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A DOCTOR","duration":837.338,"hashedId":"hcnhdkwv6h","branding":false,"enableCustomerLogo":false,"seoDescription":"a Customized Chrome Videos video","preloadPreference":null,"flashPlayerUrl":"https://embed-ssl.wistia.com/flash/embed_player_v2.0.swf?2017-04-20","showAbout":true,"createdAt":1478642556,"firstEmbedForAccount":false,"firstShareForAccount":false,"stats":{"loadCount":6479,"playCount":516,"uniqueLoadCount":4022,"uniquePlayCount":382,"averageEngagement":0.420625},"trackingTransmitInterval":27,"integrations":{"google_analytics":true},"captions":[{"language":"eng","text":"[MUSIC PLAYING]\n\nChoosing a fertility\ndoctor may be\n\none of the most\nimportant decisions\n\nyou make in your lifetime.\n\nThere's just a lot\nof doctors out there,\n\nand you're trying to\nmake a quick decision.\n\nAnd there's so much that\nhangs in the balance--\n\nyour money, your\ntime, your emotions.\n\nAt the end of the\nday this is really\n\na matching issue-- who's going\nto be a good fit for you?\n\nFertility doctors and fertility\npatients are really varied,\n\nso what works for you\nmight be completely\n\nwrong for the next patient.\n\nThe thing that\nsurprised me the most\n\nwas just how\nindividual we all are.\n\nFor me and my partner, the\nfamily building process\n\nwas complicated.\n\nFor me, it was really\nabout having a doctor\n\nthat I felt had the patience\nand the inquisitiveness.\n\nMy wife loves a\ngood bedside manner.\n\nI was willing to trade\nthe great bedside manner\n\nand become just a number\nin a big hospital.\n\nI do think that I would\nwant a doctor that\n\nis a little bit more\nwilling to take risk.\n\nIt is one of the quintessential\nerrors in our specialty\n\nthat we have assumed\nthat everybody\n\nshould be treated the same way.\n\nLike elsewhere in medicine,\nbut in vitro fertilization\n\ntoo, has to be individualized.\n\nThat every patient, in\na way, is different.\n\nIs every fertility doctor a good\nfit for any kind of patient?\n\nI don't think that's true.\n\nWe do a great job.\n\nWe're not for everybody.\n\nWe have patients\nthat want to text\n\nwith the doctors in the\nmiddle of the night,\n\nand we have to say, no that's\nnot a realistic expectation.\n\nI'm sure there have\nbeen patients who've\n\ncome to me, who've said that\njust wasn't a good match,\n\nand didn't come back.\n\nI can't really take good care of\nyou if you're not comfortable,\n\nand sometimes that's\nbecause for some reason\n\nour personalities\njust don't fit,\n\nour philosophies just don't fit.\n\nDescribe your\ntendencies as a doctor,\n\nand who is that a good fit for?\n\nWe are focused exclusively\non recurrent pregnancy loss.\n\nThat is what we do.\n\nReproductive\nendocrinologists and\n\nthe reproductive embryologists\nsee the world very differently.\n\nIVF, indeed, is my specialty.\n\nNow, the reproductive\nendocrinologists\n\nare sub-specialists of OBG-YN.\n\nMy wife is an OBG-YN.\n\nOBG-YN's really do a phenomenal\njob regarding women's health,\n\nbut they're not\nmale specialists.\n\nUrologists are.\n\nI think sometimes\nhumor can be helpful.\n\nI think that a lot of\npatients find comfort in me\n\nand find that I'm\nrelatable, and feel\n\nlike they can ask me anything.\n\nWe have other\npatients who say, I\n\nwant the gray hair on the team.\n\nI want the oldest, most\nexperienced physician.\n\nPatients will definitely\nhave differing experiences\n\nat various centers,\nand by experience I\n\nmean the actual\nsatisfaction of their care,\n\nas well as their outcome.\n\nIt's not just the\nphysician-- it's the nurses,\n\nit's the person\nat the front desk,\n\nit's the person in the\nbilling department.\n\nChances are you\ndon't have the time\n\nto go interview every\nfertility doctor in town,\n\nbut maybe you'll end up going\nto the first fertility doctor\n\nthat you hear about.\n\nAnd according to our data,\nthere's a greater than 50%\n\nchance you'll ultimately end\nup leaving the doctor unhappy,\n\nbut not before you\nsacrificed a lot.