Friday, July 01, 2016

Updated success story using donor eggs

FINALLY OUR DREAM TO PARENTHOOD ACHIEVED @ DR. MALPANI’S CLINIC USING DONOR (EGGS)

Update: I wanted to update my success story. We have been blessed with a beautiful, healthy child. As soon as I held my baby, years of pain, heartache, suffering, doubts related to donor decision etc went for a toss forever. I am so thankful to GOD. I feel so good about myself for mustering the courage, taking the risk and deciding to go via donor route and man it was worth the risk! I admit I had bouts of doubtful, stressful days during my pregnancy where I panicked how will the baby look like, what if the baby doesn’t look like my husband, what if the baby completely looks different and I would say it’s pretty natural to have these fears and I kept allowing my fears to come out openly so that I could work on them (thanks to Fertileheart). I didn’t want to hold on to these fears during the precious pregnancy time, it was time for enjoyment, at the same time, I knew it was not right to shove the fears away. I decided to face them boldly. As soon as I held my precious baby in my arms, all my fears vanished. Looks of my baby are least important and I sincerely don’t know if the baby looks like my husband or not. All I can say is my precious doll is way to beautiful and is absolutely mamma’s property!  I am just feeling grateful to – God, Dr.Malpani and the donor. Thanks Dr. Malpani Sir, I have trusted you fully and made the donor decision and I would say this turned out to be the best decision of my life.

Finally after all the years of pain and desperation to have a baby (8yrs), we finally conceived our child. In the most humble way we want to convey our sincere gratitude to Dr. Malpani. My diagnosis was poor ovarian reserve (low amh, high fsh). Before starting our cycle at Dr. Malpani’s clinic, we went through several rounds of treatments in the past both in US and India – 4 clomids, 3 IUIs, laproscopy for checking for endometriosis, 2 failed IVF attempts and 1 failed donor tissue (egg) cycle (I am using “tissue” for a reason, it’s not my term, one of the RE in USA used it and I liked the concept and psychologically it simplifies and is soothing). Post all failed treatments, I completely lost faith -mainly on the doctors, because of the way the whole case was dealt, there was absolutely no compassion, no understanding and it was all money oriented treatment and exploiting patients at the vulnerable moments. Based on all such experiences (both in India and US) and the kind of doctors I came across made me doubt if I could ever believe in a doctor again. I took a sabbatical from the doctors altogether for 3 yrs. That said, as and when the treatments were failing, my longing for a baby increased exponentially. There was a strong urge to not lose hope that I can have a baby in this life.

 I would like to share in detail 3 things via this testimonial:
1.    How did I arrive at donor decision?
2.    How did I arrive into Dr. Malpani’s safe hands?
3.    What really went well with my cycle at Dr. Malpani’s clinic

I am providing a very detailed account of my journey just for the sake of the new patients. Hope my journey will make your decisions easier.

How did I arrive at donor decision?

Not having a biological connection with your baby is heart wrenching. When I was given this option few years back, I wanted to scream at the top of my voice. I was devastated knowing that I couldn’t do it myself. Even my first egg sharing experience was not our choice. The doctor utilized the emotional moment and coaxed us into egg sharing and we succumbed to that moment. But after all the emotional turmoil, my longing for a child grew stronger. I started to google to find hope stories and that’s how I came across a remarkable person, Julia Indichova who is the author of the books “The Inconceivable” and “The Fertile Female” and her incredible work “FertileHeart OVUM Tools (Fertileheart.com)”. After ardently practicing the visualization work with my heart and soul and by participating in Fertile Heart online teleconference sessions & attending the workshop in New York (in person), that were led by Julia Indichova, I realized that this whole fertility and baby journey was indeed a miracle and a blessing and not a curse or a burden. It strengthened my inner voice, allowed me to view myself as the supreme authority, take charge of mine and my not yet born baby’s welfare and develop immense faith and confidence and understand the fact that baby making is a miracle, no matter whichever route it happens – natural or via IVF/donor/adoption/surrogacy.  I understood the fact and bowed down to the current of life and let go of my control that the baby comes on his/her timetable and not mine. After all the hard work for couple of years, I have naturally arrived at a point where my heart, her majesty clearly provided the guidance to follow my longing and welcome a child into my life no matter how he/she ended up, which is how I chose the donor route as it no longer mattered to me how my child arrived into my world, becoming a MOTHER was of utmost importance to me, while I completely trusted, respected , and ensured I had permission from my body baby to go this route because without its tremendous support I could have never become pregnant in the first place. I have never given up on myself. I still believe I can get pregnant by myself naturally or via ART, but my longing to be a MOM is clearer than having a biological connection with my child. This was definitely not an overnight, hasty decision. The visualization work really allowed the answer to come up on its own accord at physical, mental and emotional planes. My body, mind and soul were in unison about this decision and most importantly I had complete support of my husband. He was a pillar of support to me throughout this whole journey and it just strengthened our bond enormously with no leaps and bounds. And last but not least, we would like to thank the donor wholeheartedly. I pray to GOD to really bless her with health, wealth, and happiness.
I would encourage folks who are struggling on this journey to spend just few minutes of your time to watch this video – http://www.fertileheart.com/about-fertile-heart/fertile-welcome-victim-visionary/

