Playing by the Rules…..at Dominion Fertility.

Yes, it’s true…I was deprived as a child. Instead of carting me around the Boston area every weekend to play organized sports, my parents insisted that my schedule not dictate the way in which my family spent every Saturday and Sunday. However, as an adult (although my wife would perhaps argue with that categorization) I have fallen into the trap of doing just the opposite with weekend softball and basketball games inevitably determining our schedule. But this Spring has been even more intense than usual as I ended up coaching my daughter Susannah’s 7th grade rec league softball team.

You know that the coaching gene pool is shallow when DrG gets the nod as the head coach. In any case, before each game the two coaches meet, shake hands and discuss with the Umpire some logistics concerning the game about to be played. Last Sunday our team was playing a team coached by a good friend of ours and the Ump went through the litany of rules pausing to ask about the Infield Fly Rule. Now I don’t know about you, dear reader, but the Infield Fly Rule has always been the Unicorn of Rules as far as I was concerned. Both coaches agreed that the Infield Fly Rule was in force and I stated that I was fine with this as long as someone could actually explain the rule to me….No explanation was forthcoming and we started the game.

In the 2nd Inning we had runners on first and second with no outs. Susannah was at bat and had already hit a triple in the first inning. She swung hard and hit a towering pop up….in the infield. I was the base coach at first and told my runner to wait….she ignored me and took off for second base. Ditto the runner at second who broke for third. The Ump later claimed that he shouted “Infield Fly!” No one heard him. The shortstop got under the pop-up…and as is pretty common at this skill level…dropped the catch. My runners at second and third looked very happy until my friend instructed his girls to throw the ball to second and then to first. The Ump then yelled “that’s 3 outs!” and inning was over. Yup, I had just helplessly watched a triple play. Not my finest moment as a coach….However, in my defense I had repeatedly told the girls not to run on a ball hit in the air unless there were two outs. I asked my player who was on first why she ran when Susannah hit a pop-up. She replied “She hit it in the air? I had no idea. I just ran.” Oh well…..

So what does my failure as a Girls’ Softball Coach have to do with infertility? Well, just this…you need to understand and follow the rules. Here at Dominion we have some rules in place to protect everyone…patient, doctor and unborn child…. Here are three examples of some rules at Dominion that make sense but sometimes lead to discussion about bending the rules:

1.

All patients undergoing IVF must have a mock embryo transfer before the actual transfer is attempted. I had a patient a few years ago that had undergone several IVF cycles at another clinic. She had had a Cesarean delivery and was surprised that her treatments had failed in spite of excellent embryo quality. As we prepared to do another IVF cycle she balked at the idea of a mock embryo transfer. I insisted and was surprised to see that the transfer catheter repeatedly entered the C-section scan and failed to go up into the uterine cavity. It was only with careful manipulation that the catheter could be seen going into the right location. She conceived with the first transfer here but I always wondered if maybe the previous transfers had been “easy” because no one realized that the catheter was failing to make it past the C-section scar​s

2. Patients do not have to married to seek fertility care. BUT they cannot be married to OTHER people at the time. Seriously. Do I have to spell this one out? And yet….I have been told that actually the patient’s estranged husband is totally supportive of her doing IVF….. with her new partner… and that her soon to be ex-husband is is even fine with her using his insurance to pay for it. We have called a few of these soon to be ex-husbands and I must admit that their take on the situation has differed greatly from the patient.

3. Consents to undergo a frozen embryo transfer (FET) cycle must be signed by both parties and notarized. Several years ago there was a case at Boston IVF where a patient returned for an FET cycle (following a successful initial IVF cycle) and failed to inform the doctor/staff that she was now divorced (or at least estranged). The FET was successful and she had another child…but the case wound up in court as the ex-husband sued Boston IVF to provide child support to a child that he had not agreed to conceive via FET. I cannot even imagine how that child will feel about the situation….poor kid.

These are just 3 of the rules that we follow. Other rules are dictated by the FDA or just by common sense. I am fine with patients asking about rules and procedures but rest assured that there almost always is a method to the madness.

So how did the softball game end? Well, my girls rallied in the bottom of the last inning and scored 5 runs to tie the game with Susannah smashing a hard grounder to drive in the tying run. Under BCC softball rules, a team can score only 5 runs in an inning unless they are trailing by more than 5 runs in which case they can score as many as needed to tie, but they cannot win. So after our epic comeback I declared “Pandas win 7-7.” Ultimately the game was a valuable teaching lesson for coach and players. I learned what the Infield Fly Rule is all about and I wager that the girls wont forget it either. So please listen to your doctors and staff, no matter what clinic you are working with….Be a winner and follow the rules.