August 15, 2014

Defining Patient-Centered Care

Patient-Centered Infertility Care

Infertility is a life crisis for the millions of people affected. Why infertility happens, what to do about it and where to go for answers are overwhelming questions for those suffering this devastating disease.

Infertility is a common affliction affecting up to 15% of those trying to have a baby. The causes vary from the subtle to the obvious but a complete evaluation can be accomplished within the time frame of a normal menstrual cycle. If menses are not regular the evaluation can still be completed within one calendar month. Treatment choices depend on potential causes and vary from something simple like appropriate timing of intercourse to more involved solutions including In Vitro Fertilization (IVF). Successful pregnancy outcome depends on treatment. Treatment outcomes should be compared with the option of trying to conceive naturally. The chance of conceiving per month of trying for women under age 35 is only 20% per month. After a year of attempting conception without success that 20% chance per month drops to <4% per month and if the woman is over 35 years of age the chance of conception drops to <4% after only 6 months of trying to have a baby.

Unfortunately it is very difficult for those suffering infertility to compare pregnancy success rates among the over 450 fertility centers in the United States and neither the American Society for Reproductive Medicine (ASRM), their subsidiary organization composed of IVF specialists in the Society for Assisted Reproductive Technology (SART) nor the governmental agency, the Centers for Disease Control (CDC) make it easy for patients to compare IVF programs. In fact the official position of the ASRM and SART is that IVF programs should not be compared and even states this on their website.

So what are patients to do? How are they to know where they are going is the best for them? Who is really looking out for them and their interests? First, it is important to ask your doctor what they mean by success. Success means different things to different people. Success may mean the chance of a pregnancy by doing something different than what you have been doing. The chance of pregnancy does not mean the same thing as the chance of a baby and the chance of a baby does not mean the same thing as the chance of one healthy baby. The most important question for a patient to ask if they are contemplating IVF is, “What is my chance given my diagnosis to have a healthy baby if only one embryo is transferred?” Another important question is how safe for me is the treatment and equally important is, “How much will my treatment cost?” Defining patient-centered care can vary, but asking these questions may challenge the current approach to patient care offered by all but a few fertility centers. Honest answers to these fundamental questions is how patient-centered care should be defined.

We at the Fertility Centers of New England understand that providing the right care at the right time for the right cost is of fundamental importance. At the Fertility Centers of new England 55% of women under age 35 have an elective single embryo transfer (eSET) enabling over a 50% pregnancy success rate; and for those without insurance, we over free initial consultations and IVF Assist, which is the most cost effective IVF plan available. This is how the Fertility Centers of New England defines patient-centered care. Contact us today. We can help.

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Joseph A. Hill, III, M.D.

Joseph A. Hill, III, M.D. Board-Certified in Reproductive Endocrinology and Infertility