How did I land at Dr. Malpani’s Clinic?

With that preface on the Fertileheart work and its impact, I would like to now focus on how I finally decided to go with Dr. Malpani. The fertileheart work taught me that it was absolutely necessary for us to take reigns into our hands, it’s our life, our baby and so we have vested interest to absolutely ask right questions and gain clarity before we begin the treatment. Once I made a decision to pursue donor route, it was utmost critical for me to find the right, trustworthy doctor. I have my own worse experiences & I have heard so many horror stories online, especially while embarking on donor route where we have no clue who the donor could be, what her background is, we are solely dependent on the doctor who will be making this decision on our behalf and so picking the right doctor was extremely crucial. Also this is pretty costly affair and I have already spent several thousands of dollars on all kinds of treatments in the past, not to forget the mental agony we had to face each time. Hence, this time I was not worried about how long it took to find the right doctor, I was in no hurry. I actually did my doctor research for 4-5months. I picked the most famous doctors from every nook and corner of India. With my rich experience of facing unreliable doctors & fraudulent clinics, I was sending emails to the doctors with similar content and carefully analyzed their responses:

•    How much time did they take to respond; who is corresponding with the patient - main doctor, junior docs or some admin folks?
•    How are they responding, what mode of communication do they prefer? Did they insist on seeing you in person before starting the treatment?
•    Did they ask for additional tests before commencement of the treatment, in spite of providing all the details?  Are they promising any guarantees for success? (I wasn’t expecting anyone to do this)
•    What’s their response on the diagnosis and my age (btn I am 35), are they saying it’s too late and I need to hurry and will be missing the baby bus if I delay further?
•    Do they have valid websites? If yes, what kind of staff do they have, what kind of equipment do they have?
•    what kind of treatment protocols were they following, what kind of information on the treatment did they provide on their websites and in the emails
•    When googled what kind of information I could get on the doctors (both positive and negative)
•    Last but most important of all, the testimonials that were published on their websites, are they detailed enough, did the patients provide their email ids, were the testimonials sharing detailed accounts of patients journey (one can’t make up this part, everyone’s journey is different)?
These were some of the key criteria that I used for my research. And the next step was to start sending out emails to the patients who provided emails ids in the testimonial websites. Actually other than Dr. Malpani’s website, I hardly found other websites where patient email ids were exposed. I have emailed around 10 patients of Dr.Malpani (some of them who went via donor process), guess what?? 8 out of 10 folks emailed me back, re-assuring I was making the best decision of my life. One of the patients was kind enough to email me her kids pictures (who went the donor route). I was so overwhelmed with her response and the faces of her beautiful children just melted my heart. That’s it, it was clear to me that I was going to place myself in the safest hands. There was no looking back. Building the trust was key for this process.

