Finding a fertility clinic can be a challenging endeavor, and no one wants to do it twice. But when you're feeling unheard, concerned about the care you're receiving, or starting to doubt your doctor's guidance, the thought creeps in - is it time to move on to a different practice? In my 36 years in the world of fertility (first as a patient, and later as an advocate), I have never once heard someone say, "Well, I can get pregnant at home, but your offices look really pretty, so I’m going to come in for fertility treatment instead." Not once.Ever. According to the World Health Organization (WHO), 1 in 6 people worldwide struggle with infertility. In the United States, that number increases to 1 in 5. So if you're having trouble conceiving, know that you're far from alone. The American Society for Reproductive Medicine (ASRM) defines infertility as: Not sure where to begin your search for afertility care provider? Start here: Ask your gynecologist which fertility clinics they recommend in your area. They will often have well-established relationships with local reproductive endocrinologists and refer patients to them (who typically return for prenatal care after treatment and share their experience). If you're comfortable asking the trusted people in your life, you'll likely discover that far more people than you expected have gone through infertility and have some recommendations. The internet can be a great resource, but know that some practicespay to have their name shown first on search engines - so just because you see one clinic repeatedly pop up in search results doesn't necessarily mean it's the best one. Did you know? The Society for Assisted Reproductive Technology (SART) and the Centers for Disease Control & Prevention (CDC) offer easy-to-use online tools that reveal IVF success rates for fertility practices across the United States. Once you make the monumental decision to seek help from a fertility specialist, do your research, and go through the process of becoming a new patient at a practice, you (of course) hope it will be smooth sailing from there. You may start off quite optimistic, and then start to feel increasingly frustrated as time goes on. If you're feeling completely hopeless, it’s usually time to find a new practice. Yes, some fertility patients have to undergo many rounds of IVF before they finally have that one successful cycle. A sense of hopelessness is normal at times, but for those in a good fertility program, there should always be some amount of hope. Even if 99% of you feels depressed, discouraged, and defeated, that 1% of hope you're holding on to will keep you walking in your clinic's door to try again. Maybe you don’t feel comfortable when you visit their office or interact with their staff, you find out that a different doctor or fertility practice has better pregnancy results, you move to a new city and need to start over, or fertility treatment simply isn’t working. If you've tried your best to communicate concerns to your team and sufficient efforts haven't been made to improve your experience, it may be time to say goodbye and find a new doctor or practice. Learn what to focus on when searching for a fertility practice in order to give yourself the best possible chances of success.In this article:
Asking for Help Isn't Easy
When should I see a fertility specialist?
3 Ways to Find a Fertility Clinic
Your OB/GYN
Friends or Family
Google
Is your fertility clinic a good fit?
Reasons to Leave Your Current Provider
Looking for a fertility specialist?
On Deciding to Leave Your Fertility Clinic
So, you want (or need) to start over again. You’re exhausted. Understandable!
You had a not-so-great experience with your last care provider, and now you have "baggage." You know that you shouldn’t carry it with you to the next doctor you see, but you also don’t want a repeat performance of whatever happened that wasn’t satisfying or acceptable to you at your previous clinic.
How do you find the balance between trust, experience, and your own history? It’s not easy! You’re in the middle of one of the most important quests of your life. Having a child may be one of the most significant, life-changing goals you ever attempt to accomplish.
By acknowledging the depth of this journey's importance, the importance of getting it right, and how much pressure this puts on you, we start to understand why it's so emotional and difficult to think about switching fertility clinics and starting over.
The Emotional Transition Period
If you're usually an easygoing person, the stress of fertility treatment can turn the pressure all the way up and transform you into someone you hardly recognize. This is normal.
Think about a pot of water. It doesn’t boil right away, no matter how high you turn the flame on the stove. It slowly heats up, comes to a rolling boil, and then, if the flame isn’t turned down, it becomes a rapid boil and can even spill over. Taking this analogy one step further, it can evaporate all the water, scorch the pot, and even start a fire.
Fertility treatment can be like that.
If your first fertility clinic experience wasn't what you wanted, needed, or expected, then you’re likely walking into the next fertility practice at a slow boil. You may have some reserve left - you’re not boiling over yet, but that slow boil is there, ready to heat up easily and quickly.
Keep this analogy in mind as we move to the next phase.
Shifting the Narrative
What do you want from your next fertility practice? And is there anything you hope to do differently? Ideally, you want to give them a chance - a nice clean slate. But this may not feel easy to do when you’ve just had less than a stellar experience elsewhere.
9 Tips for Starting Over at a New Clinic
Let’s let go of ideal and instead be realistic. With that in mind, here is my best advice, based on 36 years of experience in the fertility field (plus my own 6.5 year experience at multiple fertility practices).
1. Look Inward
- Spend a moment with yourself
- Talk to people that you trust and respect
- Include your therapist or counselor, if you have one
What happened at your previous fertility practice that you wish you could have handled better (or differently)? The best thing you can do is address this piece of the puzzle, since it’s the one you have the most control over. If something didn’t work for you at the last practice that YOU can change, that’s great - because it gives you something to do that’s in your own control.
