(This story by Nora Doyle-Burr was first published in the Valley News on May 9, 2017.)
[L]EBANON — Dartmouth-Hitchcock will no longer offer treatments such as in vitro fertilization to couples struggling with infertility.
Last week, providers in D-H’s Reproductive Endocrinology and Infertility program began informing patients about the planned closing of the program, Dr. Edward J. Merrens, D-H’s chief clinical officer, said in a phone interview on Monday.
The decision to discontinue the program at the end of this month stemmed from difficulty in finding “the right amount of staffing” to support the work, which can involve monitoring patients seven days a week, Merrens said.
Because of the nature of the treatments, patients have to come in at specific times without delay, Merrens said.
“We were concerned that we just could not keep the program going, given staffing and resource issues,” he said.
D-H officials had been reviewing the program for a long time, Merrens said. Given that there were not many procedures scheduled in the near future, now seemed like the right time to close safely and with minimal disruption to patients’ care, he said.
Financial considerations didn’t factor into the decision, Merrens said.
“The program made a profit,” he said.
The program’s three physicians will remain on staff for the rest of the month to give them a chance to speak with the patients, Merrens said. The program currently has 124 patients in the system, he said. They are being provided information about future care and transferring medical records and specimens to other providers.
The program’s closing will affect all locations where D-H offers infertility services, including Lebanon, Brattleboro, Bedford, Concord and Nashua.
Alternatives for patients in the region include University of Vermont Medical Center in Burlington; IVF New England, which has New Hampshire locations in Bedford and Salem; and Baystate Health, which is based in Springfield, Massachusetts, Merrens said.
D-H will maintain its infertility laboratory and the ability to preserve samples for people who want to transport specimens elsewhere, Merrens said.
D-H will reimburse patients who have made down payments for services not yet provided, Merrens said. Because fertility treatments are often not covered by insurance, patients often foot the bill themselves.
“We’re hoping no one’s cycles and timing will be affected,” Merrens said. “Having a child, especially when you’ve struggled, is one of the most emotional issues. … The relationships (patients have) had with physicians, nurses and people on the team has been very important. (We) have not wanted money to be a factor.”
Dr. Paul D. Manganiello, who is a retired director of the division of reproductive endocrinology at D-H, said in an interview on Monday that he was shocked and saddened to hear that the program is closing.
Manganiello, who helped start the program when he arrived in 1979, said the closing will have repercussions across the entire department. It will mean that medical students and residents will not have the opportunity to develop experience in reproductive endocrinology, he said.
“I would hope that this would reopen after a period of time,” said Manganiello. “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.”
Manganiello, who now works as the volunteer medical director of Good Neighbor Health Clinic in White River Junction, predicted the closing would weigh heaviest on patients in northern New Hampshire. He noted that it’s easier to drive north or south than it is to travel east or west.
“I’m very sad,” Manganiello said. “It’s an important program.”