Details of Best in Class Treatment at Dr. Malpani’s clinic

I started my communication with Dr. Malpani and God really bless him, I have no clue how he manages to respond to the emails within just hours. He carefully guided me on what all tests and ultrasounds I had to get done in USA and how to order the medications etc & guided me through every small step with extreme patience to prepare towards my treatment cycle. Here’s what makes Dr. Malpani’s Clinic the best in class fertility clinic:
•    For patients like me who are overseas, all our conversations were via emails. In fact he clearly mentioned that he preferred email communication as that way it’s all documented and the scope for confusion is fairly low. So I directly met him on Day13 of my cycle. Trust me I just don’t think this is a possible with any other doctor.
•    Throughout the whole process, we have exchanged around 300 emails. Thank you so very much Sir for being patient and answering every silly question of mine
•    He always encouraged questions. This really makes him unique compared to other doctors. As most of them never like patients asking questions and don’t bother to answer them. That was the same be it in India or US. At least the doctors I met felt threatened or irritated when I asked them questions.
•    I finally went to Mumbai and stayed there exactly for 10 days. Everything was meticulously planned. The sperm collection box had our details clearly laid out, no chance of mess up. This might seem simple but things like this define the quality of the clinic (this was a huge issue at another famous Chennai clinic where I went earlier).
•    Looks are deceptive, so don’t go with the outside look of the clinic and don’t judge. Clinic was neat, clean, high quality procedures, would say on par with USA standards, I was very surprised, especially based on my previous Chennai experience, which was a huge hospital.
•    Best part of Dr. Malpani when we met him in person was, he just simplifies everything and puts his patients at ease, provides complete clarity on the process. IVF process itself is such a complicated process and all my earlier experiences were pretty horrific, like a rolla-coaster ride. But this time, it was literally like a holiday for us, we spent quality time in Mumbai, free of tension (also because of the Fertileheart work, I learnt nothing was in my control and there is no point fretting over every small thing, so started letting go of controlling ever uncontrollable situation….lol)
•    On the day of transfer, Dr. Sai, embryologist showed us our embryos. It was a beautiful moment. I never saw embryos earlier. He explained to us about the quality of the embryos. This I felt is a very crucial step and UNIQUE to Dr. Malpani’s clinic for 2 reasons: Firstly, this shows the confidence of the clinic and their exemplary work and secondly, it instantly connects us to the unborn child, triggering lots of psychological effects within the body. (At this juncture, I need to share my horrific experience at Chennai clinic where my ET was done along with another patient on Day2 (Yes you read it correctly), Doctor waited for Rahu Kalam to pass and there was horrific silence by embryologist when I asked how did they ensure that the embryos were not mixed up. 4 embryos were transferred. Same darn equipment was used….unhygienic. Rest you can imagine my plight, thank god that ivf failed)
•    Embryo transfer (ET) procedure was performed in such a sophisticated way on DAY5, using abdominal ultrasound that provides good picture of the uterus and helps to transfer the embryos more accurately. Day 5 transfer again proves the confidence the clinic has in their staff, processes and best in class technology. I have never seen using ultrasound even in US for ET.
•    Dr. Malpani’s bed side manners were just impeccable. He continuously engaged me in a conversation on what all I did in Mumbai for the past week while transferring the embryos and were talking to the embryos to nicely stick with “momma”. It was such a sweet moment. Before we left the clinic, we got pictures of the embryos along with our medical file. Again we never saw this in our 8yrs of experience. This sets the clinic at a totally different level compared to other clinics.
•    Dr. Malpani is very open and frank. He clearly mentioned no need of any kind of bed rest post ET (whereas for my last failed ivf in Chennai, I was put on very strict bed rest, not even allowed to change from side to side, it was so much torturous, they made us stay in their hospital for  15 days post transfer. I now realized their fraudulent act, too late but at least this info might help you guys who are reading this testimonial). In fact I travelled back to US 3 days after ET.
•    Another thing that I greatly appreciated was that he clearly said that he and his team have the best expertise, state of art, best in class equipment but post embryo transfer its all left to nature as no one till date have exact answer on what happens during implantation and didn’t guarantee the result but asked to maintain positive attitude, at the same time not to blame myself for failure, if at all it fails. And if at all the cycle fails, we are first to blame our self – Oh maybe I shouldn’t have travelled, taken bed rest, oops I sneezed, coughed. He clearly said the embryos cannot be touched by any external force and are safe in uterus and will not be impacted any of our gestures. I really was amazed at his frankness. Most of the patients might not like to hear it, but that’s truth. He did all he can to his best ability. No wonder baby making is a miracle, else all of us could have our babies using IVF without issues. That’s where I strongly feel GOD comes into play to prove his magic.

