Wednesday, April 29, 2015

The IVF Gamble


One of my patients wanted to know, “Is IVF a gamble, Doctor”?  She’d already done two cycles, both of which had failed , and she wasn’t sure what he should be doing next. " Does this mean that the patient needs to buy a lottery ticket every time she does an IVF cycle ? And that no one ever knows whether the cycle is going to work or when it’s going to work?  How do I know how many cycles to repeat and how do I know when I should stop?” 

All these are very pertinent questions and the truth is we actually don’t have any good answers to them. Yes, it’s true that IVF is a gamble but then so many things in life are a gamble. Even getting pregnant in the bedroom is a gamble, because human reproduction is not very efficient.  And while IVF tries to improve that efficiency, it has its limitations , because we need to deal with a biological system which we do not have the ability to control beyond a particular point. 

Patients do need to understand what is at stake - and that this is often a gamble which is worth taking.  It’s an expensive gamble, but then on the other hand when it works, the return is well worth it ! It’s important that patients understand the uncertainty involved and also what doctors can do in order to minimise that uncertainty, but beyond a particular point, this is a journey which they need to walk for themselves.

As doctors, we can act as companions, and we can  hold their hand to help them, but we can never be sure when they will reach that destination ; what they will have to do to get there; how long it will take them ; and how many ups and downs and detours they are going to have to go through .

There is a certain amount of luck involved , and this is because we cannot completely control complex biological processes . One way of maximising your luck ( and reducing your risk) is by finding a good IVF clinic.

If patients do their homework, and have been counselled properly and have realistic expectations, this can be quite an exciting journey, because the fruit of the journey - the reward at the end of it, makes it all worthwhile.

How much to risk and how much to gamble, are not decisions which a doctor can make.  Each patient needs to find these answers within their own heart.


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




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