Interview: Dr. Allison Rodgers
Dr. Rodgers is board certified in both Obstetrics and Gynecology and Reproductive Endocrinology and Infertility, and has been practicing medicine since 2004. She currently practices at the nationally and internationally-recognized Fertility Centers of Illinois. Dr. Rodgers’ personal experiences with both secondary infertility and pregnancy loss give her unique insight into reproductive medicine, and she is well-known for her compassionate and individualized patient care. Dr. Rodgers’ blog Destination: Parenthood is featured on ChicagoNow.
What motivated you to focus your career on fertility?
I was really drawn to the physiology of pregnancy and conception, so in medical school, I came to the conclusion that this was what I wanted to do.
Once you started experiencing your own personal struggles and issues with infertility and loss, how did that affect your work?
I think that as physicians, as health care providers, we need to be able to be very empathetic and take care of a whole host of things. As a cardiologist, you don't have to have a heart attack to be able to take care of someone who has a heart attack, right? We don't need to have to go through everything our patients have gone through to take care of them. However, from the emotional side, I gained the very personal insight of how difficult it is. They say that going through an infertility diagnosis is as stressful as cancer or HIV. I saw patients struggling but it wasn't until I went though it myself that I could really relate in a unique way.
What would you say is your favorite thing about working with your patients?
Building relationships with patients. You take them through this very difficult journey-you’re their guide, cheerleader, and coach. You share tears of pain with them and then at the end, share tears of joy. To witness the happy endings-it's the best thing in the world.
What do you find yourself saying to these patients?
I spend a lot of time with patients who have not been successful and are coming to see me for another opinion. I think a lot of people come in feeling very hopeless and, in fact, their situations are so hopeful and there is so much that can be done for them. I try to give patients realistic expectations and I spend a lot of time talking to them about what a good prognosis they really have.
Do you find that most patients are more apt to be hopeless and then find they can get pregnant, or vice versa?
I think there is a mix, obviously, but I do think there is a significant number of patients who, by the time they come to me, have been trying on their own for a long time. Or they have been trying with their OB for a long time, and are finally getting to me-I think that they're feeling pretty frustrated and upset by the time I see them.
That makes sense. What does a success story look like to you?
I think that helping people get what they want, whatever that may be.
Are there any outcomes that have stuck with you or made you really proud?
The majority of patients that I see have a very, very good prognosis and end up being successful. I think that there are definitely a lot of stories where people have tried with other doctors and have not been successful and then they come to me and we are very successful. I've had lots of patients like that. The hard cases, the cases that have the poorest prognosis and helping those patients be successful, that's the best.
What can you tell somebody dealing with infertility that may help put them at ease at the start of their treatment?
I try to give patients a very realistic expectation about what their prognosis is. I do really think that the process can be overwhelming so I really try to give patients resources and contact information- to my nurse, myself, et cetera. That way, when they go home and think about it and have questions or are worried, they can have someone to reach out to. Someone to reassure them about what we're doing, what the next steps are, all that.
Are there any misconceptions about infertility that you want to put to rest?
I live in a state that has a state mandate for fertility coverage. But there are a lot of places not like that. So, a lot of people say, “oh, it's going to be crazy expensive.” I also hear: “you're going to end up with twins;” “you're going to have to do IVF;” or “you're going to feel miserable.” I think when people talk to the people in their lives about going through treatment, there's always somebody's horror story or somebody's misconception about what I do that I have to dispel. I would encourage patients that technology is moving extraordinarily fast and there is so much we can do to be helpful to them. I would encourage them to talk to a medical professional about what concerns they have about treatment, etc., instead of the people in their lives who may be well-intentioned but may not be giving them the right information.
Do you have any thoughts on less traditional methods to treat infertility?
I think that there's a lot of people who do amazing work. Obviously, I'm a medical doctor, so I'm very interested in evidence-based medicine, research trials showing that differences can be made. I'm very interested in numbers and statistics and I want my patients to be as successful as possible. But, we're not just a physical body. We are a mind, a soul, a body, and I think that incorporating things like yoga and acupuncture are really helpful for a lot of patients for stress management and help to get through treatment. I feel like some people are very well-intentioned but really don't know what they're doing. People who prey on those who are hopeless and will charge a lot of money for things that have not been proven to be effective. People are hopeful because it's quote unquote natural or something and it's not successful. I think some of these things it doesn't hurt to try, but not if you're wasting precious time. Obviously, age can be a factor and you don't want to be wasting a lot of time that may be the time that you have to get pregnant. I always encourage patients trying to take a very holistic approach and incorporating different modalities of treatment but obviously I'm biased with where I'm coming from.
What are your thoughts on stress and infertility?
I do think that there is for sure evidence that stress decreases pregnancy rates. The hard part is that we're all stressed. A lot of us work and have to balance the stress of a job, financial stress, trying to make sure there is food in the refrigerator and you don't run out of bleach. I'll tell you about the million things on my list every day that are just normal living, right, and then this on top of it can be very hard! I really encourage patients to do stress management. I myself saw a therapist when I was going through this and it was extremely helpful. I think that by the time you walk in my door, you probably could use a therapist because it's such a difficult thing to go through. There's a lot of other things such as, yoga, acupuncture, and massage. People do painting classes. People do all kinds of things for stress management. I really encourage my patients to explore things and I give patients the homework of taking some time for themselves.