\n\nIt was not easy to\nleave our first doctor.\n\nWe were adamant\nthat we were going\n\nto find the best doctor\nfor us, because we\n\ndon't want to be jumping\naround from doctor to doctor.\n\nWe cycled three times\nwith our second doctor,\n\nand I think in hindsight I\nprobably should have moved on\n\nafter the second cycle.\n\nSo it took three whole years.\n\nWithin those three years\nwere several failed attempts.\n\nSo we have the\nexperience of working\n\nwith two different clinics.\n\nFinding the right match\nis really time consuming\n\nand it's hard, but\nit's definitely\n\nworth it in the long run.\n\nWe've read the accounts of over\nthousands of fertility patients\n\nand paid close attention\nto where patients are happy\n\nand where they're less happy.\n\nWe've noticed a handful\nof interesting trends\n\nthat hopefully help you out.\n\nLet's make sure you land at the\nright place at the first time\n\naround.\n\nHere's the fertility IQ\nprotocol with questions\n\nthat you should ask your\ndoctor and your clinic\n\nto make sure you're\nat the right place.\n\nSo if you're thinking\nabout doing egg freezing,\n\nmake sure you go to a\nclinic that actually\n\nknows how to do egg freezing.\n\nOver 50% of the clinics\nout there have never\n\nthawed a frozen egg cycle.\n\nYou also want to consider\nwhether you would actually\n\nwant to be an IVF\npatient at this clinic.\n\nIf you go back to use\nthese eggs, that's IVF\n\nand it's much more complicated\nboth medically and emotionally\n\nthan just egg freezing.\n\nSo speaking of IVF, if your\ngoal is to try and conceive now,\n\nmake sure you go\nto a clinic that\n\nactually has enough experience.\n\nA cutoff point might be\naround 200 or so cycles,\n\nand you can go to\nFertilityIQ.com\n\nto look up what each\nclinic cycle volume is.\n\nSo the downside with some\nof these very small centers\n\nwhen they don't have very\nhigh volume in the lab,\n\nI think it's a little\nhard to kind of keep up\n\nto date with the technology\nand then make changes as needed\n\nand see the outcome.\n\nYou also want to\nunderstand how aggressive\n\nis your doctor and clinic?\n\nAre they going to want to\nstart you immediately on IVF,\n\nor first start off with a\nlot of Clomid and IUI cycles?\n\nAre they going to want\nto ramp it up to the max,\n\nor are they going to want to\ngo low and slow with hormones?\n\nYou need to really consider\nyour own preferences--\n\nfrom your budget\nto your timeline\n\nto your preferences\naround hormones.\n\nMy doctor told me we'll try\nIUI with you three times.\n\nIf it doesn't work by then,\nyou're running out of sperm.\n\nIt's probably time\nto move on to IVF.\n\nOK, well now we're on\nthe fast track to IVF.\n\nOr you love something\nmore natural,\n\nand the doctor is like, no,\nyou need to go with IVF.\n\nYou're not even ready\nfor IVF have right now,\n\nyou're just trying to get\npregnant the last two months.\n\nSo is this the doctor for you?\n\nSo undergoing IUI was kind\nof just like the appetizer,\n\nand then IVF was like, wow this\nis a much bigger situation.\n\nHonestly, I can make\na baby for anybody\n\nif they have no boundaries and\nno limitations in time or money\n\nor insurance, but that\ndoesn't necessarily mean\n\nthat's right for everybody.\n\nA lot of people don't\nbelieve in donor egg\n\nor don't feel\ncomfortable with IVF.\n\nThere's over 15 different\ntypes of fertility diagnoses,\n\nand you want to\nmake sure that you\n\ngo to a doctor that's\nreally good at treating\n\nwhat it is that you have.\n\nAlmost no doctor will ever\nturn down new business,\n\nbut if you have endometriosis\nyou want to make sure\n\nyou're probably not going\nto see a doctor that\n\nlikes to focus on PCOS.\n\nIs this clinic set up\nto deal with my case?\n\nAnd they'll always say, oh\nwe can deal with everyone\n\nand-- I don't know if\nthat's always true.\n\nI think it's fair to say that\nthe fact that the patient is\n\ncoming to you doesn't\nmean that they have\n\nwhat you necessarily\nare treating.