When an IVF cycle fails, the first question the patient asks the doctor is: What went wrong? The elephant in the room is - Did you do something wrong, doctor ? This is not a question which patients have the courage to ask the doctor, but it's a doubt they all entertain in their mind.
This question, Why did the IVF cycle fail, leaves most doctors flummoxed. This is because even in a perfect IVF cycle, where everything goes right, the success rate will be less than 50 percent. However, when the patient chooses such words to express his anguish, it suggests she is implying that the doctor was incompetent or negligent, or did something incorrectly, or simply wasn't proficient enough. This upsets the doctor and sometimes he starts getting defensive. Rather than being honest that he does not know why one particular cycle succeeded and why another one failed, he will order a battery of very expensive tests just to pacify the patient and show her that he is on a quest to find the answer to this rather unanswerable question.
Science too has limitations
Mature doctors will sit down and explain to patients that there is no technology available as yet to determine what happens to the embryo after it is transferred to the uterus. This is hardly surprising, given the fact that we are transferring a microscopic ball of living cells inside the uterus. Human reproduction remains an inefficient enterprise, whether it’s being assisted in the clinic or it’s being done within the confines of the bedroom.
However, not all patients are mature enough to understand the limitations of medical technology and science. Rather than explaining the limitations of our science, it's much easier for the doctor to order a battery of tests. This often fools the patient , who thinks that the doctor is now digging deeper in order to get to the root of the failure. Once he finds the problem, they will be able to get on right track. After all, and once he has figured out the abnormality and taken care of it, she will achieve success.
This is delusional thinking. After all, if there was a test which could provide this information, then every sensible IVF doctor would do it before starting the first IVF cycle itself. Why would they wait for IVF failure to order the test? No doctor wants his patients to fail! I’d be very happy if all our patients got pregnant in the first cycle itself. These happy patients would then refer lot of other patients to me, keeping me as busy as a bee – and I would not have to answer questions such as, “Doctor, what went wrong?”
Do your homework
However, because patients aren't willing to listen to the truth, doctors sometimes resort to manufacturing answers. This is actually a disservice to the patient who ends up wasting a lot of time and money chasing red herrings, and ultimately not getting any closer to her goal of having a baby. Patients need to do their homework before starting IVF, so that even if the cycle fails, they don't go to pieces and start looking for a scapegoat. They need to understand that even if nothing goes wrong, not every IVF cycle will end in a baby!
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