The following is the transcript of a 2011 Q and A session with re-known fertility doctor, Dr. Michael Feinman and the previous owner of this blog. Dr. Feinman is a doctor at the Huntington Fertility Clinic and he shared some insight which I think may be interesting.
Goodkin: How did you decide to go into the field of Fertility?
Dr. Michael Feinman: Oddly enough, I was pretty determined as a medical student, not to go into Ob-Gyn. This was not due to any negative feelings about women. Quite the contrary! It’s just that I had different ideas in mind when I decided to become a doctor. During my Ob-Gyn clerkship in the third year of medical school at UCLA, I first learned about what was happening in the field of reproductive endocrinology and I became excited at the possibility of entering a new field at “the ground level,” and being part of its early development. As my life has turned out, family life has been very important to me, so the ability to be a medical pioneer and help people have children has proved to be a double blessing for me.
GK: After X years of experience, what is the hardest part of your job?
MF: After 25 years of experience, clearly the hardest part of the job is telling women they are not pregnant, especially if they have undergone several procedures already.
GK: What about the most rewarding?
MF: Conversely, the most rewarding part of the job is telling a woman who has been trying for years that she is finally pregnant. This can be particularly intense in the third-party parenting arena, where women may have been going through occasionally misguided treatment for years.
GK: What is the average age of your patients? Has it gone up in the last ten years?
MF: The average age of our patients is around 37. While it is hard to say if the actual average has gone up, it does seem like there are more women past the biological age of childbearing looking to have children.
GK: When people come to you, they are generally in a state of desperation. How can you help them emotionally?
MF: Part of my belief in compassionate care is to be as honest as possible. Some women are so committed to a particular treatment plan, regardless of its possibility for success and I try to help them understand that a different approach may actually land a baby in their lap, thus reducing their state of desperation. This approach is not always appreciated, but I think it is important to help women make the best choices based on their situation, my experience, and what the medical literature shows. I also liberally encourage patients to work with counselors to help them learn the art of stress reduction.
GK: Being a western medicine guy, do you think things like acupuncture can really help increase fertility?
MF: I am very open-minded about alternative approaches. However, I do like to see evidence. Currently, the evidence for acupuncture is mixed but suggests that there is a modest 10% improvement in pregnancy rates for women who undergo this in conjunction with IVF. Other forms of stress reduction have also been shown to be helpful, so I support any treatment that reduces stress.
GK: What about gender selection? Is it the new craze in fertility treatments? Can you tell us if people ask for girls or boys more?
MF: It is totally possible to select the gender of the child. Fortunately, this has not become a “craze” in the U.S. yet. Most people understand that a healthy baby is a blessing and do not care about the gender so much. Also, the majority of people are not that anxious to undergo the types of procedures that result in accurate gender selection. At HRC, we only offer these procedures to patients who already have a child of the opposite gender. We call this “family balancing,” instead of gender selection.
GK: You must come across a lot of non-traditional families in your profession, despite the diversity of the families what commonalities do you find?
MF: Regardless of “family type,” most of the people I have met and helped understand that loving and raising children in a nurturing environment is one of the most rewarding aspects of life.
GK: Have you ever declined to treat a patient. If so, why?
MF: I try not to be overly judgmental with patients. With divorce rates soaring, it is clear that the once typical Ozzie and Harriet family model often does not stay that way. People can have inappropriate desires and expectations regardless of their sexual orientation or marital status. I occasionally turn away patients when I feel strongly that they have come to a decision to have children for reasons that might not be beneficial for the welfare of the future offspring. Also, if there is a medical contraindication or danger to treatment, I will try to dissuade the person from proceeding.