\n\nYou should also understand your\ndoctor and clinic's preferences\n\nand biases around single versus\nmultiple embryo transfers.\n\nYou might feel OK with the\nconcept of having twins,\n\nbut your clinic might\nnot, or vice versa,\n\nand you should know\nthat in advance.\n\nSome won't even\nentertain putting\n\nin more than one embryo.\n\nSo we follow doctor's\nadvice, right?\n\nWe're putting in one\nscreened embryo these days.\n\nSometimes a second\nscreened embryo.\n\nI really want you to just\nhave one embryo per uterus\n\nat a time.\n\nThere's also the\nvery realistic chance\n\nyou're going to have trouble\nconceiving using your own eggs,\n\nand it's important to clear\nup front with your doctor\n\nwhether their intentions\nwould be at that point\n\nto having you use an egg donor.\n\nNow there can be lots of great\nreasons to use an egg donor,\n\nbut you'll want to understand\nway in advance what\n\ntheir motivations are and why.\n\nI just felt that we\ndidn't see eye to eye,\n\nand the reason for that\nwas after our second failed\n\ncycle he said, you\nknow I really think\n\nyou should consider donor eggs.\n\nAnd I know that that's a\nreally sensitive subject,\n\nbut I just felt that it\nwas really premature.\n\nIf your FSH is high,\nyour AMH is low,\n\nyour chances aren't very good.\n\nEgg donor would be\nyour best option.\n\nShe stopped me right\nthere and said,\n\ndon't ever talk about\negg donor again with me.\n\nI don't want to talk about it.\n\nYou also want to understand\nhow will your doctor adjust\n\nyour protocol if your\ntreatment is not successful?\n\nYou want your doctor to take\nthat information from one cycle\n\nand adjust things\nand tweak things so\n\nthat you'll have a better\nchance in your next cycle.\n\nSo it's important to tailor\nthe treatment to what's\n\nreally affecting the patient.\n\nThe reality is, every\npatient is different\n\nand there's an enormous\nnumber of factors\n\nthat can cause pregnancy loss.\n\nAnd so it's\nimportant to identify\n\nwhat that cause is for the\nparticular patient sitting\n\nin front of you.\n\nReally having a clinician\nthat's willing to,\n\nsort of, tweak and figure\nout, or maybe just completely\n\nthrow it out and do\nsomething totally different,\n\nto me becomes a really\nimportant trait to have.\n\nNext you want to think\nabout whether you\n\nwant to be at a big\nclinic or whether you\n\nwant to be at a small clinic.\n\nLike everything in life,\nthere are tradeoffs.\n\nTypically the larger\nclinics have more\n\nin the way of resources,\nbut most patients\n\ntell us when they go there\na larger clinic they end up\n\nfeeling more like a number,\nand maybe in that case\n\nyou'd be happier in a smaller\nclinic where every day\n\nyou're probably going\nto end up seeing\n\nthe same doctor, the same\nnurse, the same phlebotomist.\n\nThe larger a clinic\nthe more likely\n\nthey are to include a\nmale reproductive expert\n\non their staff.\n\nThe larger lab just accrues\na lot more data in real time.\n\nSo that's one thing, in terms\nof a large versus small lab.\n\nThat place was run\nlike a machine.\n\nAnd it was a good machine,\nbecause they got me pregnant.\n\nThe downside to a larger\ncenter is that oftentimes there\n\nis a lot of different\nphysicians who work there.\n\nIt's very busy.\n\nThe waiting room is very busy.\n\nSo I think that's a trade off\nat some of the larger centers.\n\nYou know, patients\na lot of times\n\nexpress a feeling that\nnobody really knows who I am.\n\nI see a different\ndoctor every time I go.\n\nI actually came from\na very big center\n\nand then moved on to a small\ncenter, because I really\n\nwant to do this individualized\ntreatment for my patients.\n\nSo it's kind of choosing what it\nis that really matters to you--\n\ndo you really want your hand\nheld through the process?\n\nDo you mind being one of 200\npatients sitting in a waiting\n\nroom?