I would like to cheat on answering this question by giving you two things that I find to be very hard in being an REI or Reproductive Endocrinologist. They are at opposite ends of the spectrum, but balancing them still remains my greatest challenge. The first is that there is no possible way one can keep up with all of the changes and breakthroughs that modern science affords us. When first out of fellowship, we all try to “keep up with things” and read voraciously. With science expanding in the way it does, especially the reproductive sciences, this is an impossible job. It took me several years to find this out, and many complaints from my wife about turning the light out at night. In our struggle to get better at what we do, there are manners to stay abreast of what is happening however. Conferences, small scientific interest groups and doctor chat rooms can supply what is necessary to constantly improve the manner in which we do things without either assuming you know everything or actually trying to accomplish this; which is impossible. At the Sher Institute, the doctors are constantly asking their peers opinions on new research or bringing up new ideas they have come across in their own reading to get the input of the rest of the group.
The second, and more important in my mind, difficulty I have is truly getting my patients to understand what is going on and why. Some patients are very inquisitive by nature and ask the questions that allow them to not only follow why each step is necessary, but how it fits into the pathway to success. Unfortunately, I have found that most patients are almost afraid to ask any questions, especially to their doctor. The more you know about your treatment, the more relaxed you become. IVF can seem like a very complex issue on the surface, but there are basic tenets of understanding that can greatly help patients understand why we are doing what we are doing. When you understand why some of these complicated maneuvers and protocols are necessary it is easier to take care of you. You also become part of your own care team at that point and aid in the treatment and hence in the chances of success. Ask questions, become involved. I have had patients in whose eyes I have seen an almost complete surrender of understanding. This can make both success and lack of success harder to understand and hence harder to deal with. This is one of the reasons I give my patients my direct e-mail address. It makes my cell phone ring. They can contact me at any time and ask me any question. In my heart there are no silly questions, save perhaps the one question you did not ask. So please, in order to help your doctor out and to aid in your own care, ask questions and try to understand what is going on.
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Pelvic adhesive disease is the cause of the problem in about 35% of couples that present to our clinics for the treatment of infertility. This unfortunately very common problem stems from an alteration of the normal anatomy of the abdomen from some sort of inflammation. In order to truly understand its’ effect upon fertility, you … Read more
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Gary M. Horowitz, MD
One of the greatest fears among patients undergoing in vitro fertilization or other Assisted Reproductive Technologies (ART) is that the steps necessary to achieve this much wanted pregnancy may put the embryos that are created at risk for genetic abnormalities. We have known for many years that nearly half of embryos created using IVF are … Read more
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Gary M. Horowitz, MD
There is a Bill before the Senate that has made the headlines this week (NY times Op Ed page 26 August 2912) which merges two seemingly completely unrelated quantities: disabled American veterans and the search for fertility insurance coverage. As currently written, this bill would allow infertility benefits for disabled veterans who now need them. … Read more
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Gary M. Horowitz, MD
The headlines of many of the country’s largest newspapers rang this week echoing a call by the World Health Organization (WHO) to decry the unconscionable distribution of medications of inferior quality to the world’s poorer populations (See The Washington Post’s Op-Ed page 13 July or New York Times Science Section of the same day). While … Read more
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Gary M. Horowitz, MD
The July 17, 2012 issue of the New York Times carried a banner article (High doses of hormones faulted in failure of fertility care) about the dangers of every patient’s worst IVF nightmare: hospitalization for ovarian hyperstimulation syndrome without clinical success (the desired pregnancy). A very unfortunate patient was stimulated for IVF and wound up … Read more
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Gary M. Horowitz, MD
Certainly the most anticipated lab test in a fertility clinic is a human chorionic gonadotropin (hCG) level. While everyone knows that having a positive beta hCG is the ultimate prize, it is far more difficult to truly understand what the test is really telling you. First, what does a + hCG test really mean? Here … Read more
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Gary M. Horowitz, MD
Much has been made of the birth on July 25, 1978 of Louise Brown, the world’s first child conceived by what was at that time a revolutionary scientific technique called in vitro fertilization (IVF). This initial success has opened to the doors of parenthood to millions of couples who, prior to this, had little if any chance of having … Read more
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Gary M. Horowitz, MD
The uterus is essentially a muscle with a very specialized lining called the endometrium, inside of which pregnancy develops. Although this definition sounds very simplistic, it still works very well when considering conditions and diseases of the uterine environment that can effect implantation of the embryo and the successful outcome of a pregnancy. These abnormalities … Read more
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Gary M. Horowitz, MD
The process of going through an IVF stimulation cycle is hard to endure at the best of times. The strange mixture of medications, ultrasounds and the assorted probings and proddings which make up the cycle can be overwhelming at times. The process itself initially seems like a mixture of rocket science and magic and can … Read more
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Gary M. Horowitz, MD
Ask Our Doctors
Love this post! I think it’s so true that you need to feel like you can ask your doctor the process and really explain things to you. We all need to be stress free and this is exactly how we can do that. Thanks Dr. Horowitz for this great post! So great to know what SIRM has doctor’s that can admit they don’t know it all but they are willing to do the research and communication to get you the right answer.