•    Even though I am not in Mumbai and successfully got into my 2nd trimester, till date if I have any questions, Dr. Malpani always answers them promptly. Even my US Obgyn keeps asking me to check with him for any questions 
•    Lastly, he has excellent source of information on his website. It’s like a mini library and the blogs he writes, especially encouraging folks to do the homework, ask questions, importance of meditation, encourages alternate medicine and patients to make their own decision etc just shows his impeccable, compassionate human being and that is what makes him BEST doctor
•    Lastly, I just have one complaint SIR, when all the work that you are doing is so FERTILE, why do you call your clinic as “Infertility Clinic”? Please change the name to Dr. Malpani Fertility Clinic Sir !!
Finally my conclusion, you are in best and safe hands if you plan to go with Dr. Malpani. I sincerely thank GOD for making me arrive at the right clinic finally after all these years. And thank you Sir for your all your expertise and finally introducing me and my husband to our long desired path of parenthood!!!!

If I can be of any help to any of the patients, please feel free to send me an email to smymalladi@gmail.com

Thursday, June 30, 2016

Reviewing IVF doctor's online reviews



When patients select an IVF clinic, most go online to get more information about the clinic, so that they can make a well-informed decision.  They check out the website of the clinic, because this provides lots of useful information; and they also check out reviews about the doctor.  Patient reviews - what other patients have to say about the doctor , can  be extremely helpful when you are searching for the right doctor .  In fact we use customer reviews all the time for lots of stuff - for example, when buying a book on amazon; or selecting a restaurant on zomato.

 The trouble is that reviewing a doctor is very different from reviewing a book, and you need to be very careful when you analyse reviews about doctors. You need to look at lots of reviews on different sites in order to get a fair opinion.

Now, some patients will get put off when they read negative reviews about a doctor, but this is not always a very sensible approach. We all know that it's not possible to keep everyone happy all the time, and one disgruntled patient can post lots of negative reviews about one doctor on multiple sites because she doesn't like that particular doctor, and has a spiteful personality ( which often says more about her than about the doctor !)

This is why you need to take reviews with a pinch of salt, and just because one patient has had a bad experience doesn't necessarily mean that doctor is bad.

Similarly, you should worry a little bit about a doctor who seems to have all positive, glowing reviews. As we all know, it's possible to game reviews, and lots of doctors do this, because they know positive reviews can be very important in attracting patients. Thus, if there are lots of reviews which are written on the same date , or many of the reviews seem to be very similar to one another, you should be careful.

Of course, there are very sophisticated clinics which use PR agencies to write false reviews for them. This is an extremely clever ploy , which some IVF doctors use in order to get lots of positive ratings, and it can be very hard for the average patient to know how authentic or reliable some of these ratings are. This is why you should use ratings as an additional tool in your armamentarium when you're selecting a doctor, but don't get mislead by these ratings. As with everything else, they have pros and cons, and smart patients learn how to evaluate them critically.

Finally, do contribute your feedback as well, especially if you are happy with your doctor, in order to make these ratings more accurate and reliable. This will help other infertile patients to find the right IVF doctor !

Need help in getting pregnant ? Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you !




Monday, June 27, 2016

The IVF gamble




Lots of infertile couples refuse to do IVF because they think of it as being a gamble. They think their chances of success are poor, and they don't want to risk spending a lot of money if the doctor cannot provide them with a guaranteed result. Of course, a guarantee in IVF is a very unrealistic expectation. It would be great if we could provide this, but we can't control biological processes , because doctors are human beings, just like their patients are.

Some patients would rather wait for a miracle , and they believe that their God will help them to have a baby. I think it's great to have faith in a higher power , and being spiritual helps you to cope with the travails of infertility, but if you want God to help you to win the lottery, you do need to at least buy a lottery ticket in the first place !

Patients need to understand that IVF is not like buying a lottery ticket  where everything is a matter of chance. It's much more like playing a poker game , where you can learn to improve your chances of success. 

In a lottery , you have no way of controlling what the outcome is going to be. However, there is a much greater element of skill in playing poker, where there is a big difference between a professional poker player and an amateur. Amateurs lose lots of money, because they get emotional and try to take shortcuts. A professional , on the other hand , will do his homework and study the maths, so that he is aware of the odds of success in each  hand he plays . He understands the laws of probability, and will not let his emotions cloud his judgment . He will not make wrong moves, because he knows what the traps and pitfalls are. While he knows that the outcome in any hand is uncertain, he follows the right process, so that he maximises his chances of success over time.

This is exactly the way a smart IVF patient will approach IVF treatment.  She has studied her chances of success; understands that there is a risk of failure; and will calmly and logically weigh all the pros and cons before making a decision. This is why it's extremely important that you find a good IVF clinic which is transparent, open and has your best interests at heart - after all, your chances of winning at poker are much better if you make sure you have been dealt a good hand !