Questions to Ask
Looking back, were you clear about what you needed? Did you make assumptions because you didn’t want to ask too many questions? If you were uncomfortable, do you wish you’d have spoken up earlier? Did you stay in a situation because you didn’t want to be thought of as "difficult?"
Take action: Get clear with yourself about how you’d like to be the best advocate for yourself going forward, based on what you learned in your last experience.
2. Be Open & Honest
Remember that you are entering a fresh environment at this new fertility practice. Give them a chance! Let your new Care Team know that you’ve had a difficult experience before and share what you’ve learned you need. Your new fertility practice may not be able to do everything that you want, but tell them what those things are.
Each fertility practice will have their own protocols and procedures. They likely handle things a certain way because they know those methods have been successful with other patients.
Take action:Tell your new team what you need and then discuss what's possible.
3. Don't Be Hard On Yourself
Remember the stove pot analogy?
Fertility treatment feels a bit like being slowly heated up without even realizing it. It often gets more intense as you go along - with every test result, procedure, waiting period, the heat gets cranked up higher and higher until you realize how stressed you are feeling.
Be kind to yourself. Understand how hard this journey is and be gentle with yourself. This isn’t some mushy sentiment to ignore - because how you treat yourself in the middle of a life-changing situation will directly relate to how you manage that situation.
Take action: Remind yourself that you are in the middle of a very complex situation that is affecting you mentally, emotionally, physiologically, hormonally, and societally.
4. Stay Hopeful
If you notice you're thinking thoughts like, "This cycle won’t work, that medication didn’t work, these are terrible test results, this isn’t enough, I’m not enough," challenge yourself to counter them with thoughts like, "This new treatment could work, I am enough, this isn’t the end, my body is strong."
Take action: Counter the negative chatter in your head with positive chatter. If that doesn't feel possible yet, try to at least give them equal time.
5. Express Vulnerability
What would it be like for you to say to your new caregivers, "I’m here because I really want to build my family and I’m putting my trust in you to be my partner in that goal - even though it feels scary after my last experience." What do you think hearing that would be like for them?
One thing I’ve learned only recently is that if I don’t want to be treated like a number at a doctor’s office, I have to be myself. I have to not act like just another number. I have to be open and let my healthcare providers see me as I am. When we relate to our caregivers with vulnerability, the response is almost always empathetic.
Take action: Let your new team know that you feel vulnerable and are working hard to trust them. It’s amazing what kind of impact that honesty can have.
6. Share Your Communication Preferences
Tell your new Care Team the best way to communicate with you, whether it be email, phone, text, patient portal, etc. Then be sure to check for messages from them and read or listen carefully whenever results are shared or instructions are provided.
Explain to your new team whether you would like to hear all results (good or bad) or only hear updates if there is a change in your treatment protocol. Communicate clearly what your preferences are.
It's also important to understand that each clinic has created a system that works well and will work within that system. Not everything you request will be possible. Expect boundaries - some of which you will not like, but know that you can also set your own boundaries.
Having a communication loop that is complete will prevent most misunderstandings.
Be your own best advocate!
Get 20 actionable tips straight from experienced fertility advocates who understand how difficult this journey can truly be.
7. Tell Them Your Medical History
Did you learn something from your last fertility treatment experience that might be important for your new care providers to know? Tell them! Yes, even if you think it may be included in your medical history. For example, if you had bad side effects on a particular birth control or had an adverse reaction to an IVF medication, bring it up to your new team.
8. Don't Hide Your Feelings
If something happens that upsets you or makes you uncomfortable, tell your Care Team. Give them a chance to explain what’s happened and process it with them until you feel satisfied with the resolution. If they can’t help you, don't hesitate to "bump it up" to a manager.
Take action: You want to have a better experience this time, so advocate for yourself. Share how you're feeling so your new practice can help address issues as needed.
9. Ask for Support
Explore the support services your new practice has - simply ask a team member what’s available. If you have a patient coordinator or navigator, ask them. If there’s a resource page on the website, check it out and try what’s being offered.
Even if it’s not something you'd normally go for, try it anyway. You don’t know what you don’t know. That support group or meetup you didn't think you'd enjoy might turn out to be just what you need at this very critical point in your life. Keep an open mind.
Illume Fertility also offers free, one-on-one support from a Patient Advocate (that's me!) If you're looking for a listening ear or want to learn more about what I've shared here, you can reach me by phone at (203) 354-1157.
Build Your Community
Examine your own support system and think about who in your life you're able to confide in.
If it's time to broaden that circle of support, there are many great (virtual and in-person) support groups out there. Here are a few reputable resources to get you started:
- RESOLVE: The National Infertility Association
- All Paths (formerly Resolve New England)
- The Jewish Fertility Foundation
- Family Equality
- Illume Fertility
- Yesh Tikva
What comes next?
As you make the shift to a new fertility clinic, get to know your new team and let them get to know you. Trust their guidance. Let them know you’re excited to be there, even if you're still a little nervous too.Give them a chance to support you.
Embrace this fresh start. You wanted a different experience and you took the steps to get here. While you adjust to your new clinic environment, be clear with yourself and your new team, then take a deep breath and assume the best.
The people working at your new practice want nothing more than to help you through this process with as much ease as possible so you can finally achieve your goal - having a baby.
