Montreal woman speaks out after 'dehumanizing' egg retrieval with the MUHC

In 2021, Esther Viragh made a big life decision.

"At the time, I was turning 36, and I was beginning to worry that I wasn't going to find a partner I could settle down with and have a family with," Viragh, now 38, told CTV News. "Being as pragmatic as I am, I decided to just go for it and freeze my eggs and to buy myself a couple of more years."

Viragh made the arrangements through the McGill University Health Centre (MUHC) Reproductive Centre.

On paper, the procedure was a success. But Viragh describes her experience at the clinic as "dehumanizing," "excruciating," and "baffling."

Three years and $3,000 later, she's calling on the MUHC to improve its communication with patients and its sensitivity training for practitioners, hoping to ignite a conversation about women's health, compassionate care, and vaginal pain.

An unexpected switch

Six years ago, Viragh was diagnosed with primary vaginismus and provoked vulvodynia. The former causes intense pain during vaginal penetration, while the latter causes pain at the entrance of the vagina, i.e. the vulva.

Viragh knew her conditions might make the egg-retrieval procedure, which is performed vaginally, more uncomfortable.

"I mentioned it to literally every single person I came into contact with, because that was in my control -- to share that information. Because of course, it's not visible -- that's one of the things with these conditions -- it's not visible to the naked eye, but the pain is very real," she explained.

Viragh says that, for the most part, the Reproductive Centre's staff were receptive and sympathetic to her situation. That includes the doctor assigned to her file, whom she consulted with over the phone.

"They showed a lot of empathy and understanding. Just mentioning that there's pain in that area, people automatically feel a sense of empathy and compassion," she said.

But on the day of the procedure, something unexpected happened.

"At a certain point, I turned towards one of the nurses surrounding me and I asked where my doctor was," Viragh recounted. "She said that she was on holiday and that this other doctor -- a male doctor -- would perform the surgery."

Viragh had met this doctor once before. Two days before the procedure, he performed her final transvaginal ultrasound -- and did not make a good first impression.

"I felt he was quite insensitive to my condition," she said, alleging that while he did perform the ultrasound slowly and cautiously, as she requested, he made no verbal acknowledgement after she explained her medical conditions.

"He just continued carrying on with the preparation of the tools as if I hadn't expressed myself," Viragh recounted.

Reached by CTV News, a spokesperson for the MUHC said that "usually, doctors' schedules are known in advance, and if there are any changes, patients are notified before their appointment."

But Viragh says she received no such notice ahead of her procedure, and was therefore stunned to see this male doctor walk through the operating room doors instead of the female doctor she had been working with.

What made it all the more confusing was, during the ultrasound a few days prior, this male doctor reportedly gave Viragh some instructions that left her feeling uneasy.

"While examining me, he claimed to see some kind of shadow on the screen. And he made a printout of that image, and instructed me to give that printout to my doctor the day of operation [...] but the person who shows up in the room is this very person who had done the ultrasound two days prior."

Viragh says the whole ordeal did not inspire confidence.

"At that point, I was just in complete shock, and I began to panic."

'Excruciating' pain

Grappling with these sudden changes, Viragh said she "frantically" reminded the doctor and nurses of her conditions, imploring them to go slowly.

Medical records reviewed by CTV News show Viragh was given fentanyl and the sedative Midazolam ahead of the procedure. But for whatever reason, she says they didn't work.

"My threshold for pain is pretty high, so I've had instances in different medical situations where more painkillers or more sedation was required for me to not feel the pain," she explained.

"I don't know if the amount of sedation was insufficient or [if] it was sufficient but, because of the situation and the stress that I was feeling, any amount of sedation would not have been enough."

She described the pain she felt during the procedure as "excruciating."

"That's something I think that there needs to be more sensitivity about," Viragh said. "If someone is placed in an environment where they are scared, they feel unsafe, they feel unheard, and they are in distress -- the perception of pain is magnified."

According to Viragh, the staff upped her dose, once -- but "it still didn't do anything." After that, nothing else was done to alleviate her pain as she continued to cry out in agony, Viragh claims.

"You're witnessing a person clearly in distress. They're clearly experiencing great amounts of pain. The sedation that you've administered is clearly not taking effect. And instead of halting, checking in, asking if this person is okay, asking if they want to withdraw consent, instead of doing all of that -- showing compassion -- you carry on. You carry on, you ignore, you go about as usual, and you proceed until the very end."

"This experience, for me, was dehumanizing."

Esther Viragh, pictured in February 2024, is speaking out about what she calls a traumatic experience freezing her eggs with the MUHC Reproductive Centre. (CTV News)

'Fear and insecurity'

Dr. Phoebe Friesen is a medical ethicist and professor at McGill University.

While she can't comment on Viragh's case specifically, she says compassion and openness are essential during a procedure like this.