Need help in getting pregnant ? Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you !




Friday, June 24, 2016

Why do patients continue going to the same IVF doctor even after getting poor care ?


An infertile  patient just sent me this email.

Hello doctor,
This is my 3rd ivf cycle with donor egg  .. And my doctor does not provide any information about anything. My last 2 cycles failed ..in first cycle I bled on same day after ET . And in 2nd ET 1 frozen egg was transferred , which is also fail.. Now my doctor suggest me for 3rd cycle .. Today is my 13th day of period doctor tested my blood today  FSH and LH .. Which is very high Fsh is 86.4 and LH is 36.

Please advise me should i go for it ?
        Thank you

It can be very hard to advice such a patient.

She knows she is getting very poor quality care, but inspite of this, she continues her treatment with the same doctor !

Is it because this doctor provides cheap medical care ?  While it is true that patients do have financial constraints, and that IVF can be expensive, she is just throwing away her money by going to a bad clinic. Now I can understand that it's hard for a patient to differentiate between a good clinic and a bad clinic before they do their first IVF cycle. But when they have experienced poor quality treatment when doing th first cycle, then why do they persist in wasting time with the same doctor ?

Some clinics lock patients in by taking their fees in advance for a 3-cycle package. While this can seem to be an attractive option, because it reduces costs and offers the patient more hope, if the clinic is a bad clinic, she will just continue wasting precious time. What's worse is that this will deprive her of the chance to find a good clinic - and this is an opportunity cost she really cannot afford to fritter away ! Because she has burned her fingers with one IVF clinic, she will now distrust all IVF clinics, and will not have the confidence to try afresh with a better IVF clinic.

It's obvious that the doctor is taking advantage of her ignorance, and taking her for a ride - but why is she allowing the doctor to do this ? Shouldn't patients take responsibility for their decisions, rather than passively leave everything upto their doctor ?

Need help in getting pregnant ? Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you !







Wednesday, June 22, 2016

Red flags when selecting an IVF clinic


All IVF patients know that which clinic they select for doing their IVF treatment can have a big impact on the outcome of their cycle, and this is why they spend a lot of energy and time in shopping around for the right IVF doctor. Unfortunately, a lot of them are not really sophisticated enough to be able to differentiate a good doctor and a bad doctor, and most will end up going to whichever IVF clinic their family doctor sends them to.

In the past, you could trust that your family doctor would send you to a good clinic, but as we all know, this is no longer a reliable method for selecting an IVF clinic , because the medical profession is riddled with corruption. This is why you need to do your own homework and your due diligence before blindly trusting anyone. It's a good idea to check out the IVF clinic your family doctor goes to, but please also check out at least one more.

Here are some red flags you should look out for when you are selecting an IVF clinic.

If you go to a clinic which makes you routinely wait a long time, that's a red flag, which means they don't respect your time and they're not well organized.

If you don't get a chance to talk to the main doctor, that's a cause for concern as well. Lots of clinics make you talk to the junior doctor, who will take a history which the senior doctor glances at, so that you have maybe three or four minutes to talk to the main doctor. This works well if you have routine run-of-the-mill problem, but if you want individualized, specialized, personalized care from the senior doctor, then this is not such a great method.

You should worry if everyone is put through the same battery of tests. This is a " mindless medicine" protocol where one size is made to fit all, because the senior doctor does not want to apply his mind to tailoring the treatment for the individual patient.  This is never a good idea , because every patient is different . If you are asked to do tests, there should be an explanation for what tests are being done; why they're being done ; what the doctor expects to find; and how this will change your treatment options.

You should especially wary when the tests are very expensive;  or when you're forced to go to a particular lab for the tests. Often there is a hidden agenda as to why the doctor is sending you for a particular test.

Some doctors do certain unproven tests for everyone - for example, a hysteroscopy or PCR tests for endometrial TB.  You should also worry if the doctor routinely asks for multiple tests to rule out a particular disease. Thus , some doctors have a bee in their bonnet about genital tuberculosis as a cause for infertility , and some will treat everyone with anti-TB medicines , irrespective of whether the tests are positive or negative ! I don't think this is good quality medical care and these anti-TB medicines can be toxic, have side effects, and make you waste a lot of time and money.

