Most IVF cycles go as planned, and most eggs and embryos behave themselves. However , every once in a while we will have an outlier , where a patient doesn’t perform as well as we expected . For example, even though the follicles look great , we don’t get eggs from each of them; and even if the eggs look great , they don’t fertilize. We then need to figure out what went wrong , and we need to start planning what we’re going to do in order to fix the problem. Now usually there's very little we can do in the same cycle itself, which means we need to start thinking about what we can do differently in the next cycle. This is why a lot of IVF specialists talk about what they will do in the next cycle , based upon what they have learned in the current cycle, because the information is "fresh" in their mind.
However, the moment the patient hears the word " next cycle ", her heart sinks. Every patient starts every IVF cycle with the hope that this will be her first and last - that will end with a baby , and she won’t ever need to go through the ordeal again.
She feels that because doctors do so many IVF cycles, one cycle is like any other , and therefore if one doesn't work , we are happy to just try again. This sometimes give patients the impression that doctors are hardhearted and cold-blooded , and they couldn’t care less, but this is not true. We need to be able to look at each IVF cycle analytically , rather than purely emotionally, and while our hearts do break when things don’t go well , we also need to think with our head , and try to figure out what we can do in order to fix the problem.
Even if the IVF cycle doesn’t lead to a baby , it does give us valuable information , based upon which we can tweak the protocol and maximize the patient's chances of getting pregnant in the next cycle. When patients find out that things aren’t going well m some of them go to pieces , and will just not be able to get their courage together again to attempt another next cycle. Fortunately , most are much more mature , because they have realistic expectations, and have done their homework . They understand that IVF is not a sure shot attempt , and they are willing to be patient , and to think about what the next action steps should be .
They just need breathing space, where they can collect themselves and gather their strength , and gear themselves to try again. In fact, second cycles are often much easier , simply because the doctor is in a better position to know how your body performs , and can therefore maximize your chances by tweaking the treatment plan.
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