desperate.  In fact the women that see you are emptying their life savings to have a chance at the miracles you perform.  I know that there have been thousands of patients you have helped to realize their dreams of motherhood, and that is undeniably wonderful.

But please consider your approach.  If you wish to cherry-pick women to offer services to, so that you can continue to boast high success rates, that is your right.  But consider the ramifications of your words and actions to those of us who are trickier patients to manage.  Those of us with deeper issues, such as a genetic predisposition to miscarriage.  You don't want to bother with us?  Fine.  But don't destroy our hopes and dreams.  Don't convince women like me, who happen to find themselves pregnant all the fucking time, that we are doomed to a future as a grim statistic, based on a number produced during a blood draw, that only apparently matters if your patient is doing IVF.


  1. Amen! Don't bother editing. It's perfect.

  2. Wow. Can I hire you to write one to the doc that told me she would send me to a social worker if I "kept worrying" about my doomed pregnancy- that I needed to realize "I was having a baby in April," the same baby that I lost at 19 weeks?

    Or how about to the doctor that told me that a quick fix to endometriosis pain was "just go get pregnant." You could tell her that the reason women with endometriosis often are infertile are because the endometriosis causes a missing protein in their lining? She might change her tune then.

    So well written and so on point. Ironically when we first went to the "Baby Factory" in 2011 it was to see Dr. Y about testing due to endometriosis. We did an HSG that the tech said was abnormal but Dr. Y never called back to tell me that. In fact, he never called back... Ever.

    Dr. Cuddles was the only one to take a proper look at those hsg slides two years later to find my septum. This was after two miscarriages.

    This letter is amazing. You SHOULD send it. You mightve inspired me to write my own.

    1. What Dr. Cuddles lacks in personality she more than makes up for in competence.

  3. Hi - found you today via Lost & Found. So many common threads in our stories (RPL, Asherman's, an amazing RE in Boston who has also fixed me too many times to count). I look forward to following your story and hope this pregnancy is THE ONE.

    1. Sad welcome to my blog. Did you see Dr. I? This pregnancy will not be the one, unfortunately (as I have felt deep in my bones for a week now). As a fellow traveler on the RPL road, you get it I'm sure. I am going to remain optimistic that I can keep getting pregnant.

    2. Oh, and allow me to gush over your blog. I truly *feel* your voice and your experiences, and not just because there are eery similarities in our medical histories.

  4. Very well written! I agree Dr Y is a dickhead! Dr M from same clinic convinced me I needed donor eggs after 3 spontaneous losses-2 chromosomally abnormal results. Oh wait this after telling me 2 yrs earlier that my only chance of conceiving at my age was with ivf. Then saying well it must have been the fertility meds!! Take credit for my weekly acupuncture treatments why don't ya! Donor eggs is my answer he said. Six perfectly "graded" blastocysts. 2 more losses. He said it couldn't possibly be the egg! No! Because young 25 yr old donors only have good eggs he claimed. My dh and I insisted on PGS -which revealed that one of our remaining 4 embryos had an aneuploidy. The genetic counsellor said that the error came from the egg! Donor eggs that we paid thousands of dollars for!

    1. Guarantees. They promise a baby or my money back but they can't give me back my sanity

    2. I realize that REs literally get to play God, but this clinic has a batch of the most arrogant doctors imaginable. Some of them, I'm convinced, have personality disorders.