When I see how badly some IVF patients have been managed , my blood boils . I recently saw a patient who had a ruptured ectopic pregnancy after an IVF treatment cycle . This is a definite red flag which means that patient has been mismanaged and that the quality of medical care provided has been extremely poor . A ruptured ectopic after IVF treatment often means that the care has been negligent.
Once a patient gets pregnant after IVF, it’s the duty of the doctor ( and the patient) to monitor the pregnancy to make sure that it is progressing well . This can be done easily by checking hCG levels , and doing an ultrasound scan when the HCG level is more than 1000 mIU/ml. This is simple to do and not expensive.
If the HCG level is more than 1000 mIU/ml, and we cannot see a pregnancy scan inside the uterus, this means the patient has an ectopic pregnancy. It’s very easy to treat an ectopic pregnancy when it is diagnosed early ( as it should be after IVF treatment). The doctor just needs to give an IM methotrexate injection to kills the pregnancy and prevent it from growing.
The tragedy is that doctors often fail to consider the diagnosis of ectopic. This is unforgivable ! If the diagnosis is not made on time, the pregnancy keeps on growing. It may start leaking blood, and can even rupture. This can be a life-threatening complication .
The biggest tragedy is that this is a completely preventable complication ! Doctors need to be aware of the fact that IVF pregnancies need to be monitored ; and patients need to insist that their doctors monitor them carefully . Otherwise, they will end up as one of those unhappy statistics of a ruptured ectopic after IVF , which will reduce their fertility even further.
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