Thursday, April 16, 2015

Why patients need to find an IVF doctor they can trust


I'm very pleased when IVF patients do their homework and arm themselves with information so that they can have realistic expectations of their treatment. It's important that they try to drill down , and understand what their treatment options are. For example, I feel every IVF patient should know the difference between a day three and a day five transfer , and the pros and cons of both, so they can make well-informed decisions. It's much easier to partner with these patients, because we can factor in their preferences and opinions, and this helps us to maximize their chances of getting pregnant.

However , there is a fine balance between being blissfully unaware, and trying to play doctor.

Some patients carry their homework too far , and end up confronting the IVF doctor. For example, they will challenge every recommendation their doctor gives them. While it's important to be assertive, being aggressive does not help - and this is a line which patients and doctors both need to respect.

Now presumably the doctor you have selected is an expert , and has thought through carefully about the treatment plan he has crafted for you. ( I agree this is not always true, and many assembly line clinics will use a "tick-box", one-size-fits-all generic treatment plan for all their patients. If you think this is happening in your case, please push back and find  another doctor !)

However, there are some patients who will do a Google search , find alternative options , and then ask the doctor, Why are you suggesting a short Lupron protocol? This website from the USA suggests that a long protocol is better ! Why aren't you using that for me ?

It's important to clarify your doubts, but taking a confrontational attitude is not helpful . Patients need to find a doctor they can trust , and while it's important to verify what the doctor is saying, this doesn't mean that you should treat everything he says with suspicion either ! There's lots of information online but a lot of this information is not provided in the right context. Knowledge is power, but you need to convert that knowledge into wisdom first . This is why you need to find a doctor who you can trust , who understands what your individual problem is ; and who will then define a protocol to maximize your chances of getting pregnant.

If you cannot trust your doctor , and if you do not feel that your doctor has your best interests at
heart , then you should find another doctor. If you find that you need to crosscheck every suggestion he makes with Dr Google, then this is a sign that perhaps this doctor is not the right one for you.

While you don't need to blindly trust your doctor, at some point you need to understand the boundary between being a patient and being a doctor. Once you trust your doctor, you should give him the freedom to make the professional medical decisions - after all, this is what his job is, and that's what you are paying him his fees for !

Cross questioning him all the time will not only irritate the doctor, it will also end up leaving you very confused. The reality is that there are many ways of superovulating a patient , and it's not that one way is always better than the other . In fact, the reason there are so many protocols means that no single protocol works best all the time for every patient ! It's important that the doctor uses a protocol which he's comfortable with , and with which he has had good results because he is experienced with utilising it, rather than trying out the newest and latest protocols , because that's what a particular website or a particular IVF clinic does.

The trouble with a lot of new protocols is that they have steep learning curves , and in fact pregnancy rates can drop sharply while the doctor is trying to master these protocols . The patient would be far better off if the doctor uses a protocol he's comfortable and confident with , rather than try something new because that's the "flavour of the month". Sometimes, old is gold !

Need help in understanding your IVF protocol ? 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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