Create IVF Clinic

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Eleven months into our relationship with Mt. Sinai's fertility clinic, we felt totally dejected and wanted to move on (see previous post here). The final straw was the discovery that our clinic would be closed for two weeks over Christmas. They expect clients to lose one of just 12 chances per year to start a family - no skeleton staff working, nothing. How is it that I have always been expected to work stat holidays to ensure clients are serviced, in a much less important industry? The Create IVF clinic had a booth at last year's Pride weekend, and we dug up the brochure we'd taken.

The clinic manager is named Debbie Davies, a friendly and knowledgeable RN who responded to our emails. My wife and I eventually met with her on a snowy night after work for a tour. The clinic was closed and empty, which allowed us to appreciate its scale.

Although the building exterior looks like any other bland low-rise on Bay St., they have spared no expense inside. Debbie led us through the enormous waiting room flanked by two giant aquariums, and proudly pointed out the squiggly ceiling lights were custom designed to represent sperm, and the giant circular area in the middle represented the egg. How clever. You could fit five of Mt. Sinai's waiting rooms into this one. She told us they typically "process" 80 women (poor choice of words while saying how personal their care is) each morning for cycle monitoring, and showed us some of their state-of-the-art exam rooms. A few were equipped with ultrasound machines to help guide difficult inseminations; an option we'd never known existed. Small metal windows with sliding panels were cut into the walls, which acted as a direct pass-through to the lab behind (our doctor would later joke when handed a donor sample, "I'll take fries with that."), and a labyrinth of hallways and rooms that all looked bright, clean, and new. The polar opposite of Mt. Sinai. Funnily enough, Debbie told us that many of their staff had trained at Mt. Sinai, but made it sound as though moving on from there was an obvious progression.

Back at the massive, segmented reception area, a billboard-sized cork board was covered in client letters, baby photos, newspaper reviews, and staff profiles. It was impossible to miss, and no doubt succeeded in reassuring the masses that they were right where they ought to be. We were not immune to this contagious optimism.

Debbie promised us what we'd been missing at Mt. Sinai, which was a relationship with a single, dedicated doctor–and he would be doing the inseminations. Create functions much differently than Mt. Sinai for cycle monitoring. No appointment times are given; the clinic opens at 7 a.m. and it's first come, first served. Patients write their name and information on three separate clipboards for blood work, ultrasound, and a doctor's meeting, then wait for each in turn. (We would later discover that the meeting with the doctor is optional and will take the longest–the doctors don't typically arrive until 8:30 or later, and then begin seeing the women in order of their signatures. If you arrived at 7 and had your blood work and ultrasound done quickly, you could easily sit in the waiting room watching the fish swim for over two hours.) Given that I had had all the preliminary scans and blood work done at Mt. Sinai, they were willing to let me skip a few steps and set me up as a new patient with Dr. Ari Baratz immediately. Debbie said she would ensure my file was created, and I could just show up midway through my next cycle to begin basic monitoring. 

Of course when we arrived on the appointed day, I was greeted with blank stares from Dr. Baratz' secretary, no file could be found, and Debbie was away. Instead of standard tests, a horribly rude nurse demanded that I undergo a "new patient ultrasound" and have a full work-up done. She insisted that I drink ten glasses of water and wait an hour. When I went to check in with her at the hour, she snapped that they were "trying to accommodate me" even though I "came in at the wrong time". I began to question whether being a complete douchebag was a prerequisite to being hired at any fertility clinic. The whole experience took over 3 hours, and made me late for work yet again.

Debbie apologized profusely when she heard what had happened, but couldn't explain where the ball had been dropped. We also received an apologetic phone call from Dr. Baratz–whom we hadn't met yet–which was a nice gesture, but we once again felt completely helpless in the machinery of the medical system.

Dr. Baratz cancelled our first appointment for a consultation, and then called to reschedule the time of the second appointment. Not a great start. I booked a precious day off work with plans to run holiday errands in the morning and arrive at Create for our 1:30 p.m. appointment. When we arrived, Dr. Baratz came out to tell us he was running THREE HOURS behind, and asked us if we "wanted to wait". Incredibly frustrated we said no, given that we had dinner plans. It was an unbelievable waste of time and money (for transit and parking), and we had to try to schedule our consultation for the third time. We should have run for the hills.

When we finally sat across from him, Dr. Baratz was friendly but full of bad news. He confirmed my worst fears, which were that as a woman of over 40 my chances of conceiving were diminishing by the day. He said our best chance to conceive would be through IVF, because "if you want to get somewhere, do you want to take the bus, or do you want to take a plane?". Again our feeling was that with no medical conditions–no real "infertility" aside from being a same-sex couple–we did not want to put my body or our bank account through the drugs and procedures associated with IVF. Nor did we want to end up with twins, which we knew was a high possibility. We still wanted to give a drug-free IUI process a couple of more chances. We couldn't shake the feeling that this shiny new clinic with its shiny new machines was paid for by pushing clients towards the more expensive procedures. 

