Monday, May 11, 2015

What can IVF patients learn from Goldilocks ?


 IVF can be a complex treatment , which involves multiple steps and lots of different treatment protocols. Often patients are very confused as to which treatment protocol is best.

There are some IVF clinics that do not waste too much time on doing tests - they go ahead with ahead with the IVF treatment cycle and use only basic ultrasound scanning and an occasional blood test to monitor the patient's progress . Others will spend a lot of time and money on doing extensive tests before starting the cycle. They prepare the patient with lots of  supplements, and will also use alternative medicines both before and during the treatment . They do lots of tests to monitor ovarian response during the cycle, so sometimes the patient ends up feeling like a pin cushion.

It’s hard for the patient to know whether the clinic which is doing too little is cutting corners, because they aren't well equipped or knowledgeable;  or whether the clinic that is doing too much is doing it just to maximize their revenue , without adding any value from a medical point. Is doing all the additional stuff just a way of keeping patients happy, because they believe that everything possible which can be done is being done by their clinic ( even though it may be useless)? Many patients are still fooled into believing that more is better.

At Malpani Infertility Clinic , we try to keep things simple without over-complicating them . When the cycle succeeds, patients are very happy because they realize that we got down to basics and did exactly what was needed , without wasting time, money and energy on irrelevant bells and whistles and frills , which really don’t affect the outcome of the treatment. On the other hand , if patients don't get pregnant, they get upset because they feel we didn’t do enough. They feel we should have done more tests before starting the treatment ; or done more "careful" monitoring during the cycle, by doing daily scans and tests.

However , daily ultrasound scans and blood tests during the IVF treatment have not been shown to add any value , except to the clinic's bottom-line.  This is where Goldilocks comes in. You don’t want an IVF doctor to do too much  ; and on the other hand , you don’t want one who does too little either. You need to find someone who strikes the right balance - the middle path which provides the maximum chances of success, without wasting time and money - the protocol which is the most cost-effective.

I guess a tailored approach would work best , where the key is managing the patient's expectations ,and doing lots of tests for patients who want these; and doing just the bare basics for those who don't like being poked and prodded. We  try to be upfront with our patients , and explain to them that just because lots of tests can be done , is no reason to do them. We are consciously making a decision not to do additional tests. Once patients understand this , they are appreciative about the treatment protocol you select, because they understand the rationale behind your suggestions.

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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