\n\nIt was worth feeling\nuncomfortable and having\n\nvarious men every\nother day coming in\n\nand sticking my feet\nin those stirrups,\n\nknowing that I'm doing\nthis for a purpose.\n\nIt's all going to be OK.\n\nIf it's big, does this mean this\ndoctor is seeing 100 patients\n\nand forgot who you are?\n\nSo those are very\nimportant questions,\n\nand very important\nsense of knowing\n\nwhen they go to the IVF center.\n\nYou may feel like the doctors\nat an academic institution\n\nare more consistently\nvetted, but on the other hand\n\nour data shows you're less\nlikely to see those doctors\n\nand less likely to have those\ndoctors perform your procedure.\n\nThe fertility treatment process\ninvolves a lot of variables,\n\nand medical errors do get made.\n\nAccording to our data,\none in five patients\n\nrecords a medical error was made\nwhile they were being treated.\n\nAlso, according to our\ndata, those patients\n\nwere 60% less likely to end up\nhaving a successful outcome.\n\nYou also want to understand\nhow good is a clinic's lab?\n\nEmbryologists have told us\nthat an excellent lab can\n\ndouble your chances of\nsuccess, so this is obviously\n\nvery important.\n\nYou want to know--\ndoes your lab have\n\nthe expertise, the\nprocess, and the technology\n\nto ensure that you succeed?\n\nWe actually have an entire\nvideo on the site that tells you\n\nwhich questions you\nshould be asking your lab,\n\nso if you want more detail\ndefinitely check that out.\n\nI think over time\nI realized, wow,\n\nlike, I don't hear as\nmuch about the lab,\n\nand yet I think it's\nso insanely important.\n\nSo there's a wide range of\nIVF laboratories out there.\n\nGoing to an excellent\nlab versus an average lab\n\ncould likely increase\nyour chances by two-fold.\n\nI think you can\nprobably do better\n\nwith a solid reproductive\nendocrinologist\n\nand an excellent laboratory,\nrather than vice versa.\n\nThe average IVF patient will end\nup doing more than three cycles\n\nand spending more than\n$60,000 before they end up\n\nhaving a successful outcome.\n\nPatients who rated the\nbilling department highly\n\nwere far more likely to\nrecommend that clinic,\n\nregardless of whether they\nwere successful or not.\n\nAn excellent\nfinancial coordinator\n\nwill guide you through the\nprocess, help you save money,\n\nmake sure you're not\npaying for something\n\nyou're not supposed\nto be paying for.\n\nAnd then you have your financial\ncoordinators that kind of just\n\ngive you the basic info,\nbut don't really teach you.\n\nDon't really show you what to\nexpect, which doesn't really\n\nhelp the patient,\nbecause then they\n\nhave to kind of\ninvestigate everything.\n\nOh, did I leave out the\nmost important part?\n\nIf this were free,\neveryone would do it.\n\nIt's really costly, and\nyou have to factor that in,\n\nbecause it's a lot of money.\n\nI think one of the things\nthat's really mystified me,\n\nas far as this whole\nprocess, is the cost.\n\nIn the end, they end up\npaying at least anywhere\n\nbetween $3,000 to $5,000 more\nthan what they anticipated\n\nthey would have spent.\n\nThey're like, sign this.\n\nYou owe $4,500 because you're\ngoing to do this thing.\n\nI wish I had asked\nmore questions.\n\nI wish I had said, well\nexplain why I need to do this.\n\nAnd a lot of times\nit is a receptionist.\n\nMaybe she doesn't know\nwhy you need to do this.\n\nShe's just doing her job.\n\nIt's not her job to be\nextra friendly to you.\n\nBut I would just sign\non the dotted line\n\nand hand over my\ncredit card, and just\n\nstress out about it silently\nsitting in the waiting room,\n\ninstead of really getting\nthe answers that I wanted.\n\nObviously, this is a lot of\ninformation to throw at you,\n\nbut it is truly important\nthat you get answers\n\nto these questions.\n\nSome of this your\ndoctor can provide you,\n\nand for everything else\njust go to FertilityIQ\n\nfor more insight."},{"language":"eng","text":"[MUSIC PLAYING]\n\nChoosing a fertility\ndoctor may be\n\none of the most\nimportant decisions\n\nyou make in your lifetime.