The What, When, and How of second opinion appointments

What is a second opinion appointment?
A second opinion appointment is exactly what it sounds like - an appointment with a different doctor to hear how they would approach your care.

When should I consider getting a second opinion?
Second opinions can be helpful at many points in your treatment process. When first considering fertility treatments, you may want to consult 2 to 3 different doctors at different clinics. Depending on your specific case, there can be significant variation in how different doctors approach your care. Some may be more aggressive, recommending “pulling out all the stops” from the beginning (e.g. intracytoplasmic sperm injection and chromosomal testing). Others may take a more graded approach, trying a couple rounds of intrauterine insemination or a more basic IVF protocol first and adding more complex techniques if needed. The right approach for you depends on your unique clinical case but also your values and your financial situation. Second opinion appointments can help you understand your options and what feels right to you. In addition, doctors each have their own style and clinics have different “vibes”. It may sound superficial but you’ll be at the clinic A LOT! So, finding a doctor that you have good chemistry with and a clinic that feels comfortable and convenient can help make the whole process less stressful.

Second opinions can also be helpful once you’ve begun treatment. Unfortunately, even sophisticated medical treatments like IVF still involve a lot of trial and error to optimize for each individual patient. Your response in each treatment cycle tells your doctor more about your unique physiology and this learning should inform your care. So, for example, if you have completed 2 or more treatment cycles without success and your doctor is not recommending any changes to your protocol, you may want to consider getting a second opinion.

Finally, if things are just not working or don’t feel right, consider a second opinion. Perhaps your doctor is recommending an expensive test that you aren’t convinced you need. Or maybe they are suggesting that it is time to look into other approaches like egg donation, surrogacy, or adoption. These are big decisions. Getting input from other professionals can help you feel more confident making them.

How do I get a second opinion appointment?
The best approach is to tell your doctor that you would like to seek a second opinion. They will probably be able to refer you to a colleague with experience treating patients like you. Your doctor will not be offended by your request! Second opinions are standard practice. And, if your doctor is offended? Yup, you’re right. Then, it’s time to consider a second opinion.

Alternatively, you can use Google, websites like FertilityIQ, or your insurance company directory to find another reproductive endocrinologist. Try to find someone with expertise relevant to your specific case (e.g. if you have polycystic ovary syndrome, then find someone who lists this or ovulation disorders as their specialization).
 
When scheduling the appointment, be sure to specify that it is a second opinion appointment. The doctor’s office should request that you send your medical records from your current clinic prior to the appointment. If not, obtain your medical records and bring them with you to your appointment.

Spend time prior to the appointment thinking about what specifically you want to get from it and writing down your questions. Since there will likely be a lot of information to digest, don’t attend the appointment alone. Go as a couple or bring someone knowledgeable enough about infertility treatments to help by taking notes and reminding you of your questions.

Finally, ask the second opinion doctor to send a letter describing their findings and any recommendations they have for your care to your primary reproductive endocrinologist.

Do I have to pay out of pocket for a second opinion?
Typically, if the second physician is within your insurance network, you will only need to pay a co-pay. But, I recommend that you call your insurance company first to confirm this. If the doctor is out of your insurance network, you will need to pay the full cost of the appointment. The cost of this can range between $200 and $400 so, again, you’ll want to ask this when calling to make the appointment. 

Ok, I got a second opinion, now what?
If the second doctor generally agrees with your current doctor’s treatment plan, you can feel more confident proceeding. If not, schedule an appointment with your current doctor to discuss the second doctor’s recommendation. See what they say and then check in with your gut. Remember that it is both your right and your responsibility to feel comfortable with your treatment plan.


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