What to Expect from a Second Opinion

To prepare for a second opinion, it is helpful to know what is typically involved and what you can do to maximize the benefit of additional medical consultation with a fertility specialist.

You have received some fertility treatment with your Ob/Gyn but you are not making any progress. Perhaps you’ve seen a fertility specialist, but you’re not satisfied with the provider, the treatment plan, and/or the fertility center. Or, you have been advised that your best chance for having a baby is adoption or to use donor eggs or donor sperm. In any of the above scenarios, you decide you want to seek a second opinion.

(At the Reproductive Science Center (RSC) of New England an appointment for a second opinion is set-up as a new patient visit. This is typically an hour plus appointment. The fee is $300 (payable before or on the day of your appointment).  Patients are sent a New Patient folder that includes, among other items, a Health History Questionnaire. The completed questionnaire and your complete medical record must be received at RSC Lexington one week in advance of your appointment date.)

1. Your Medical Record
“The cornerstone of evaluating a patient who is seeking a second opinion,” states Dr. Isaac Glatstein, Associate Medical Director at the Reproductive Science Center of New England, “is having the patient’s complete medical record. Patients can ensure that they will be getting the very best from the physician by making sure that the record is not only complete but also clean and legible. Records that are copies of copies are difficult to read. Our goal is to go over every detail of a patient’s previous treatment. We are looking for any possible reason for the cause of one’s infertility and the best options for treatment.”

Patients also need to understand that records must be obtained from every physician who has addressed your difficulty becoming pregnant. This might include your Primary Care Physician, your Ob/Gyn, and a Reproductive Endocrinologist. (The most recent doctor you’ve seen is not the repository for all of your records).

2. The Consultation
During the appointment, your second opinion physician will review your record in detail including discussion about the testing and treatment(s) you have had and medications you have and/or are now taking. “I am also interested in any insights the patient has about why previous treatment has not been successful,” states Dr. Glatstein.

3. Additional Testing
Usually tests that have been correctly and recently performed do not need to be repeated. Procedures will be ordered, however, if you have not had certain important diagnostic tests such as a hysterosalpinogram (radiologic procedure that visualizes the uterine cavity and condition of fallopian tubes).

4. Results

The second opinion consultation can result in new ideas about additional testing and treatment options that may have been overlooked. A second opinion is not only a fresh look from a different set of eyes, but also physicians have differing professional experience to draw upon in assessing the circumstances associated with a patient’s condition.

Sometimes a second opinion reaffirms a previous physician’s opinion/prognosis. This can be true in regard to the use of donor eggs or sperm, or choosing adoption. “These can be emotionally charged options for some couples,” states Dr. Glatstein, “and it is perfectly reasonable to want a second opinion. Frequently, an affirmation of this option can help a couple move forward toward more detailed information and education.” (Patients at RSC can receive psychological counseling/support free of charge regarding any aspect of their infertility treatment and journey. This includes help in choosing donor egg and/or gestational surrogacy, and adoption options).

A second opinion appointment with a fertility specialist at the Reproductive Science Center of New England can be scheduled online or by calling (800) 858-4832.

Isaac Glatstein, MD (source for this article) is the Associate Medical Director at the Reproductive Science Center (RSC) of New England.