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Getting a Second Opinion About Fertility Treatment

By: Sangeet Khanna - Updated: 6 Sep 2017 | comments*Discuss
Questions To Ask The Fertility Doctor

Fertility assessments require a multidisciplinary approach which usually begins with the primary care doctor. The primary care doctor may be a family doctor an internist or an obstetrics and gynaecologist. He or she may then refer you to a specialist who is trained to diagnose and treat your unique condition. Despite this level of expertise, it may still be beneficial to consult another specialist for a second opinion.

Although the practice of medicine is governed by strict moral and ethical principals, some doctors may differ in their approach. Fertility causes and treatments are so diverse, that a difference of opinion between medically trained doctors is not uncommon.

A second opinion facilitates the exploration of other treatment options, or at times offers a completely different diagnosis. Medical sub-specialties trained in the area of fertility, include, endocrinology, urology and Obstetrics and Gynaecology. Even within these sub-specialties, there is further training specifically for fertility.

Be Prepared

When deciding on a second opinion it is best to be prepared. It may be helpful to bring lab reports and/or diagnostic test reports such as X-rays, sonograms, etc. This consultation should be an open forum for you to discuss efficacy of treatment, side effects and even alternative options. It may even be helpful to request for literature which compares different treatment options and have the consultant explain the results and ramifications of such medical information.

Below is a list of questions you should ask your doctor when obtaining a second opinion. These questions should be addressed to the initial doctor as well as the consulting doctor. By addressing these questions to both doctors you can compare answers and help make a more confident and educated decision.

Questions to Ask the Doctor

  • How effective is the proposed treatment
  • Is the proposed treatment the best treatment option for my unique situation
  • What are the major side effects
  • How will the proposed treatment impact my present day life?
  • What are some of the alternative treatment options
  • What are the chances of conceiving naturally without any medical intervention?
  • Will the proposed treatment option increase the risk of adverse effects to the baby
  • Are there any potential long term effects to the proposed treatment
Undergoing fertility treatments can be extremely stressful and difficult. Depending on the cause, treatments may involve, taking pills, being injected with hormonal shots and even surgery.

Aside from the physical demands, fertility treatments can also be emotionally and financially draining. Since so much is at stake, one should be absolutely certain of their diagnosis and treatment approach. Seeking a second opinion will often depend on the initial diagnosis, and the effected partner. If the infertility issue is discovered to be caused by the male partner, it may be helpful to seek the consultation of an urologist, or a reproductive endocrinologist who treats male infertility. Urology is a surgical sub-specialisation which requires additional post graduate training. They perform fertility procedures such as vasectomies, vasectomy reversals and microsurgeries. They may also perform biopsy procedures to asses for testicular cancer. Reproductive endocrinologists are experts in diagnosing and treating infertility, due to hormonal abnormalities.

For issues with female infertility, it is best to seek the advice of a doctor specially trained in fertility medicine. Fertility specialists are trained in performing special procedures, which require delicate skill and exquisite precision. Procedures such as Invitro fertilisation, Gamete- Intra Fallopian Transfers using sperm and/or eggs, can only be done by such doctors.

Regardless of the cause of infertility each doctor has their own approach to treatment and can be drastically different from other experts within the same field.

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Hi We are a same-sex couple and decided to try IVF to start our family. My wife is 29 years-old and in perfect health. We had a bumpy road at the start due to errors with the GP and delays so we decided to go to Care. 90% of the staff we have engaged with have been supportive, providing us with ample information. Despite our high expectations from Care, we have had issues with our assigned doctor. From the start all test results and scan results have been excellent with no concerns from our doctor or other Care staff. On the first scan my wife has 28 follicles with no sign of abnormalities. We were accepted for egg donation and the process moved forward quickly. My wife had a low dose protocol as the doctor felt there were no issues. The downregulation drug was administered for a long period to allow the recipient to match my wife's cycle and stimulation drugs started. From the first scan, it was clear the stimulation drugs were having a limited affect (all 15 follicles under 8). The doctor increased the dose to 3 and told us to continue. By the next scan, the follicles were still small with some 1x11, 1x10 and the remaining 16 under 8. The nurse scanning my wife was visibly surprised by the result and suggested we may have to increase to 4 doses. By the final scan we had 2x21, 1x20 and 2x19 with the result of the follicles lagging behind (1x12 and the rest under 8). The nurse wasn't happy about the 3 large follicles but said we would be ready for egg collection. We had to wait 3 days for egg collection and by this point the large follicles increased in size while the small once continued lagging. At egg collection ththe doctor told us he expect to collect at least 5 mature eggs based on the scans. We were rather upset as that's lower than we expected and not an acceptable number for donation. On my wife's return from EC she was extremely upset as the doctor said it was dissapointming that he only collected 4 eggs. I was completely shocked that the doctor felt that it was appropriate to deliver such heartbreaking news to my wife while she was still out of it with sedation. Eventually after hours of waiting, I had to ask for someone to come and discuss the situation with us. The embryologist explained then situation and supported us through it. The frustration came after this point, the doctor point blank refused to speak to us (the nurse asked him outside our room). Two hours later we were tonne discharged and the nurse was extremely shocked that the doctor had failed to visit. She had to find him (in his office) and tell him to come see us. We had questions, but he was clearly disinterested and actually said "you were the patient I expected the least trouble with - we can increase the drugs at starting point next time". He then left. The next day we had a call from the embryologist to tell us no eggs fertilised as all were immature. In all honesty, we expected this to happen. The larger follicles were too large
Escape - 6-Sep-17 @ 10:39 AM
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