\n\nThere's just a lot\nof doctors out there,\n\nand you're trying to\nmake a quick decision.\n\nAnd there's so much that\nhangs in the balance--\n\nyour money, your\ntime, your emotions.\n\nAt the end of the\nday this is really\n\na matching issue-- who's going\nto be a good fit for you?\n\nFertility doctors and fertility\npatients are really varied,\n\nso what works for you\nmight be completely\n\nwrong for the next patient.\n\nThe thing that\nsurprised me the most\n\nwas just how\nindividual we all are.\n\nFor me and my partner, the\nfamily building process\n\nwas complicated.\n\nFor me, it was really\nabout having a doctor\n\nthat I felt had the patience\nand the inquisitiveness.\n\nMy wife loves a\ngood bedside manner.\n\nI was willing to trade\nthe great bedside manner\n\nand become just a number\nin a big hospital.\n\nI do think that I would\nwant a doctor that\n\nis a little bit more\nwilling to take risk.\n\nIt is one of the quintessential\nerrors in our specialty\n\nthat we have assumed\nthat everybody\n\nshould be treated the same way.\n\nLike elsewhere in medicine,\nbut in vitro fertilization\n\ntoo, has to be individualized.\n\nThat every patient, in\na way, is different.\n\nIs every fertility doctor a good\nfit for any kind of patient?\n\nI don't think that's true.\n\nWe do a great job.\n\nWe're not for everybody.\n\nWe have patients\nthat want to text\n\nwith the doctors in the\nmiddle of the night,\n\nand we have to say, no that's\nnot a realistic expectation.\n\nI'm sure there have\nbeen patients who've\n\ncome to me, who've said that\njust wasn't a good match,\n\nand didn't come back.\n\nI can't really take good care of\nyou if you're not comfortable,\n\nand sometimes that's\nbecause for some reason\n\nour personalities\njust don't fit,\n\nour philosophies just don't fit.\n\nDescribe your\ntendencies as a doctor,\n\nand who is that a good fit for?\n\nWe are focused exclusively\non recurrent pregnancy loss.\n\nThat is what we do.\n\nReproductive\nendocrinologists and\n\nthe reproductive embryologists\nsee the world very differently.\n\nIVF, indeed, is my specialty.\n\nNow, the reproductive\nendocrinologists\n\nare sub-specialists of OBG-YN.\n\nMy wife is an OBG-YN.\n\nOBG-YN's really do a phenomenal\njob regarding women's health,\n\nbut they're not\nmale specialists.\n\nUrologists are.\n\nI think sometimes\nhumor can be helpful.\n\nI think that a lot of\npatients find comfort in me\n\nand find that I'm\nrelatable, and feel\n\nlike they can ask me anything.\n\nWe have other\npatients who say, I\n\nwant the gray hair on the team.\n\nI want the oldest, most\nexperienced physician.\n\nPatients will definitely\nhave differing experiences\n\nat various centers,\nand by experience I\n\nmean the actual\nsatisfaction of their care,\n\nas well as their outcome.\n\nIt's not just the\nphysician-- it's the nurses,\n\nit's the person\nat the front desk,\n\nit's the person in the\nbilling department.\n\nChances are you\ndon't have the time\n\nto go interview every\nfertility doctor in town,\n\nbut maybe you'll end up going\nto the first fertility doctor\n\nthat you hear about.\n\nAnd according to our data,\nthere's a greater than 50%\n\nchance you'll ultimately end\nup leaving the doctor unhappy,\n\nbut not before you\nsacrificed a lot.\n\nIt was not easy to\nleave our first doctor.\n\nWe were adamant\nthat we were going\n\nto find the best doctor\nfor us, because we\n\ndon't want to be jumping\naround from doctor to doctor.\n\nWe cycled three times\nwith our second doctor,\n\nand I think in hindsight I\nprobably should have moved on\n\nafter the second cycle.\n\nSo it took three whole years.\n\nWithin those three years\nwere several failed attempts.\n\nSo we have the\nexperience of working\n\nwith two different clinics.\n\nFinding the right match\nis really time consuming\n\nand it's hard, but\nit's definitely\n\nworth it in the long run.\n\nWe've read the accounts of over\nthousands of fertility patients\n\nand paid close attention\nto where patients are happy\n\nand where they're less happy.