Dr. Baratz informed us that Create's protocol was to perform two IUI procedures on consecutive days with each cycle, to ensure they hit that ovulation window. This point was reassuring to my worried brain at the time, however each cycle would of course cost twice as much as at Mt. Sinai. Later on we would discover that no research shows double inseminations result in higher pregnancy rates. It is not done at most clinics.

At Create, you must order donor samples through their nursing staff, instead of dealing directly with Outreach as we did at Mt. Sinai. We ordered six samples at once to ensure we had plenty of stock to work with, and because a price reduction is offered at that quantity. The invoice we received from Create did not reflect this however, and there were other financial concerns as well. The short of it was that we were being overcharged, but we had to wait to follow up with the billing office until staff returned after Christmas.

When I finally spoke with the billing manager named Liz, she barely let me get a question out before snapping at me that what we'd been billed was their "standard fee", and that they "hardly make any money on it". Pardon? I had to attempt a few times to explain that we weren't just complaining about the high price, we had more specific concerns. She finally understood there was an actual discrepancy in figures, and said she would call me back. Of course, she did not. 

In the meantime we found that our first cycle at Create (IUI #4 & 5) was unsuccessful, and had to leap right into monitoring a second cycle. I ultimately contacted Debbie to resolve the billing issues, and got on a Groundhog Day roller coaster ride of trying to get a satisfactory explanation for the hundreds of dollars we appeared to have been overcharged. This continued throughout our second cycle at Create (IUI #6 & 7), which was also unsuccessful. After many frustrating and stressful voice mails and emails we eventually did receive a refund of nearly $700 from Create, and an apologetic phone call from Dr. Baratz himself, but the damage was done. If we couldn't trust this clinic with a few thousand dollars, how could we trust them with several times that amount for an IVF cycle?

We decided we were better off at Mt. Sinai after all, and called for an appointment with Dr. Liu to discuss moving on to an IVF protocol.

Arbor Investigations

I tried to let this sit for as long as I could, as I am worn out from trying to fight various sources for nonexistent customer service. I lasted five weeks before I went postal, and now it's been two more.

I hired Linda from Arbor Investigations (otherwise known as Vancouver Private Investigator) at the end of January to begin the search for my father (see previous post here). She talked a good game in the beginning, trying to make a connection with me by saying she was from Toronto originally, and she sounded perfectly reasonable. My credit card was charged $500 the moment I agreed to retain them, which was the only sign that they had received my e-mailed contract. My unease at the lack of contact grew as each day and then week passed with no messages from them. I obsessively checked my email inbox, wondering if at any moment the mystery of my father's whereabouts would finally be solved.

I sent an email tentatively asking what I should expect in terms of communication and follow-up, as they had only explained what they would do, not when I would receive progress reports. There was no response, which was my first clue how this would go. I waited five days and followed up with a phone call, and was told by the woman they only get in touch when there is news, but she would ask Linda to give me a call. I received a generic email later that day from a company address but with no signature, so I had no idea who it was from. It said it could take up to 30 days for there to be any news. And so I waited.

After 30 days had passed with no further communication, I sent another email expressing my disappointment and asking where things were at. Is this really rocket science? All it takes is a two-minute call or email to say what steps have been taken and what is coming next. It's common sense to try to make your clients feel as though you are actually working for them. This time my email was responded to by a woman named Julie who said they were still working on it, and she would ask Linda to get in touch. No surprise - no call from Linda.

Another week went by and I phoned again, finally reaching Linda in person. She said they had confirmed my father had not died in the province of BC, nor did he own property there (which I'd already checked through a realtor friend, and told them so), nor did he have a telephone in his name. They were now waiting to hear back from another contact about the existence of a cable t.v. account. This all struck me as incredibly lame for 5 weeks of work. I asked what would follow the cable inquiry, and she said they would likely want to move on to another province, and she would be in touch as soon as there was news.

After replaying this conversation repeatedly that night, my gut told me not to trust these people at all. It made no sense that it had taken 5 weeks to confirm just a few pieces of the most basic information, nor that the next step would be to check each other province one by one. I sent another email asking for a financial accounting of what had been spent of my $500 retainer thus far, and saying that I would want to terminate the agreement and obtain a refund of the remainder of the fee. I guess I should not have been surprised that again I received no response or acknowledgement of my email.

Two more weeks passed, and I finally called but was sent straight to voice mail. I left a very emotional message asking for the owner of the agency to contact me, and followed up with an email.

I received a brief email from Julie saying that "quite a bit of work" had been done on my file, and she would review the case with Linda.

What I received in the end was a Word document in an email titled "Closed Notice", saying that much time had been invested in searching on their end, they had been unsuccessful finding any trace of my father, and the file was now closed. No accounting of how my $500 was allocated. 

It's shocking to me how many unprofessional people there are in the world who seem able to work completely independently, with no recourse for clientele to escalate issues. It's galling, considering my years spent in customer service and management where the customers were always responded to and appeased. 

I don't have the energy or the money to start this process all over again. Maybe he is better left unfound.