"Consent is not given one time. It's given continuously, and especially we need to think of that in procedures that are really painful or really distressing, we want to seek that ongoing consent. So there are different ways to work towards that: asking the patient continuously, 'Is it still okay? Should I keep going? Do you want a break?' You know, providing openings for them to communicate when they might not feel comfortable, sort of interrupting and saying 'Hey, I need to stop.'"

Friesen said this kind of sensitivity is particularly important for practitioners in fertility and women's health care.

"When you think about gynaecological/reproductive health care, when you talk to patients, they use words like powerless, defenceless, exposed, insecure, nervous," she told CTV News in an interview. "There's just a lot of fear and insecurity around seeking this kind of care for a lot of patients. And especially so for some patients who might have a history of trauma or sexual assault or patients who have had negative experiences with healthcare and have distrust in the system."

"I think given that, there is a sort of extra onus on providers to be aware and attune to that kind of discomfort and fear and be sensitive to it," she added.

As far as Viragh is concerned, the care she received at the MUHC Reproductive Centre did not meet these standards.

"If you imagine the situation, you're completely powerless. On a table. Your legs are open, you have medical tools inside your vagina which is incredibly sensitive, and you're paralyzed," she said. "There wasn't that oppenness, there wasn't that safety to express, you know, 'Maybe I want to reconsider."

Asked whether doctors at the Reproductive Centre receive additional sensitivity training in this regard, the MUHC replied that:

"Physicians undergo extensive training during their residency, fellowship and throughout their careers on how to interact with patients with sensitivity and respect, and to ensure patients' consent."

A missing bill

After an individual's eggs (or ova) are retrieved, they're frozen and then placed into specialized storage, where, if all goes well, they'll remain preserved for future use.

Viragh said the $3,000 she paid to the MUHC Reproductive Centre for the procedure included one year of storage.

The clinic reportedly told her she would be sent an invoice at the end of that calendar year to pay for the storage moving forward.

But that bill never came, according to Viragh.

"Three years went by and I didn't receive any invoices. In spite of multiple emails that I sent them, several phone calls, no one responded, no one picked up the phone," she said. "The voicemail on the phone number is either full or just non-existent."

As the months ticked by, she began to fear the worst.

"My main concern was that if I'm not paying for a service, what is my guarantee that that service is actually being provided? So if I'm not paying for storage, how can I be sure that my eggs are actually being stored?" Viragh said.

"Being in this state of mind, and not even daring to think that this entire process that I went through, that I suffered through, and it could have been for absolutely nothing. And so you are left in this ongoing nightmare that just doesn't end."

In February of this year, Viragh built up the courage to visit the clinic in person.

"Returning to an environment where you experienced trauma is not an easy thing to do, to say the least. It was something I was very scared of doing."

Finally, she got the answer she was looking for: her eggs were still safely stored. Viragh says the MUHC informed her there was a backlog in accounting, and that she should expect an invoice soon.

In its statement to CTV News, the MUHC declined to comment on Viragh's specific case and would not confirm whether her invoice was late and whether she had made multiple attempts to contact the clinic.

The site of the MUHC Reproductive Centre, pictured in February 2024. (CTV News)

Complaints filed

Viragh has filed two complaints with the MUHC Ombudsman: one about the procedure itself, and the other about her struggle getting answer.

She said the Ombudsman confirmed receipt of the first complaint but has yet to say anything about the second.

As far as Viragh is concerned, there have been no major developments in either case.

The MUHC told CTV News that "due to exceptional workload in 2022-2023, there has been some delays in the treatment of complaints by the Ombudsman. Catch-up work has been carried out and those who have reached out to the Ombudsman should expect to be contacted by their office with the resolutions shortly."

'It's not talked about'

Today, with the knowledge that her eggs are intact, Viragh is turning the page.

"The absurdity of the situation is what is baffling to me, but I've just moved on," she said.

She hopes that her story will motivate the MUHC to reevaluate its approach to patient care, especially in the context of vaginal pain.

"I think where they fail is offering additional sensitivity training and education around the experience of the patients that come through those doors. The diversity of those patients, with different conditions and states of mind, and how that needs to be handled with compassion, sensitivity and care," she said. "I have no doubt that their expertise is top [of] the charts, I have no doubt they're a state-of-the-art clinic, but in terms of patient care, there needs to be quite a bit of improvement."

Reproductive care is a loaded issue, says Viragh, where practitioners have your future -- and quite literally, the most intimate parts of yourself -- in their hands.

She wants others who may have similar experiences to know that they're not alone.

"I can assure you that if this has happened to me, it has happened to others," Viragh concluded.

"It's not talked about, and so many women are left feeling completely lost and overwhelmed and oppressed by this system because there's still this stigma, there's still this fear of speaking up."