Editorial: D-H Infertility Clinic Gave Hope to Couples

Tuesday, May 16, 2017

Dartmouth-Hitchcock health system has apparently concluded that it cannot be all things to all people. This may be a simple acknowledgment of reality — perhaps a belated one — for an academic medical center with a relatively small population base. But as recent reporting by staff writer Nora Doyle-Burr indicates, winding down medical services can create a different reality for patients: Heartbreak.

That’s especially true when they regard their medical providers not merely as competent professionals but as nothing short of miracle workers. This seems to be the case with many who have benefited from D-H’s Reproductive Endocrinology and Infertility program, which is scheduled to close at all D-H locations at the end of the month. Dr. Edward J. Merrens, the organization’s chief clinical officer, told Doyle-Burr that while the program made a profit, D-H was unable to staff it with the right mix of employees to support the work, which can involve monitoring patients seven days a week.

For many of the 124 patients now in the D-H program, this explanation may be unsatisfactory. The closing will mean making a longer drive — perhaps a much longer one — to access services in Burlington or Colchester, Vt.; Exeter, N.H.; or Boston or Springfield, Mass. This is a burden in any health-care context, but perhaps especially so for infertility patients, who may need multiple long appointments in a single week, as Stacy Dion, of Tunbridge, did when conceiving her daughter, who was born in 2013. Dion told Doyle-Burr that in some weeks, she needed to go to three appointments, each lasting two hours. Adding a drive of 90 minutes or more each way would have made it a near impossibility.

The struggle to conceive and/or carry to term a child is among the sternest tests a couple can face. The specialized services offered by programs such as D-H’s provide not only clinical expertise but two things almost as important: hope and moral support. Of such alchemy, little miracles are surprisingly often born, as some of those interviewed by Doyle-Burr can attest. “It almost brings me to tears that someone else is going to be denied the happiness I’ve gotten,” said Dion. Others who are still waiting for the miracle to happen, such as Trisha and Kya White, of Ascutney, naturally feel abandoned by D-H’s decision. “It’s very, very upsetting for us just starting our journey,” said Kya White, who added that it “leaves us at a standstill of what should we do.”

Among those expressing deep disappointment in D-H’s decision was Dr. Paul D. Manganiello, who is now retired but who helped start the program in 1979. He noted that the closing also will have repercussions for the medical education offered by D-H, as medical students and residents will not have the opportunity to develop expertise in the field. “I would hope that this would reopen after a period of time,” he said. “If it’s not reassembled (it will) be very difficult for obstetrics and gynecology to continue to have a role in the medical center. It’s an integral part of any OB/GYN department.”

Perhaps that’s one reason why Merrens left ajar the door to reopening. “We always have to kind of figure out what we can and can’t do,” he said, although he noted that the current plan is for young physicians to receive their training in infertility treatment at other institutions, as do some in other specialties at present.

We hope the can-do outlook prevails, and this program can be reconstituted in a sustainable form. Of all the miracles modern medicine performs, and there are many, few transform the lives of patients more completely than giving them the opportunity to bring a child into the world and nurture it. It is a matchless gift, and one that should remain a high priority.