Greg Bales

The Center for Advanced Reproductive Care

Last week I received the following (slightly edited) e-mail in response to this post I wrote in May:

We are planning to do IVF at the University of Iowa hospitals and came to know that you guys had done it. Just want to find out about your experiences with UIHC both pros and cons.

I was unsure how to reply at first; Kathy was, too. Before we started the first IVF cycle, we researched clinics, read studies, evaluated our choices, all because we wanted to know as much as we could ahead of time so we would never be surprised by what happened. Yet as of last week, we had both forgotten most of it. GEB didn’t suddenly make us a fertile couple—we’ll carry that “infertile” label with us forever—but he gave us entirely new things to worry about.¹ Eventually, we dredged up enough stories and came up with a list. The remainder of this post is a revised version of what I wrote in reply.

We chose the Center for Advanced Reproductive Care at the University of Iowa Hospitals and Clinics (UIHC) for several reasons. First, we live in Iowa City; it’s the only clinic around. That said, we knew we would have to pay cash for the procedure. The IowaWarranty program scared us at first. Unlike other clinics’ warranty programs, it didn’t guarantee multiple IVF attempts. We were unsure whether we’d be able to afford a second or even third round if the first didn’t take. So we looked into clinics as far away as Chicago, trying to find the option that lowered our risks the most. The more we looked, the more we realized that, except for the really bad infertility clinics that we weren’t considering, the differences from one clinic to the next were marginal. We realized that it was really pretty foolish to look so far afield. UIHC’s clinic is really good; why should we buy apples from New Zealand when we have a fine tree in our backyard?

Our second reason for choosing the clinic at UIHC was that it really is an excellent clinic. Its success rates are stellar: 44 percent of IVF cycles for women over 35 and 56 percent of embryo transfers resulted in a pregnancy in 2009 (the year we participated). Few infertility clinics have results that good, especially among clinics that also promote single-embryo transfers as much as UIHC does. And that was important to us, too: We didn’t want a multiple pregnancy. (Well, Kathy flirted with the idea; I was deathly afraid that something would go wrong if she was pregnant with twins or more.) The emphasis on single-embryo transfers there told us that they were interested in long-term success, not just a high pregnancy rate.

Those were our primary reasons for choosing UIHC in the first place. They’re still pretty good reasons. That leaves open question of whether we would go back, given our experience there.

The worst part about our experience at UIHC was that the first IVF cycle didn’t work. It was heartbreaking, and immediately after the bad news, we questioned everything. We especially tried to find a way to second-guess the clinic. Why did they wait to do a 5-day transfer? Why were they recommending we switch to a 3-day transfer for our next cycle? Why didn’t they transfer more embryos? All those questions were born of our disappointment. In fact, everything had gone just as we had wanted. Ill fate or bad luck or simple chance had intervened. Two years of failure, two years of learning that sometimes things just don’t work wasn’t quite enough disappointment, I guess.

The only thing someone going to UIHC for infertility treatments might want to prepare for is the interaction with the doctors there. Nurses handle a lot of the clinic’s day-to-day operations; we saw them often and got to know them well. But we didn’t get much one-on-one time with any single doctor. One could potentially go through an entire IVF cycle and not see the same doctor twice. However, what we might have lost in individual attention, we gained tenfold in expertise and experience. And in our case, anyway, the doctors were always responsive when we asked them to be. Shortly before we started the second IVF cycle, Kathy had reason to suspect she had an autoimmune disease. One of the Center’s doctors helped her get an appointment with an already booked-tight rheumatologist so she could receive a definitive diagnosis before the IVF cycle began in earnest. As with any group of people, some doctors and some nurses are harder to get along with than others, but we never felt as though anyone had anything but our best interests at heart.

We were also pleased with the immediate post-procedure/early pregnancy care Kathy received. For a few weeks in those early days, we worried that the slightest bump would cause a miscarriage. Suddenly, the ultrasound techs began raising questions about the baby’s growth. He was a grain of rice when he should have been a grain of barley. There was little that could be done besides wait and let the baby grow—or not, but the clinic nevertheless kept close tabs on us well into that first trimester, scheduling ultrasounds and eventually helping set our minds at ease to enjoy the growing fruits of, well, their labor.

If we were to do IVF again, we would definitely do it at UIHC. There are very few good options when treating infertility. There’s often a lot of expense, and there’s very little that a couple can do to control the options available. Having our treatments at UIHC was one of the few active choices we made, and all things considered, it was a good choice.

¹ Yet why was it so easy to forget all that research, to erase all that trauma from our minds? One of the hardest things about infertility was that when we were in its tightest grip, we were stuck between Big Eras in our lives. For most of our time together, Kathy and I were (in others’ eyes) “just” married. With wistful glances and drunken pleas, our mothers accused us of play-acting adulthood, not taking their grandchild lust seriously enough. For eight years we endured such nonsense, but we also lived and worked. We talked about having kids—or rather, Kathy talked about it; I hemmed and hawed—until eventually we agreed it was time to change our state of being in the world. Shoes tied and wide-eyed, we set off down the road to parenthood. But then infertility happened. Where we had friends and family whose own travels had been strolls down tree-lined boulevards—so lovely that they had made the trip two, three times already—ours was a hike across desolate grasslands. Thorns tore at our skin. Burrs stuck to our clothes. Abandoned farmhouses peppered the steel gray horizon. Every so often we glimpsed others in that desert, but they were always at a distance. All we could do was trudge on, but we were like the blindfolded walking in circles. All that wandering left some wounds, but with help, we did eventually leave that wasteland. The time between Big Eras was longer than we expected, but it did end.