It's a good idea to talk to other patients in the clinic while you are waiting ( and sadly, there will be a lot of waiting in most IVF clinics ). This can be a good opportunity to compare notes, so you can compare your experiences with those of others.

Similarly, if you have a doctor who seems to be too trigger happy , and does a laparoscopy and hysteroscopy for every patient, this can be a red flag as well.

At the end of the day, I'm not asking you to become a doctor when you're evaluating a doctor . However, it's a good idea to do your homework and get a second opinion , so you can ask more intelligent questions and select the right doctor for yourself.

Online reviews about the clinic are useful , and this is something which should be explored as well. There are lots of sites which allow patients to review doctors , and they will give you a good sense of what other patient's experience with this doctor has been. Unfortunately, there are problems with reviews as well , and I'll be discussing this in the next post.

You can also get a good sense of the doctor's philosophy when you visit his website. Does he want to educate you  about infertility, so you know more about your problem , and can make well-informed decisions ? or is the website all about the doctor and is  celebrity patients ? While it can be great when you know that the doctor has lots of success stories, ultimately the focus of the doctor should be on the patient,  and you want a doctor who's empathetic and patient-centric.

You can learn a lot when you finally meet the doctor. Is he in a rush ? Or is he willing to sit down and discuss your concerns ? Does he address them all ? Is he optimistic and hopeful ? Is he willing to share information? Is he willing to empower you?

Money is always an important issue. IVF can be an expensive treatment, and there is no certainty whether the treatment will work or not. While it's true that the most costly clinic is not always the best, you should worry if a clinic charges too little, because it's quite likely that they may be cutting corners in order to reduce their costs. This may turn out to be much more expensive in the long run.

There are lots of unethical practices as regards payment, and you need to be on your guard. If the doctor asks for cash payments; or money under the table; or does not give you a receipt for your payment, then you need to worry. No  honest doctor will do this - and if the doctor is willing to cheat the government, why do you think he won't be willing to cheat you as well ?
Another common problem is that the doctor asks for additional money mid-way during your cycle for additional procedures ( without having discussed this with you when you signed up), when you are not in a position to say no. If this happens, then it's quite likely that you are being taken for a ride. 

Finally, how well does the doctor treat you at the end of your cycle ? Do they provide you with complete documentation proactively and routinely ? Do they provide embryo photos ? Or do they abandon you if your cycle has failed ?

If you feel you have received bad medical care, then please do speak up. You should provide feedback to the doctor, and to the hospital management as well. If you feel that they are ignoring you, then do this in writing. It's also a good idea to post your reviews online. This can help to protect other patients from unethical doctors.


 All this can seem to be a lot of time and trouble and effort. Isn't it just much easier to go to the first one who you pick or the one who's closest to you or the one you've read about in a newspaper article? Yes, it's easier but can often be the wrong decision, which can prove to be expensive.

Need help in getting pregnant ? Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you !





Sunday, June 19, 2016

What Indian pharma needs to do to engage with doctors



This is based on a talk I gave recently to Mylan Pharmaceuticals.

Indian pharma needs to reinvent the way it connects with doctors. It's high time we broke the doctor-pharma nexus and started developing ethical ways of engaging doctors, so that everyone in the Indian healthcare system - patients, doctors and pharmaceutical companies, all benefit, without adopting underhand practices.

