Lately, there has been a lot of stories about eggs crossing my computer screen! Whether it is about egg freezing or donor eggs – everyone is talking eggs. One of my fertility coaching clients came to me the other day very upset. You see, she didn’t trust her doctor anymore.
We had made the transition together – she was ready after five failed cycles of IVF to move onto donor eggs. It was a big decision and it was something we had been coaching around for several months. I had helped her find her doctor – he is a very well respected doctor and I trust him. So did she. But then something unexpected happened.
He “highly recommended” that she use a particular egg donor agency. Now – she and I had selected a different one – for several reasons. And she really liked a particular donor at the agency we had selected for her. So this was really upsetting the apple cart! And very few people ever feel safe not doing what their doctors recommends…
My client spoke with her doctor, and he said that he really disapproved of the selection her agency and he really felt strongly that she go with this other donor egg agency. I couldn’t figure out why!
But somehow, my tenacious client stumbled onto some information from a friend on an infertility message board. Apparently her doctor was part owner of the egg donor agency that he was strongly encouraging her to use! Now, her doctor never disclosed his relationship with this said agency.
I have to admit that this is a new one for me – but apparently this is a growing trend for fertility doctors to be investing in egg donor and surrogacy agencies. In fact, some IVF centers, I am told by an industry insider - only directs patients to certain agencies with kick backs in place. Sometimes, the kick backs are not in direct dollars but a promised direct referral relationship. Really? The more I dug into this – the more surprised I became. Apparently this is not an isolated case.
So how would you feel if you needed donor eggs and your doctor told you that he highly recommended a particular egg donor agency – in fact it was his preferred agency. You would go there right? Because you trust your doctor – and everyone knows that a direct referral from a physician or a trusted agency or lawyer has a profound effect on a patient’s choice.
Does this trouble you?
Do you think that The American Society of Reproductive Medicine should have guidelines about disclosing physician or even agency conflicts of interest in regard to these types of business interests directly to their patients?
When doctors present scientific papers and accept pharmaceutical money to support their work – they have to disclose this to their colleagues. Is this any different? Do patient’s deserve to know if their health care providers have “referral arrangements” or business interests if it effects their care?
How would you feel if you found out that your doctor’s referrals were financially motivated? Or even the referrals to physicians from egg donor agencies? Would you like to see a statement of disclosure from infertility centers and doctors to their patients about where they have business interests - if it effects the direction of their care? Should donor egg and surrogacy agencies have to do the same?
Would you feel comfortable asking your doctor these questions? Or would it feel too much like a confrontation?
I would love to know your thoughts. As far as my fertility coaching client went – she changed doctors.