\n\nWe've noticed a handful\nof interesting trends\n\nthat hopefully help you out.\n\nLet's make sure you land at the\nright place at the first time\n\naround.\n\nHere's the fertility IQ\nprotocol with questions\n\nthat you should ask your\ndoctor and your clinic\n\nto make sure you're\nat the right place.\n\nSo if you're thinking\nabout doing egg freezing,\n\nmake sure you go to a\nclinic that actually\n\nknows how to do egg freezing.\n\nOver 50% of the clinics\nout there have never\n\nthawed a frozen egg cycle.\n\nYou also want to consider\nwhether you would actually\n\nwant to be an IVF\npatient at this clinic.\n\nIf you go back to use\nthese eggs, that's IVF\n\nand it's much more complicated\nboth medically and emotionally\n\nthan just egg freezing.\n\nSo speaking of IVF, if your\ngoal is to try and conceive now,\n\nmake sure you go\nto a clinic that\n\nactually has enough experience.\n\nA cutoff point might be\naround 200 or so cycles,\n\nand you can go to\nFertilityIQ.com\n\nto look up what each\nclinic cycle volume is.\n\nSo the downside with some\nof these very small centers\n\nwhen they don't have very\nhigh volume in the lab,\n\nI think it's a little\nhard to kind of keep up\n\nto date with the technology\nand then make changes as needed\n\nand see the outcome.\n\nYou also want to\nunderstand how aggressive\n\nis your doctor and clinic?\n\nAre they going to want to\nstart you immediately on IVF,\n\nor first start off with a\nlot of Clomid and IUI cycles?\n\nAre they going to want\nto ramp it up to the max,\n\nor are they going to want to\ngo low and slow with hormones?\n\nYou need to really consider\nyour own preferences--\n\nfrom your budget\nto your timeline\n\nto your preferences\naround hormones.\n\nMy doctor told me we'll try\nIUI with you three times.\n\nIf it doesn't work by then,\nyou're running out of sperm.\n\nIt's probably time\nto move on to IVF.\n\nOK, well now we're on\nthe fast track to IVF.\n\nOr you love something\nmore natural,\n\nand the doctor is like, no,\nyou need to go with IVF.\n\nYou're not even ready\nfor IVF have right now,\n\nyou're just trying to get\npregnant the last two months.\n\nSo is this the doctor for you?\n\nSo undergoing IUI was kind\nof just like the appetizer,\n\nand then IVF was like, wow this\nis a much bigger situation.\n\nHonestly, I can make\na baby for anybody\n\nif they have no boundaries and\nno limitations in time or money\n\nor insurance, but that\ndoesn't necessarily mean\n\nthat's right for everybody.\n\nA lot of people don't\nbelieve in donor egg\n\nor don't feel\ncomfortable with IVF.\n\nThere's over 15 different\ntypes of fertility diagnoses,\n\nand you want to\nmake sure that you\n\ngo to a doctor that's\nreally good at treating\n\nwhat it is that you have.\n\nAlmost no doctor will ever\nturn down new business,\n\nbut if you have endometriosis\nyou want to make sure\n\nyou're probably not going\nto see a doctor that\n\nlikes to focus on PCOS.\n\nIs this clinic set up\nto deal with my case?\n\nAnd they'll always say, oh\nwe can deal with everyone\n\nand-- I don't know if\nthat's always true.\n\nI think it's fair to say that\nthe fact that the patient is\n\ncoming to you doesn't\nmean that they have\n\nwhat you necessarily\nare treating.\n\nYou should also understand your\ndoctor and clinic's preferences\n\nand biases around single versus\nmultiple embryo transfers.\n\nYou might feel OK with the\nconcept of having twins,\n\nbut your clinic might\nnot, or vice versa,\n\nand you should know\nthat in advance.\n\nSome won't even\nentertain putting\n\nin more than one embryo.\n\nSo we follow doctor's\nadvice, right?\n\nWe're putting in one\nscreened embryo these days.\n\nSometimes a second\nscreened embryo.\n\nI really want you to just\nhave one embryo per uterus\n\nat a time.\n\nThere's also the\nvery realistic chance\n\nyou're going to have trouble\nconceiving using your own eggs,\n\nand it's important to clear\nup front with your doctor\n\nwhether their intentions\nwould be at that point\n\nto having you use an egg donor.