Patient safety and empowerment: navigating the fertility journey

Healthcare expenses in the United States have soared to astronomical levels. In 2022, the average annual premium for individual employer-sponsored coverage reached a staggering $7,911, with family plans reaching an eye-popping $22,463, according to data from the Kaiser Family Foundation. Shockingly, over the past five years, family coverage premiums have surged by 20%, and over the past decade, they’ve skyrocketed by 43%. When it comes to fertility treatments, particularly In Vitro Fertilization (IVF), the financial burden is equally daunting. Currently, a single IVF cycle in the U.S. can set you back approximately $11,000 to $12,000, as reported by the Advanced Fertility Center of Chicago. Compounding the issue, infertility and IVF insurance coverage remains uncommon, leaving patients to grapple with considerable out-of-pocket expenses and significant variations in what’s covered.

As a result, many professional women navigating the complexities of fertility treatments while juggling the demands of everyday life often find themselves making hasty decisions. When an available healthcare provider offers an appointment sooner than three months down the line, it’s a tempting opportunity they can’t afford to miss. Yet, fertility is an intensely personal and emotionally charged journey for countless women, often accompanied by feelings of vulnerability, guilt, and self-reflection.

In the wake of the explosive release of the NYT’s gripping podcast series, ‘The Retrievals,’ which delves into the shocking events that unfolded at a Yale fertility clinic, where many women on their path to motherhood put their trust, patient safety has become an urgent and necessary conversation. ‘The Retrievals’ highlights the profound importance of ensuring the security and well-being of individuals embarking on fertility journeys. And as World Patient Safety Day arrives, with its theme ‘Empowering Patients for Ensured Safety’ on September 17, it’s a perfect moment to delve into this critical dialogue.

This special day recognizes the central role patients, along with their families and caregivers, play in safeguarding the quality of healthcare services. Considerable evidence demonstrates that when patients are actively engaged as vital partners in their healthcare, the results are remarkable—improved safety, higher levels of patient satisfaction, and better health outcomes. By actively participating in their healthcare decisions, patients not only secure their own well-being but also contribute to the overall safety and quality of the healthcare system.

With the banner of ‘Amplify the Patient’s Voice!’ as its rallying cry, the World Health Organization (WHO) calls upon all stakeholders to take crucial steps in ensuring patient involvement in policy development, representation within governance structures, collaborative efforts in shaping safety strategies, and active participation in personal healthcare decisions. So, as women embark on their unique fertility journeys, what are the vital questions, concerns, and warning signs they should keep in mind? MBAchic is here to break down the non-negotiables every woman should be aware of when it comes to building confidence in their medical team.

Emotional Wellbeing

Much like countless other busy working professionals in their thirties, Dr. Tiffany Mathias is embarking on her own fertility journey while being acutely aware of the experiences of numerous women who have ventured through a spectrum of fertility treatments, such as IVF, IUI, and oocyte cryopreservation. As a healthcare provider herself, (check out her #MBAchicTakeover here)  she finds herself deeply moved by the stories recounted in ‘The Retrievals,’ but equally disturbed by the fact that such unsettling events could occur in an environment meant to be a safe haven for women.

In light of these revelations, Dr. Mathias underscores the significance of several critical questions that patients must consider when seeking reproductive care and fertility treatments to safeguard their well-being. Foremost among her insights is the importance of selecting a ‘quarterback’—the primary physician with whom you can establish trust and confide in throughout your fertility journey.

“Going through just the beginning stages of the fertility process for me, even as a medical provider, I was so touched meeting my OB and my main quarterback, it was so surprising to me on multiple levels, how quickly we established rapport and how comfortable I felt so quickly being able to talk to her about so many things,” Mathias tells MBAchic. “It was so disarming to me when she said things like, ‘if you were my sister, this is what I would want you to do.’ Being a provider, I’m thinking, ‘yeah, this is something that I would feel comfortable saying that I hope helps my patients.’ But when she said that to me, I got misty-eyed, thinking, ‘wow, she really does care about me.’”  

Dr. Mathias emphasizes the immeasurable value of having a trusted medical provider who collaborates with patients to make crucial decisions and provides honest, professional guidance throughout their fertility journey.

For Allison Stoker, grappling with infertility proved to be one of life’s most formidable challenges. Despite the unwavering support of her husband and the reassuring presence of her best friend, who had already undergone IVF, Allison vividly remembers the overwhelming sense of isolation and solitude that engulfed her during this deeply personal journey.

“I felt like my body was failing us when we so badly wanted a child,” Stoker recalls. “I had always been very results-oriented and that had served me well in my life — worked hard for my MBA which got me a better job, for example. But this experience was so far outside of that, you can do everything ‘right,’ take all of the supplements, eat only the healthiest foods that people swear will improve your egg quality, but hard work doesn’t guarantee a baby.”

The Stokers got matching tattoos honoring their fertility journey

To cope, she leaned on her support system, and even connected with a few other women going through IVF on Instagram which led her to join an infertility support group where she finally felt seen and understood by other people fighting for their future children. 

