Interview with Diane Cote, Fertility Counselor in San Mateo, CA

3.) KP:   Do you give guidance or recommendations regarding medical treatment options for infertility? 

Diane: I always say right up front, I’m not a Reproductive Endocrinologist (RE).  I will disclose here that I had my own, very long journey with infertility and I may share that with a patient depending on where they are in their own process.

Again, I let them know that I’m not a medical doctor, but I provide psycho-education and consultation when necessary.  Depending on their circumstance, it can be pretty obvious that they’ll need a higher level of intervention, so I might discuss the range of options out there and encourage them to discuss them with their RE.

I will sometimes explain to them what IVF (in-vitro fertilization) is and how they would go about pursuing that option.  So, I’m able to give them very specific information about that process and also recommend several clinics in their local area.

I try to be a resource, to provide useful information, including alternatives for them to think about.  I try to answer their questions and if I can’t, I try to lead them in the right direction. But, ultimately, decisions about which interventions to pursue have to be made with their partner and their doctor.

KP:  Sounds like that would be valuable to provide that concrete information.  Having more information tends to help lower anxiety to some extent.  It sounds like you are well versed in this area with not only your professional experience as an infertility counselor, but also having had your own personal experience with infertility.

Diane:  Yes, and it’s an interesting process because people start at one place and often end up in another.  They might say, “if I don’t get pregnant in the next year, then we’ll really think about not having children or maybe we’ll adopt.”  Unfortunately, on a side note, adoption has become more and more difficult and expensive.  There are fewer children to adopt in the U.S. so it’s competitive and can take quite a long time.  Additionally, the international adoption process has become very challenging and limited.

Or, they might say, “I’ll never do in-vitro fertilization” and then two years later, they find themselves saying, ok, we want to try in-vitro.  Then if in-vitro doesn’t work and they need more intervention, they may initially say no way to a surrogate or egg donor, but then find themselves considering those options after all else has failed.  It’s a very interesting journey.

Unfortunately, people experience more and more failure around trying to get pregnant.  They find themselves making choices that they thought they wouldn’t make.  But, having a child becomes so important to them.  I help guide them along that process as well.

KP:  So, some people may initially think that they would never consider other options, but as the process goes on, they may become more open to trying further intervention, as they realize how much they want to have a child and be a parent.

3.) KP: In that I heard that in addition to working on the psychological pieces, at times you would give guidance or recommendations regarding medical treatment options? I imagine those decisions are complex. The patients are obviously working with their physicians, but I imagine that they look to you as well to process their thoughts and feelings about which way to go?

Diane: I always say right up front, I’m not a Reproductive Endocrinologist (RE). I will disclose here that I had my own, very long journey with infertility and I may share that with a patient depending on where they are in their own process.

Again, I let them know that I’m not a medical doctor, but I provide psycho-education and consultation when necessary. Depending on their circumstance, it can be pretty obvious that they’ll need a higher level of intervention, so I might discuss the range of options out there and encourage them to discuss them with their RE.
I will sometimes explain to them what IVF (in-vitro fertilization) is and how they would go about pursuing that option. So, I’m able to give them very specific information about that process and also recommend several clinics in their local area.

I try to be a resource, to provide useful information, including alternatives for them to think about. I try to answer their questions and if I can’t, I try to lead them in the right direction. But, ultimately, decisions about which interventions to pursue have to be made with their partner and their doctor.

KP: Sounds like that would be valuable to provide that concrete information. Having more information tends to help lower anxiety to some extent. It sounds like you are well versed in this area with not only your professional experience as an infertility counselor, but also having had your own personal experience with infertility.

Diane: Yes, and it’s an interesting process because people start at one place and often end up in another. They might say, “if I don’t get pregnant in the next year, then we’ll really think about not having children or maybe we’ll adopt.” Unfortunately, on a side note, adoption has become more and more difficult and expensive. There are fewer children to adopt in the U.S. so it’s competitive and can take quite a long time. Additionally, the international adoption process has become very challenging and limited.

Or, they might say, “I’ll never do in-vitro fertilization” and then two years later, they find themselves saying, ok, we want to try in-vitro. Then if in-vitro doesn’t work and they need more intervention, they may initially say no way to a surrogate or egg donor, but then find themselves considering those options after all else has failed. It’s a very interesting journey.

Unfortunately, people experience more and more failure around trying to get pregnant. They find themselves making choices that they thought they wouldn’t make. But, having a child becomes so important to them. I help guide them along that process as well.

KP: So, some people may initially think that they would never consider other options, but as the process goes on, they may become more open to trying further intervention, as they realize how much they want to have a child and be a parent.

Next: How does culture impact this whole process when it comes to dealing with infertility?

  1. This is helpful!

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