Too Much Patience Is Not a Virtue

"Patience is a virtue,
  Possess if you can,
  Found rarely in a woman,
  And never in a man."


My Grandmother used to tell me that as a child.  But every once in a while, I see a patient with too much patience.

One of the first questions I ask my patients is "how long have you been trying?"  Usually I get answers in the 6 months to 1 1/2 year range.  The other day I got the answer "six years".  She was 43.  My heart just sank.  It is rare for 43 years olds who have been unsuccessful for that long to be able to conceive with anything less than donated eggs.  She told me that she just thought she need to be patient;  that it would happen.  We are going to do some testing, I told her, but it may be too late.

Most fertile couple are pregnant within a year of trying.  So if it has been longer than a year, there is probably a problem.  It may be very simple to fix, but you need to see a doctor for testing to see what is going on.  If you are over 35, you should see a doctor after 6 months of trying to conceive without success.  This is because there really is such a thing as a biological clock, and it starts ticking loudly in your late 30's.  Because you have less fertile time left to conceive, it is recommended that you see a doctor sooner rather than later.

In talking to my patient more, I found out that she actually had tried to see a fertility specialist a few years ago.  She didn't like the doctor, though, and he recommended a lot of expensive tests and treatments.  She never went back after the initial consultation.  I hear that a lot too.  I told her that we would take it step by step, that I feel no need to order lots and lots of tests, and that I would give her all the treatment options available and their costs and she could decide.

Not all personalities mesh.  I have one "no-nonsense" nurse and one "touchy/feely" nurse, and we definitely see patients who can relate to one and not the other nurse.  The same is true for doctors.  Your doctor may be an excellent clinician, but if you don't like him or her, then it may not matter.  Especially when it comes to fertility treatment, where you are likely to be spending a lot of time with your doctor.   If you have a teribble experience with a doctor, don't let it turn you off all doctors.  If there are other doctors in your area, try a different one.  If he or she is the only specialist in the area, talk to your primary care doctor.  Perhaps he or she can act as a go-between.  Many infertility centers offer a free 15 minute phone consultation for new patients, and that can be very helpful in figuring out whether a doctor is right for you.  It also will give you an idea of what you are getting yourself into.  If you like your doctor, but you have concerns, talk to him or her.  You may be surprised how receptive they are.  I always tell my patients that I want to hear about ANY concerns.

Sometimes, I have to give patients bad news.  When I do that, I tell them that they are likely to think of more questions as the news sinks in, so they should pick up the phone and call me.  So please don't feel bad, if you walk out of the doctor's office and think of questions on the drive home.   Call him or her or set up a follow-up consultation, if you think it's going to take more than a few minutes to ask them all.  You need to be an advocate for yourself.  You should understand what's going on with your body and what options you have for treatment.   It's your doctor's job to educate you, and we enjoy doing it.  If you don't like what your doctor is telling you, that may just be because it's bad news.  But it never hurts to get a second opinion.  80% of the second opinions I give agree with the original doctor, but that means that 20% of them don't.  Even when I agree with the first doctor, patients feel better because their doubts have been put to rest.  Now they can move on and deal with the problem.  Don't feel like you need to stay with the second doctor, it is perfectly reasonable to see them for a second opinion and then go back to your original doctor.  If you like the second doctor more, you can certainly stick with him or her.  Being comfortable with and confident in your doctor is important.

So remember, patience is a virtue up to a point.  Waiting too long can be the difference between conceiving and not conceiving.  In this case, not making the decision to seek help can be making a decision not to have children.