*As featured in Fertility Road (September/October 2017)

We grow up expecting that having a baby will be the most natural process in the world. But for some of us, the natural approach doesn’t work out, and we find ourselves entering the strange world of fertility specialists, treatments, and schedules. It’s the beginning of a journey for which we have no roadmap, and one that places our dreams of parenthood in the hands of people we have never met. But are these fertility clinics and doctors, upon whom we pin so much hope, created equal?

From my personal experience of meeting twelve different doctors across seven different clinics, I’m forced to conclude that no, they are not.

So then, what makes a particular clinic or consultant first-rate? What makes them worth the extra money or travel? Or what makes this difficult path somehow bearable, just because that person is now on our side? The answer to all these questions is surely that this is the person or place that will enable us to become a parent at last. Right? Well, essentially, yes. But it can also be a little more complicated than that.

As patients, I don’t think we can stress enough that IVF treatment is a deeply personal experience. It involves raw emotions, physically intimate procedures, anxiety-provoking phone calls, and sometimes the exchange of vast sums of money. Worst of all, it often ends in failure. And that’s where, in addition to medical excellence, the ability to provide compassion, respect and empathy quickly become the ultimate requirements on any patient’s wish list.

 The importance of empathy
Walking through the doors of a fertility clinic, I imagine most patients are thinking very similar thoughts. The first one being: ‘I can’t quite believe I’m here’, followed by: ‘I’m terrified of what this is going to involve’ and: ‘I’m even more terrified that it’s not going to work.’

By the time we take our seats in the waiting room, most of us have been trying to get pregnant for at least two or three years. We have almost certainly tried less drastic measures, whether it be clomid, injectable hormones, IUI, or holistic therapies such as acupuncture, reflexology and positive visualisation.

What we are about to try, we are only too aware, is the last tool in the box. If this doesn’t work, then we will have officially reached the end of the line.

If IVF were a business contract, we would be entering into it from an unenviably weak position. We’re emotional, vulnerable and desperate – and everyone in the room knows it.

When we’re accessing NHS-funded treatment, we feel as though we ought to be grateful for the opportunity, and we’re conscious of the stampede of other patients who would happily take our place. Even when we’re paying for private treatment, we often feel pressurised by the knowledge that our consultant’s time is precious, and that we need to use it wisely.

The doctors who demonstrate to us that we’re important are the ones we hope to meet. And the doctors who acknowledge the emotional enormity of what we’re doing are the greatest finds of all. An authentic ‘I’m sorry you find yourselves here. I know this is a difficult process to go through’ can quell our anxieties in an instant (though it may also cause a lump to rise in the back of our throats).

 

Why respect matters
One of the key differences between fertility doctors who makes us feel respected and those who don’t is their ability to ask the right questions and to listen to what we have to say.

It’s true that many of these doctors have a wealth of experience and expertise on their CVs. But some of them also recognise the expertise that we, as patients, bring to the table. After all, we have lived with our bodies our entire lives; it’s more than possible that we might have picked up some valuable information and insights along the way.

Rather than mechanically reeling off a list of questions and then matching us to a standard protocol, some doctors broaden the scope of a consultation.

‘Tell me everything,’ the rare consultant invites us, as she leans forward in her chair, ‘and then together we’ll find the path ahead.’

These are the doctors who will treat us as the individuals we truly are.

They accept that, although we may look identical on paper, our needs may be entirely different from the couple they saw that morning, and the ones who are waiting outside. They are the doctors who listen to our hunches, carry out research when they don’t know the answers, and then discuss with us their findings.

We always know when we’ve met one of these doctors, because we leave their office feeling validated, supported and in control, rather than patronised, confused or small.

 When compassion becomes critical
It’s an often-overlooked fact (to the wider world) that IVF treatment still has a pretty low success rate. Most cycles fail. Some pregnancy test results are inconclusive, leading to weeks of repeat tests and investigations, and some pregnancies don’t end in a take-home baby.

And what happens then? How do the staff at the clinic respond to our anger, disappointment and grief? How do they react to our anxious calls about an unexpected show of blood before our official test date? Do they roll their eyes at the other end the phone, and tell us, somewhat impatiently, to simply wait it out, and call back with our results on our designated day? I’m not sure we can entirely blame them if they do. Working with emotionally vulnerable people is undeniably tough. Surely they can’t help but grow desensitised to our tears and hardened to our plight. They are trying to run a service, after all.

But then there’s a rare kind of clinic where the staff don’t become hardened, and where the consultants somehow remember that we’re in complete emotional turmoil, in spite of the fact that we may be driving them slightly nuts. They find the time to respond to our nineteenth email, they try to put themselves in our shoes, and they never disappear when things don’t end as we’d all hoped.

Importantly, they also don’t disappear when the treatment ends in a long-awaited positive pregnancy test. One of the strangest discoveries on the IVF journey is how lonely many of us feel when things actually do go to plan. When you’re in the midst of IVF, having a baby feels like a group effort, with a dedicated team of professionals working towards the same end goal. It can be a shock to discover that we’re suddenly on our own – and especially with so many hurdles still to overcome. The best clinics recognise the importance of their input and involvement, and the relationship we’ve built over the previous months or years. They hand us over to the care of our midwife and GP, but they also remember to always keep an open door.

What’s the secret to success?
Even if we knew at the outset exactly what we were looking for, how easy would it be to find the clinic or consultant who could provide both the medical excellence and the emotional support we require?  Across the twelve consultants and seven clinics we visited to seek help, we were able to find just the one. I hope this is set to change.

There is, undoubtedly, an art to successful IVF treatment, involving state of the art laboratories and equipment, an ability to act on the latest breakthroughs, and a commitment to providing a first-rate service and employing first-rate staff. But there is also an art to working with people, and especially people who are experiencing one of the most challenging times of their lives. And I believe it is only by combining the two that you can truly meet the needs of those seeking IVF treatment to create a family.