Saturday, January 21, 2006

I treat patients, not numbers !

As an IVF specialist, I often see older women who are worried about their fertility. A woman's fertility declines with her age because her ovarian function deteriorates with time; and a useful blood test for assessing the quality of the eggs is the FSH level ( a blood test for measuring the level of the Follicle Stimulating Hormone) in the blood. Women with poor egg quality have high FSH levels, and most doctors are unwilling to treat women with FSH levels of more than 12 because they have a lower chance of getting pregnant. Older women with a high FSH will often ask me for advise, and I tell them I have happy to do IVF for them, even if their chances are poor. I tell them we don't have an arbitrary "cut-off" - after all, we don't treat numbers, we treat patients ! As long as she understands her chances are poor, and still wants to go ahead with the IVF cycle, I am happy to do this for her, provided she has realistic expectations. This way, she achieves emotional closure and resolution - and peace of mind she tried her best, even if she didn't get pregnant.

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