\n\nNow there can be lots of great\nreasons to use an egg donor,\n\nbut you'll want to understand\nway in advance what\n\ntheir motivations are and why.\n\nI just felt that we\ndidn't see eye to eye,\n\nand the reason for that\nwas after our second failed\n\ncycle he said, you\nknow I really think\n\nyou should consider donor eggs.\n\nAnd I know that that's a\nreally sensitive subject,\n\nbut I just felt that it\nwas really premature.\n\nIf your FSH is high,\nyour AMH is low,\n\nyour chances aren't very good.\n\nEgg donor would be\nyour best option.\n\nShe stopped me right\nthere and said,\n\ndon't ever talk about\negg donor again with me.\n\nI don't want to talk about it.\n\nYou also want to understand\nhow will your doctor adjust\n\nyour protocol if your\ntreatment is not successful?\n\nYou want your doctor to take\nthat information from one cycle\n\nand adjust things\nand tweak things so\n\nthat you'll have a better\nchance in your next cycle.\n\nSo it's important to tailor\nthe treatment to what's\n\nreally affecting the patient.\n\nThe reality is, every\npatient is different\n\nand there's an enormous\nnumber of factors\n\nthat can cause pregnancy loss.\n\nAnd so it's\nimportant to identify\n\nwhat that cause is for the\nparticular patient sitting\n\nin front of you.\n\nReally having a clinician\nthat's willing to,\n\nsort of, tweak and figure\nout, or maybe just completely\n\nthrow it out and do\nsomething totally different,\n\nto me becomes a really\nimportant trait to have.\n\nNext you want to think\nabout whether you\n\nwant to be at a big\nclinic or whether you\n\nwant to be at a small clinic.\n\nLike everything in life,\nthere are tradeoffs.\n\nTypically the larger\nclinics have more\n\nin the way of resources,\nbut most patients\n\ntell us when they go there\na larger clinic they end up\n\nfeeling more like a number,\nand maybe in that case\n\nyou'd be happier in a smaller\nclinic where every day\n\nyou're probably going\nto end up seeing\n\nthe same doctor, the same\nnurse, the same phlebotomist.\n\nThe larger a clinic\nthe more likely\n\nthey are to include a\nmale reproductive expert\n\non their staff.\n\nThe larger lab just accrues\na lot more data in real time.\n\nSo that's one thing, in terms\nof a large versus small lab.\n\nThat place was run\nlike a machine.\n\nAnd it was a good machine,\nbecause they got me pregnant.\n\nThe downside to a larger\ncenter is that oftentimes there\n\nis a lot of different\nphysicians who work there.\n\nIt's very busy.\n\nThe waiting room is very busy.\n\nSo I think that's a trade off\nat some of the larger centers.\n\nYou know, patients\na lot of times\n\nexpress a feeling that\nnobody really knows who I am.\n\nI see a different\ndoctor every time I go.\n\nI actually came from\na very big center\n\nand then moved on to a small\ncenter, because I really\n\nwant to do this individualized\ntreatment for my patients.\n\nSo it's kind of choosing what it\nis that really matters to you--\n\ndo you really want your hand\nheld through the process?\n\nDo you mind being one of 200\npatients sitting in a waiting\n\nroom?\n\nIt was worth feeling\nuncomfortable and having\n\nvarious men every\nother day coming in\n\nand sticking my feet\nin those stirrups,\n\nknowing that I'm doing\nthis for a purpose.\n\nIt's all going to be OK.\n\nIf it's big, does this mean this\ndoctor is seeing 100 patients\n\nand forgot who you are?\n\nSo those are very\nimportant questions,\n\nand very important\nsense of knowing\n\nwhen they go to the IVF center.\n\nYou may feel like the doctors\nat an academic institution\n\nare more consistently\nvetted, but on the other hand\n\nour data shows you're less\nlikely to see those doctors\n\nand less likely to have those\ndoctors perform your procedure.\n\nThe fertility treatment process\ninvolves a lot of variables,\n\nand medical errors do get made.\n\nAccording to our data,\none in five patients\n\nrecords a medical error was made\nwhile they were being treated.