Saturday, June 18, 2016

All you wanted to know about egg freezing



Why should women consider egg-freezing?
Every woman is born with all the eggs she will ever have; when I tell my patients this in the course of their consultation, many of them are genuinely shocked. Men are able to produce new and viable sperm right through their life; by contrast, a woman’s eggs start aging even before birth, and this process of depletion continues until they are finally  exhausted at menopause.
Today a number of career-minded women  put off motherhood and the fact that they have a depleting egg count  can be downright  terrifying to them. But that’s not how it needs to be. Modern day reproductive technologies have made possible various options that enable women to have children much later in their life.  The key lies in knowing your options, so you can exercise them intelligently.
Egg freezing is now one of the simplest ways in which a woman can radically slow-down her biological clock; this option is one I recommend to young women who are concerned about their fertility.
When is the best time for egg-freezing?
 Its best to freeze your eggs when you are in your 20’s & 30’s. This is because younger eggs are of better quality, which means they will withstand the freeze and thaw procedure better. They also have a much better chance of fertilizing, because their mitochondrial energy levels are higher, which means they provide you a better chance of having a baby.
The trouble is that when women are good candidates for egg freezing –  between the ages of 30 to 35, they have so much going on in their life, and rightfully feel that their chances of finding the right person and getting married are so high , that they still not willing to consider the possibility that they may have difficulty having a baby in the bedroom when they want one. The biological clock is still quite muffled at this stage in a woman’s life ! This is why it’s usually when they start crossing 37 that they start exploring all these additional options. They may have heard stories from their friends, who needed to do IVF to have a baby. This is wake-up call for them, and they are prodded into exploring their reproductive desires much more closely. While we are happy to do egg freezing for any woman, no matter what her age, the reality is that they may not have such a great success rate, and it would have been much better for them to have done it earlier, rather than to have postponed making this decision for so long.
How is the egg-freezing procedure like?
The egg freezing process isn’t all that complex. Once you qualify as a candidate for egg freezing, we will then plan a cycle around your menstrual cycle. As soon as it begins, we begin administering fertility hormones. These are in the form of daily injections and you are required  to take them for about 10 days ,  after which your eggs will be extracted at the clinic. The 30 minute procedure is  done under light sedation, is quick and painless. Your eggs are then frozen by the embryologist in the IVF lab, using a flash freezing ( vitrification) protocol. Survival rates are nearly 100%.
Will freezing my eggs now make me run out of them later?
This is a misconception, and a very common one at that. This is because we are  only freezing the eggs which you would otherwise have lost. Typically, only one egg gets ovulated each month, but 30-40 follicles start the maturation process. These normally die every month, because they undergo atresia. With the fertility hormone treatment, we are effectively disrupting this loss , which means we are saving those eggs  which would have died under natural circumstances. You also need to keep in mind that the hormonal injections we use are natural hormones, which get excreted promptly, and don’t have any long-term side effects.
What are the success rates of having a healthy baby through frozen eggs?
The success rates of having a healthy baby depend upon many variables, including: the number of eggs frozen ; the quality of the eggs; and the experience and expertise of the IVF clinic doing the egg freezing.
The younger the age at which your eggs are frozen, the better your chances of having a healthy baby with them
While it’s hard to provide precise success rates for an individual woman, the rule of thumb is that a woman less than 35 should freeze approximately 20 frozen eggs to have a chance of about 80% of having a healthy baby. While the survival rate of frozen eggs after thawing is excellent, we need to remember that human reproduction is not an efficient enterprise – and this is true both in the bedroom and in the IVF lab . Thus, about 60% of these eggs will fertilise after thawing when ICSI is done; and about 40% will form Day 5 embryos ( blastocysts). When a blastocyst is transferred, it has about a 30% chance of implanting and becoming a baby. Since each frozen egg is worth its weight in gold, it’s a good idea to freeze extra eggs, to make sure your safety net is robust – and in case your want more babies in the future !  This means you may need to do 1-3 egg freezing cycles, to give yourself a good chance of having a baby. This will depend upon your ovarian reserve, and whether you have conditions such as PCOD or endometriosis. The rule is simple – more is better !
How long will my frozen eggs last?
Theoretically, forever! The eggs are frozen at -196, which means they are in a state of suspended animation, and will remain here until we thaw them, because all their metabolic activity has been stopped at this low temperature. The technology has been used for over a decade now and there are healthy children from eggs which have been frozen for 5-9 years.
Are babies that have been  created using  frozen eggs as healthy as all other babies?
Regardless of whether IVF babies have been created using fresh or frozen eggs ( or frozen sperm or embryos for that matter) , they are as healthy as any babies that have been born naturally.
What are the complications?
It’s very important that you take all these medications the way they have been prescribed by your doctor. You may also be asked to avoid sexual intercourse for a certain period of time.  The symptoms you should be wary about are:
•    Temperature above 39°C
•    Severe abdominal pain/swelling
•    Severe nausea/vomiting which doesn’t go away
•    Heavy vaginal bleeding (though light -bleeding is normal)
•    Difficulty urinating/painful urination
•    Fainting/dizziness
Any final words of advice for the readers of EggChill?
It’s great that advances in reproductive  technology now offer so many additional options to women, so that they can now control their own reproductive destinies, rather than depend upon the vagaries of nature. Biology is not destiny, and we need to make sure women are made aware of their options, so they can make well-informed choices for themselves

This article first appeared at http://eggchill.com/dr-malpani/

Want to know more about egg freezing ? Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you !




 

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