- 6:30 am. I arrive at the surgery center. Two patients undergoing IVF procedures have been preparing for weeks to have their eggs harvested today. I greet the patients in the pre-op area and answer any last minute questions. I discuss any specific issues with the anesthesiologist and let her take over as she brings the patient into the OR. I finish some charting and then go scrub. The procedures are quick. Using ultrasound-guidance, I advance a needle through the vagina into each ovarian follicle. There is tubing hooked up with suction, so the follicular fluid flows into test tubes, which get handed off to the embryologist. He works quickly through the microscope, hunting for the eggs within each tube of follicular fluid. One patient (older) gets 5 eggs. The other patient gets 23 eggs. I make sure there is no bleeding and that each patient is doing well post-operatively. I discuss some matters with the embryologists.
- 7:40 am. I come back to my office and get an update from my staff. A pregnant patient called reporting having some spotting. Another patient is having bad morning sickness. We begin doing our scheduled ultrasounds. Each patient is in the middle of the ovulation stimulation process. Some of them have follicles that are almost mature. Others have only early ones. With each ultrasound, I measure the follicles and check the uterine lining. Some patients also have blood tests done. Using this information, I will make decisions on dosing changes and when to time the inseminations and egg retrievals. There are some inseminations this morning, as well. The husbands drop off the sperm that they produced at home, and one by one, their samples will be washed and processed. All in all, I do 16 ultrasounds and three inseminations and two mock embryo transfers this morning. In between seeing each patient, I go back to my desk and review the lab tests results that come in. I glance at the day’s news headlines online. I check Google Analytics to see how many hits my website got. I drink two glass of water. I compose treatment plans for the patients who will be doing cycles in the upcoming weeks. I return a few calls from referring doctors.
- 11:30 am. All the morning ultrasounds are done. The waiting room is empty. I go back to my desk and briefly check my fantasy basketball scores from last night. I hear my medical assistants screaming happily in the distance. I smile because this means the results of this morning’s pregnancy tests are finished running and the printouts are coming off the machines now. The happy cries from my clinical coordinators and medical assistants mean someone’s favorite patient with whom they especially bonded is now pregnant! I get the results. Five tests. Three pregnant. Two not. My staff fight over who gets to call the pregnant patients with the good news. The ones with the bad news will first be notified by my staff. Then, I will call them myself at the end of the day. I finish charting on the morning patients. I discuss all the patients with my staff to make sure we’re in sync with their treatment plans. No lunch today. I have a talk to give.
- 1:05 pm. I arrive at the medical school auditorium 5 minutes late for my lecture. The 3rd-year medical students are waiting to learn about infertility. I’ve given this type of lecture over 100 times, but each one is a little different because my lecture style consists of an interactive conversation, calling on students. So after covering the basic concepts, I never know where the rest of the talk will lead. This keeps it interesting for me. This is a particularly sharp and motivated group today. I stay a little later answering the many questions.
- 2:45 pm. I’m a little late getting to the radiology center to do a HSG test on my patient. It goes well. Good news. Her tubes are clear and her uterine cavity is normal.
- 3:20 pm. Back in my private office, I take a quick nap. With the help of advanced brain-wave technology, I have trained myself to be able to enter dream-state sleep very quickly. I wake up totally recharged after only 20 minutes, able to give my full alert attention to the next patient.
- 3:50 pm. One new patient to see. I love new patient visits. I never know what kind of interesting people with which types of interesting infertility problems I’ll see. This is a fairly routine case of a couple with suboptimal sperm. We discuss their situation, some tests we’ll be doing, their treatment options and what the next step is. We talk about their dogs and a little bit about my dogs as well. I do an ultrasound exam and go back to my office to dictate the consultation report. I call the two patients who had the negative pregnancy test. One failed her first insemination cycle. She is disappointed, but optimistic for the next time. The other one failed her first IVF cycle. Ouch. We’re both feeling devastated. They embryos had looked good, too. We schedule to talk in person next week. I review some more charts.
- 5:30 pm. Leave the office. Off to the gym before meeting some church friends for dinner. Hopefully, a big dinner.
Just another day for a reproductive endocrinologist. Fast forward version
November 27, 2007 By Leave a Comment
