How I Discovered The Secrets of Successful Fertility Treatment I began to grow skeptical about the accepted methods for infertility treatment when I realized that I wasn't meeting the needs of my patients. Although I investing a lot of energy and emotion into their problems, I was becoming more and more frustrated with the way they responded to my care. Many of my patients acted as if they didn't hear my instructions. For example, every time I told Lori I'd have her test results in three days, she'd call me the next morning for the results. When I tried to schedule an ultrasound examination for Debbie, she'd either cancel at the last minute or simply not show up. Bridgette wasn't able to maintain a basal temperature chart and Jennifer always forgot to bring her temperature chart to her appointment. I couldn't understand why these intelligent and highly motivated people acted so erratically. The reasons became clear once I discovered how my patients blossomed when they became a positive force in their infertility treatment. I'd like to share with you how I uncovered these secrets and how you can benefit from my formula for success. "I feel like a guinea piggy" Growing frustration forced me to rethink my approach with infertile couples. One day Cheryl said, "I feel like a guinea pig. This whole business is dehumanizing." She broke down and cried, and I wasn't sure what I could do for her. Moreover, I was completely surprised when her husband not only refused to cooperate but even blamed me for her inability to get pregnant! In retrospect, I realize that I not only underestimated the stress my patients were experiencing but I may have even contributed to their frustration. In my clumsy attempts to defuse their depression with humor, I remember saying such insensitive things as, "You can borrow my kid for the weekend," or, "At least you don't have trouble finding baby-sitters." I wasn't the only one who didn't know what to say to infertile couples. Their families, friends, and coworkers always seemed to be in error, too; even a concerned inquiry about their infertility treatment stirred anger and anxiety. I observed that as treatments extended into months and sometimes into years, my patients seemed to become less communicative and more paranoid. Some even went so far as to isolate themselves from others. In my quest for answers to these problems I instinctively turned to the literature for guidance. When I checked the local bookstores, I found that infertility books offered few concrete suggestions. Popular literature tended to be cold, technical reproductive biology texts or too generalized to be useful. My search continued until I saw a newspaper advertisement for an infertility seminar conducted by RESOLVE, Inc., and Serono Laboratories. RESOLVE is a nationwide, nonprofit support organization for infertile couples. What I learned from RESOLVE and subsequent studies changed my whole approach to infertility practice. I became aware that in the face of a diagnosis of infertility many people experience as much or more trauma than people who are told that they suffer from a life-threatening disease. Typical are Bret and Nancy L., who discovered they were infertile in their early thirties. Feeling trapped by circumstance, they became angry and depressed. They felt guilty about their use of birth control pills for ten years. The ten-year "delay" shortened the number of fertile years Nancy had for treatment, and her increased age reduced her chances for pregnancy even further. They had always had some problems communicating with each other, and their complex and demanding treatment regimen began to aggravate the strain. My requests for temperature charts, semen analyses, and scheduled intercourse only seemed to add to their frustrations. I realized that in order to establish a positive physician-patient relationship, I also had to address the emotional needs of patients like Bret and Nancy. Since I knew that much of their stress resulted from perceived loss of control, I developed a method that put them back in control of every stage of their infertility treatment. It was a method that improved their communications, provided feedback to my staff and me, and provided better treatment. Most of all, it was a method that improved their sense of self-worth. My Five-Point Strategy for Fertility Treatment Because victims make poor patients, I selected restoration of control as the starting point of my plan. To put my patients in charge of their infertility, I instituted the following procedures. I try to involve both partners in the initial discussions and planning. In these meetings we discuss their medical histories and family goals. We talk about diagnostic alternatives, medical resources, realistic timing, and emotional, time, and financial commitments. I answer their questions and give them the medical information that will help them think through their motives and alternatives. I want both of them to begin fertility treatment with realistic expectations and mutual understanding. I have found that this planning phase is so critical to successful fertility treatment that I've devoted several chapters of this book to showing how you can implement this process on your own. A jointly designed plan puts my patients back in control of their treatment, their bodies, and their immediate future. They no longer complain of being victims or guinea pigs. And they view me as a skilled partner or facilitator who is enhancing their effort to achieve pregnancy. I offer recommendations instead of rnandates. As their partner, I suggest diagnostic procedures and courses of treatment for consideration. I discuss alternatives, side effects, the odds for success, and other relevant issues. My patients choose their course of action. I tailor my testing and treatment to their emotional needs and budgets. Some patients want to proceed at breakneck speed, while others are more comfortable with a relaxed approach. I try to adjust my scheduling to their comfort level, and I always consult with them before altering our agreed-upon strategy. A number of patients find that they must adjust their treatment to accommodate their financial resources. An overextended budget only adds to their anxiety and usually isn't necessary for effective treatment. I also help them explore what expenses may be covered by insurance. I make certain that either my nurse practitioner or I am always accessible to answer questions and offer support. Together we can provide the time, information, and consulting skills that our patients need. I refer most of my patients to the local RESOLVE chapter for information, peer support, and, if desired, group counseling. I'm very impressed with the quality of information, printed material, and support offered by RESOLVE. The most important service it offers is understanding, companionship, and acceptance. Only in this kind of environment can infertile couples feel that they are not alone in the world and that their feelings are normal. And they can learn effective coping skills from others who are experiencing similar problems. You will learn many of these skills throughout this book. I know that this five-point approach will work for you because my patients have done so well. Once they see the difference the plan makes in their lives, they seldom experience the trauma I had so frequently observed when I dealt with infertile couples. I remember one patient saying, "I didn't know that I could deal with infertility treatment as just another one of life's hurdles. Our problems used to seem so monumental before Don and I put our goals and treatment plan on paper." The next few chapters will show you step by step how to lay the groundwork for such a successful plan. Successive chapters will help you: Become informed about the most up-to-date medical information so you will know how to choose the right physician and how to tell if you are getting the best treatment Develop an individualized treatment plan with your physician so you can take an active part in your diagnosis and medical care Get control of your life and feelings of anxiety so you can stop making impossible demands on yourself and others Become a positive force in your fertility treatment Identify your "happy ending" and pursue it So now let's begin to identify the ingredients for your happy ending. Click here to read Chapter 2, Taking Control of Your Fertility or go to the Miracle Babies Online Table of Contents For more information on your initial visit to your physician read the INCIID Routine Fertility Workup or IVF.com Homepage. Miracle Babies and Other Happy Endings for Couples with Fertility Problems Copyright © 1986 Mark Perloe M.D., and Linda Gail Christie. 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