During the initial consultation visit, I ask my new patients (both husband and wife) what kind of work they do. First of all, this helps me form a clearer mental image of who they are. It also helps me screen for any unusual stress-filled situations in their lives that need to be addressed in order to help restore their fertility. Sometimes, I get a general answer that needs clarification such as “I work in computers”, “I do import/export” or “I’m a consultant”. They then can clarifiy for me by being more specific, “Well, I sit at a desk all day answering calls from angry impatient people who have just suffered a car accident and I work to process their insurance claims”, or “I fly around the country and evaluate a company’s computer software needs and then I assemble a team to customize a package for them and then we all go there and train them to use it as quickly as possible”

When people ask me what kind of work I do, I can answer their question many ways. I can answer very generally and say I’m a doctor. Or I could be a bit more specific and say I help people get pregnant. Or I could be even more specific still as describe my exact daily actions, as I did in a previous post.

However, if you really want an exact, analytical, more useful answer I would best reply by saying I work to achieve the general goal of helping people have babies and my work can be thought of as being organized into individual cycles. This last part is important to recognize and I will elaborate shortly, But before we go there, let’s discuss another example. If you were to ask what Kobe Bryant did for work, the general answer would be that he plays basketball. However, a more specific analytical answer would be that he works to get a basketball into a designated basket as often as possible while trying to prevent the same ball from going into the opponent’s designated basket. That is the defining concrete goal of his work. All the other stuff such as the passing, the rebounding, the dribbling, the shooting drills during practice, the conditioning, the strategy sessions with the coach studying game film are all just supporting actions that help modify the main task which is to drop the ball into the basket.

In a similar vein, my main work task is to do successful treatment cycles. All the other stuff, such as ordering diagnostic tests, counseling patients, training my staff, keeping my office infrastructure running, studying to keep up on the latest in my field and taking measures to avoid burnout for me and my staff are just supporting actions for the main agenda, which is to have a successful treatment cycle.
Below is a summary of the different types of treatment cycles we do:

• IUI CYCLES: The standard simple treatment cycle is an intrauterine insemination (IUI) cycle. This consists of purifying a husband’s sperm sample and transporting the final improved concentrated product deep into the wife’s uterus on the optimal day (or even at the optimal hour).
• IVF CYCLES: This is the gold standard most advanced form of treatment. This consists of taking the eggs out of the wife’s body and directly putting it together with her husband’s sperm to create embryos. Then, the best-looking of the embryos are selected and placed directly into the uterus.
• NATURAL CYCLES: While over 90% of the cycles we do are either IUI or IVF, there are some patients for whom we help get their eggs ready and monitor to tell them the optimal timing. Then they just proceed to have sex naturally and get pregnant that way.

As I said earler while the heart of what I do is centered around the above-mentioned cycles, I do a lot of supporting actions as well, actions that help improve the success of the actual cycles:

• CONSULTATION: One of the most important skills for an RE is to decide which type of cycle is best for each individual patient and when to perform them. Some patients are better off trying on their own for a little longer. Others should start by trying IUI. Others are best served by going directly to IVF. Sadly, still others are best advised to give up and look at alternatives such as adopting or quitting all together. Making the optimal decision regarding which option is best requires gathering information through interviewing the patients, examining them and ordering tests.
• SURGERY: Many times, the success of a cycle depends on critically improving the condition of the patient’s uterus, where the baby is destined to live. Some common crucial ways of doing this including removing any offending tumors or polyps from the cavity and removing any diseased Fallopian tubes that might have a tendency to leak embryotoxic fluid into the cavity and kill the embryos.
• MAINTAINING INFRASTRUCTURE: In order to conduct my treatment cycles, I need to have a physical location with propertly functioning equipment and well stocked supplies. More important, I need a team of top-notch staff. Much of my time is spent recruiting and training a great team and making sure that I can do my part to fulfill their needs and wishes as well, so that they can come to work every day with enthusiasm and happiness, ready to do their best for our patients.
• EDUCATION AND SELF-DEVELOPMENT: Since I am responsible for coordinating all this in the first place, I take on the burden of always learning more. This is not a minor point and is arguably one of the most important things a good reproductive endocrinologist does.

There you have it. So the next time someone asks me what kind of work I do, depending on my mood, I can give them the abbreviated “I’m a doctor” answer or I can direct them to this web page for the long detailed version.