Podcast reveals IVF patients suffered excruciating pain — and were routinely ignored
One of the most disturbing recent health-care stories came to light during the summer via a five-part podcast series called “The Retrievals” — a collaboration between The New York Times and the podcast production company Serial.
The series exposed an unthinkable scandal at the Yale Fertility Center while also exploring some of the most troubling aspects of in vitro-fertilization (IVF), addiction and how the medical community perceives, interprets and all-too-often dismisses the pain of female patients.
"The Retrievals" recounts how, during 2020-21, a nurse in the center named Donna Monticone secretly replaced vials of the opioid fentanyl used to reduce pain during egg retrievals with saline solution.
The reason: She was feeding her own opioid addiction.
However, the women who were being treated at the clinic were the ones who bore the brunt of Monticone’s deception. The post-scandal investigation revealed as many as 200 patients may have been the victims of Monticone’s misdeeds. And in dozens of cases, Monticone was also the patient’s nurse.
Monticone would eventually be charged for what she did and served eight days in jail for her crimes. In court records, she said she began using fentanyl as a way to numb the stress and anxiety of leaving an abusive marriage and being embroiled in a custody battle for her kids.
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Pain meds stolen, leaving IVF patients to suffer unnecessarily
The patients at the Yale Fertility Center were undergoing a procedure called egg retrieval, in which eggs are removed from the body and then either fertilized or frozen.
The patients were told by their doctors that they’d be both sedated and given a painkiller prior to the procedure. They were told to expect moderate — but tolerable — discomfort.
But as "The Retrievals" host Susan Burton explained on "PBS NewsHour, “what the women described to me was feeling severe, unexpected pain either during or after the procedure. And in the absence of accurate information about what happened to them ... many of the women blamed themselves or thought this is just what women go through.”
Dozens of women interviewed in "The Retrievals" reported being wide awake for the whole procedure and being in excruciating pain. Even worse: They communicated this to their doctors and were summarily ignored.
Women’s pain routinely dismissed
Numerous studies have shown that women’s expressions of pain to their health-care providers are often ignored.
In a 2021 study at the University of Miami, researchers found that when male and female patients expressed the same amount of pain, observers viewed female patients' pain as less intense and more likely to benefit from psychotherapy vs. medication as compared to men's pain, thus “exposing a significant patient gender bias that could lead to disparities in treatments.”
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Harvard University Medical School reports that “one study even showed women who received coronary bypass surgery were only half as likely to be prescribed painkillers, as compared to men who had undergone the same procedure.”
What’s more, nationwide data from emergency rooms shows that women wait 65 minutes before receiving pain medication for acute abdominal pain while men wait only 49 minutes.
In Burton’s exploration of the Yale Fertility Center scandal, she found anecdotal confirmation of these previous findings.
As she explained, “One of the things that was so interesting about this series was the way that pain had been normalized around this egg retrieval procedure at this clinic. When we talk about pain being ignored, we often think of going to a doctor and saying ‘I'm feeling this pain’ and the doctor dismissing us. But not treating pain adequately in the first place is another way of dismissing pain, another way of saying, it doesn't matter.”
Ways for women to advocate for themselves
The Society to Improve Diagnosis in Medicine offers a few suggestions to help women who feel like their pain or other health concerns are being dismissed by their doctors:
If your symptoms are ignored, ask, “What might this be?” And then ask, “What do I do if these symptoms get worse?” These types of questions help the doctor to stop and consider the options.
Try to find a medical practice you can trust. Health-care professionals are under severe time constraints but that doesn’t mean they shouldn’t have time to hear their patients’ reasonable concerns and goals. If you feel that your doctor or nurse-practitioner is consistently ignoring what you have to say, even if your symptoms continue to progress, find another primary care practice.
If you feel your primary care doctor doesn’t take your symptoms seriously, ask for a referral to a specialist or go to a different practice for a second opinion. A fresh set of eyes can be extremely helpful.
Review how to present your symptoms factually, clearly, quickly, and without unnecessary minutiae. Sometimes symptoms aren’t ignored by the doctor, they’re just lost in a list that’s too long or includes what the clinician feels are irrelevant details. Ask them how to best present the information. Most importantly, put your symptoms into context.
Learn about the types of screenings that should be performed routinely for patients of your age, gender, and race. Discuss it with your medical practice. If they refuse to do the relevant routine screenings, seek another medical practice that is more conscientious and aware of why different genders, ages, and races have different medical concerns.
Ask for help — repeatedly if necessary — in figuring out how to deal with your current symptoms, while also stressing the need to determine the root cause of those symptoms.
Always be polite — but also be willing to speak up. And, when necessary, recognize you may have to “fight” for yourself and your overall well-being.
Podcast ‘hit a nerve’
Burton says her work on "The Retrievals" has been especially gratifying — even if the topic was difficult to deal with at times.
“This podcast has really hit a nerve. I have heard from hundreds of listeners, not only fertility patients, but just patients who've had all kinds of experience of unacknowledged or inadequately treated pain in medical settings, ranging in age from teenagers to women in their 70s.”
This article originally appeared on Palm Beach Post: The Retrievals podcast exposed dismissal of women's pain while undergoing egg retrieval