\n\nAlso, according to our\ndata, those patients\n\nwere 60% less likely to end up\nhaving a successful outcome.\n\nYou also want to understand\nhow good is a clinic's lab?\n\nEmbryologists have told us\nthat an excellent lab can\n\ndouble your chances of\nsuccess, so this is obviously\n\nvery important.\n\nYou want to know--\ndoes your lab have\n\nthe expertise, the\nprocess, and the technology\n\nto ensure that you succeed?\n\nWe actually have an entire\nvideo on the site that tells you\n\nwhich questions you\nshould be asking your lab,\n\nso if you want more detail\ndefinitely check that out.\n\nI think over time\nI realized, wow,\n\nlike, I don't hear as\nmuch about the lab,\n\nand yet I think it's\nso insanely important.\n\nSo there's a wide range of\nIVF laboratories out there.\n\nGoing to an excellent\nlab versus an average lab\n\ncould likely increase\nyour chances by two-fold.\n\nI think you can\nprobably do better\n\nwith a solid reproductive\nendocrinologist\n\nand an excellent laboratory,\nrather than vice versa.\n\nThe average IVF patient will end\nup doing more than three cycles\n\nand spending more than\n$60,000 before they end up\n\nhaving a successful outcome.\n\nPatients who rated the\nbilling department highly\n\nwere far more likely to\nrecommend that clinic,\n\nregardless of whether they\nwere successful or not.\n\nAn excellent\nfinancial coordinator\n\nwill guide you through the\nprocess, help you save money,\n\nmake sure you're not\npaying for something\n\nyou're not supposed\nto be paying for.\n\nAnd then you have your financial\ncoordinators that kind of just\n\ngive you the basic info,\nbut don't really teach you.\n\nDon't really show you what to\nexpect, which doesn't really\n\nhelp the patient,\nbecause then they\n\nhave to kind of\ninvestigate everything.\n\nOh, did I leave out the\nmost important part?\n\nIf this were free,\neveryone would do it.\n\nIt's really costly, and\nyou have to factor that in,\n\nbecause it's a lot of money.\n\nI think one of the things\nthat's really mystified me,\n\nas far as this whole\nprocess, is the cost.\n\nIn the end, they end up\npaying at least anywhere\n\nbetween $3,000 to $5,000 more\nthan what they anticipated\n\nthey would have spent.\n\nThey're like, sign this.\n\nYou owe $4,500 because you're\ngoing to do this thing.\n\nI wish I had asked\nmore questions.\n\nI wish I had said, well\nexplain why I need to do this.\n\nAnd a lot of times\nit is a receptionist.\n\nMaybe she doesn't know\nwhy you need to do this.\n\nShe's just doing her job.\n\nIt's not her job to be\nextra friendly to you.\n\nBut I would just sign\non the dotted line\n\nand hand over my\ncredit card, and just\n\nstress out about it silently\nsitting in the waiting room,\n\ninstead of really getting\nthe answers that I wanted.\n\nObviously, this is a lot of\ninformation to throw at you,\n\nbut it is truly important\nthat you get answers\n\nto these questions.\n\nSome of this your\ndoctor can provide you,\n\nand for everything else\njust go to FertilityIQ\n\nfor more insight."}],"transcript":{"videoId":"e915bc47-1a1c-4abc-ae38-0ca336cd48d1"},"hls_enabled":true,"embed_options":{"volumeControl":"true","fullscreenButton":"true","controlsVisibleOnLoad":"false","playerColor":"f68c71","bpbTime":"false","anonymizeIp":true,"vulcan":"true","videoQuality":"","version":"v2","stillUrl":"https://embed-ssl.wistia.com/deliveries/204836cd1d375ca0503c59b54a0ab707a2ab18c4.bin","playButton":"true","smallPlayButton":"true","playbar":"true","settingsControl":"true","qualityControl":"true","playbackRateControl":"true","autoPlay":"false","endVideoBehavior":"default","branding":"false","plugin":{"share":{"channels":"facebook-twitter-embed","pageTitle":"Wistia's Agency Partner Program","pageUrl":"http://crlvideo.wistia.com/medias/f0mrbf55oy","downloadType":"sd_mp4","tweetText":"{video_name}","overrideUrl":"false","conversionOpportunityKey":"wistia-production_1483056"},"captions-v1":{"onByDefault":"false"}},"playsinline":true}},"options":{}})