For most surgical operations, the outcome of treatment is pretty much the same , no matter who the doctor is, and which hospital you select. Thus, most competent surgeons will perform routine operations such as appendectomy and tonsillectomy perfectly adequately , and patients will go home without any problems .
However , the situation seems to be completely different with IVF. This is because IVF is such a complicated treatment , which involves not only clinical expertise , but sophisticated IVF lab services as well. Because of the many biological variables involved in IVF treatment, the success rate amongst IVF clinics varies widely . In fact, the success rates in the best clinic can be upto four times as high as the worst.
There are lots of reasons for this wide variation .
The experience and the expertise of the IVF doctor makes a world of a difference. Good doctors have mastered the art of superovulating patients.IVF success rates depend on the quality of embryos , and this in turn depends on the quality of the eggs which the patient grows. Expert doctors can coax even the failing ovaries of older patients to yield good quality eggs.
The expertise of the doctor may not make much difference for most young patients , who will grow eggs well, no matter which protocol is used. However, for difficult patients - for example , those with polycystic ovarian disease or those with poor ovarian reserve, the superovulation protocol the doctor uses can make the difference between failure and success .
The IVF lab has an extremely important role to play . Unfortunately , this is an area where lots of IVF clinics take shortcuts . Many don't even have a full-time embryologist ! Their equipment is often of poor quality and routine quality control measures ( for example, checking the temperature and CO2 level in the incubator ; and the pH of the culture medium) are never performed.
Many embryologists do not have the expertise to do ICSI properly – and lots do not have the confidence of being able to grow embryos to the blastocyst stage. Sadly, it’s easy to take ignorant patients for a ride, and these clinics take advantage of the patient’s gullibility.
The poor patients suffer, and end up failing multiple cycles , when all they need is to take treatment at a good clinic which has a good IVF lab , which can generate good-quality embryos for them.
Finally, the most important variable is proper patient selection . Some clinics will cherry pick patients, and treat only those who have a good prognosis, thus inflating their success rates. Others will treat everyone who comes to them, no matter how slim their chances of success, after counseling them , to make sure they have realistic expectations . Finally, the worst ones will “ treat “ patients who have no chances of getting pregnant. They go through the motions of doing IVF for them , just in order to generate money .
It can be hard for patients to make out which clinic is good and which clinic is bad . This is why it’s important for patients to educate themselves , so they can find out which clinic offers the facilities they need in order to maximize their chances of getting pregnant . This does require doing homework and putting in a certain amount of effort , but it's well worth it when the IVF cycle succeeds !
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