At what point would you suggest someone having trouble conceiving look for help or seek out a reproductive endocrinologist?
The traditional thought is that anybody who is 35 or older should come at six months of trying. Anyone who is under 35 should come at a year. That being said, if you're not getting regular periods, then you may not be ovulating. So: if you have any menstrual irregularities; if you've been previously told there is an issue with your eggs; or if you've had surgery on your ovaries before, there may be issues. If you have diagnosis of endometriosis, there may be issues, or if there is any sort of male sexual dysfunction. Those are some things where you should see somebody sooner.
Any thoughts on what somebody should consider when choosing their fertility specialist or center?
There's a lot of people who get pregnant without needing IVF. But, for IVF, the quality of the lab is extraordinarily important. For all fertility treatment, it's really important that you feel very comfortable with your physician and the physician's team, including the nurses and their support staff and that you feel like you're able to address concerns, get questions answered, and have someone to go to when you're not sure what's going on.
What should one expect when first visiting a fertility clinic? I know it's hard to say definitively because everybody's treatment is so individualized.
When I see a patient for the first time, I take a very detailed history, review any previous records they have done, and then I put together an evaluation plan of what I would like to see in terms of answering the questions I have about their case. Some general health stuff, typically: an evaluation of semen analysis; evaluation of the tubes; the uterus; ovarian reserve ovulatory function; and a bunch of other things just for general health and a healthy pregnancy. I usually talk with the patient, then do a consultation, and then make some recommendations on evaluation. Typically we do that evaluation during certain parts of the menstrual cycle so it takes a couple weeks to get all that testing done. Then I like to meet back with the patient and go over all the results and work together as a team with the patient to come up with a treatment plan.
Is there any question you feel they should be sure to ask? It sounds like it may not be an issue for your patients since you keep the lines of communication so open?
I think we all tend to think about things later as we're driving or whatever, mulling things over and processing, and I think my patients leave my first appointment with literally a checklist of the things that I would like to see from them. I have myself and my nurse go over things in a very detailed manner. Then I also give them emails for myself, my nurse, phone numbers so that if they have follow-up questions or they're not sure when to come back, whatever, they can ask anything that comes up along the way.
What are the most current and effective treatments for infertility currently?
Generally, fertility treatments include pills or shots to help make more eggs and then we combine that with either intercourse, inseminations (where we put the sperm up inside the uterus), or IVF (more invasive and more successful).
Any advancements that we haven't really heard about in the public in the field?
There is so much going on right now. I think a lot of it is looking at trying to improve genetic analysis of embryos and genetic analysis of the uterine lining. There is also a lot of research done on IVF techniques. There is all kinds of new stuff coming out of trying to change or alter the way we do IVF to be more successful and more cost effective.
Any advice you can offer to those that have been through a miscarriage?
Obviously there is a huge loss when patients have gone through a miscarriage and I think it's important to grieve that loss. And, I would encourage people that, as awful as it was to go through a loss, there is a silver lining that you were able to get pregnant-not always but almost always, it's something wrong with the embryo or the baby and not necessarily the patient's body. Time is not totally on our side but as soon as you can gather the strength to move forward, you should. I can tell you, literally, the day I found out I had my miscarriage, I was like, okay, when can we move forward again? Not that I didn't grieve. I did, but I was like, okay, let me try to get myself one step closer to my goal of having a baby. I do see a lot of patients who say, “I need a break,” and they just sort of step back.
Is there ever a point where you realize somebody is not going to get pregnant and if so, what do you do then?
I think that there are definitely times where I have multiple conversations with patients about how it may be time to start thinking about donor eggs or maybe it's time to start thinking about using a gestational carrier. Those are hard things so I bring them up early: “hey, this is always an option, let's think about it.” And, as treatments fail, it's something people consider more and more. I think it's really a case by case as an individual basis but I have patients who goes through a couple IVF cycles with no embryos. Either we didn't get eggs or the eggs didn't fertilize or they weren't mature. Those are cases that are heartbreaking obviously for a patient but it's really important to tell them, “Hey, there's a lot of hope. Let's think about other options.” Obviously, nobody wants to think about other options like that.
Why do you think there is so much secrecy surrounding infertility and miscarriage?
I think that there's a lot of people who have a lot of sadness and grief around what's going on with them. We all have a little bit of keeping up with the Joneses a little bit, and I think for some, it sort of represents failure of a woman, failure of a marriage, failure of your body. I think there's a lot of women who feel like they're failing and they're so sad and ashamed and upset about it that they don't really feel comfortable talking about it. It's a really hard thing to go through. There's plenty of things that our friends and our family members go through financially, emotionally. We have no idea. People are having difficulty in their marriage. People are having difficulty paying their mortgage. You have no idea. I think that this is just another one of those super difficult things that people go through that people just aren't very open about.
Dr. Rodgers, thank you so much for your time and insight, I look forward to talking to you again soon!
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