“I didn’t share publicly about my infertility and IVF journey during the difficult times, but after I became pregnant I felt ready to share about it,” Stoker says. “I’ve had so many people tell me that they are also going through infertility, and it’s been amazing for me to connect with others and provide encouragement and support on their journeys. 

Red Flags

Dr. Mathias underscores the significance of being alert to certain warning signs in the healthcare provider-patient relationship. She acknowledges that healthcare professionals often contend with demanding schedules, but she emphasizes that critical concerns should never be disregarded. If, as a patient, you ever feel uneasy or apprehensive, it’s a valid and essential reason to reconsider both your treatment path and the specific provider accompanying you on this profoundly personal journey.

“If you feel repeatedly dismissed or you’re trying to talk about a concern that you have and you don’t feel like it’s being addressed repeatedly, I think that’s a red flag,” says Mathias. 

Through her Fertility Rally support group, Stoker learned that many fertility doctors get “scored” each year based on how successful their IVF outcomes are.

“Doctors who are overly concerned with these scores will see patients as an easy win and encourage people who could likely have success with lower forms of fertility intervention to immediately try IVF, it’s definitely a red flag if a fertility doctor immediately tries to force IVF without real evidence for why lower forms of intervention (such as medication and/or intrauterine insemination) wouldn’t be viable options,” Stoker adds. “Unfortunately this was my experience, which I didn’t find out until I got a second opinion from a fantastic doctor who told me I likely could have conceived without IVF. At that point, I already had embryos and moved forward with my embryo transfer which resulted in my wonderful son, Kasper.”

Allison's fertility journey

Seeking Support

Informed decision-making and patient advocacy encompass not only asking the right questions but also seeking support from those around you. While Dr. Mathias, like many accomplished professional women, possesses a strong sense of independence and self-assuredness when it comes to decision-making, she has come to appreciate the significant advantages of involving her close friends, family members, and her husband in open dialogue as she navigates her unique fertility journey.

“Going through the process, I think you learn a lot about yourself, and if you’re a busy professional, you don’t always have time to sit there and think, ‘oh, what are the things that I forget to do? What are the things that happen to me when I have sedation? What are the things that I need to think about when I go to the doctor’s office?’ But being able to have somebody that I could talk to about my experiences was so invaluable personally for me, because I learned so many things that I needed to keep at the front of my mind that I needed to remember to ask about that I don’t think I would have ever thought about or intentionally asked about,” Dr. Mathias says. “It’s important to involve other people to not go through this alone because you really do go through a roller coaster of emotions when you’re going through something as important and sensitive as this, as many people as you can have on your team, it can only help you.” 

The Stokers announce their pregnancy

In Stoker’s own fertility treatment experience, she was able to strike a balance between advocating for her unique needs and trusting the expertise of the medical team thanks to the support and encouragement from her infertility support group. In this way, she says she was able to tap into her maternal instincts and play an active role in creating a safe and supportive environment throughout her fertility journey. 

It was really hard for me to balance trusting my medical team and advocating for myself, I am very much a people-pleaser and I hate conflict, so standing up for myself doesn’t come naturally,” Stoker recalls. “My infertility support group really encouraged me to push back on certain things my doctor suggested and to get a second opinion. I often tell people going through infertility that they are warriors fighting for their future kids.”

Allison and her newborn baby

Choosing a Trusted Provider 

So, what are some key factors and considerations that individuals should prioritize when choosing a healthcare provider or clinic for their health needs?

Stoker says she always tries to remind other fertility patients that they are real people deserving of individualized care and consideration. To other women who may be going through similar challenges, she suggests joining support groups or looking into free resources (one of her personal favorites is RESOLVE). Thanks to the network of supportive women she joined, she was able to learn about supplements and procedures to discuss with her medical team. 

“You are not alone,” Stoker says. “There is no shame in what you are going through. You didn’t do anything wrong and this doesn’t mean you’re not meant to be a parent. I’m sorry the road is long for you. I hold you in my heart with so much hope that you will have the happy ending you deserve.”

Dr. Mathias adds that taking the time to research, ask questions, and switch providers until you feel truly secure and confident in your decision is crucial to ensure patient safety, especially for women who are working hard in their professional lives to make waves, and shape society. 

“It’s very hard to move and shake things if you’re not taking care of yourself, and if you’re not [prioritizing self care], you make it harder for yourself to prioritize the important stuff and to make meaningful high quality decisions, not just in your personal life, but also in your professional life,” says Mathias. 

To make World Patient Day truly impactful, medical communities must continue working towards creating spaces and chances for a diverse range of patients and families to share their thoughts, worries, hopes, and choices openly and honestly. By coming together like this, we’re working towards improving safety, putting patients at the center of care, building trust, and making healthcare fairer for everyone.

Allison's fertility journey and portraits

Photos from Allison Blakley Stoker

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