It’s very disappointing to see how clueless most IVF patients are about what happens in the IVF lab. Sometimes, as with any biological system, things do not work out as expected; for example, the sperm may just fail to fertilize any of the eggs (total failure of fertilization). In such cases, it’s important for the doctor to take responsibility and be transparent with the patient; this will help him troubleshoot the problem and offer a solution.
Now comes the even more unfortunate part (that borders on the shocking) - most doctors are completely unaware of exactly what procedures take place in the lab. Sure, they know that eggs are fertilized and allowed to “culture” there, but their knowledge doesn’t go deeper than that. They are essentially clinicians who are trained as gynecologists; and all the lab work is typically left to the embryologist.
To a certain extent, this can be overlooked, if the lab also has a full-time qualified embryologist. However, most IVF clinics in India find that this is a luxury they can ill afford. These clinics just have to make do with the services of traveling embryologists or poorly qualified lab technicians. When it comes to lab procedures, every single step is crucial in achieving the desired result.
Unfortunately, there are just too many inexperienced embryologists or very poorly qualified ones doing the rounds. They are able to manage the straightforward IVF cases; however they aren’t always able to work with challenging patients. For example, they may not have the ability or skill to handle testicular sperm and will simply tell the patients that it’s best for them to use donor sperm.
They will concoct a variety of excuses just to pull a cloak over their incompetence. Therefore even in instances when a patient has a large number of embryos to spare; instead of freezing them for her, they lie through their teeth and tell her that the pregnancy rates with frozen embryos are poor. They will then simply discard them or donate them to other patients.
Cloaking their Incompetence
It’s clear that the there is very poor documentation of lab protocols in these labs. If mishaps occur, they will be neither documented nor reported. A poor quality lab will never be able to produce good quality embryos and that is exactly what happens here. But the patient has no inkling of what is happening behind the confines of the lab’s walls and everything is kept under wraps. Before the transfer, the patients are given a cursory glimpse of the fragmented embryos under the microscope; they doctors claim that these are good quality embryos that are cleaving.
They don’t give patients a copy of their embryo’s photographs- this should be a red flag for patients as more often than not, it is an indication that the lab is poorly equipped or maintains dismal quality standards. They may have no power backup for the lab equipment and in case of a power failure (which is common in many parts of our country), the embryos will arrest in the incubator. However, this information too, is held back from the patient.
Sadly the poor patient bears the brunt of this gross incompetence. When an IVF cycle fails, the blame is often laid on “poor egg quality”. The patient is asked to look for other options, such as donor eggs. Most patients are naïve and since they are also ill-informed, many just accept their fate. Little do they suspect that the doctor has taken them for a ride. It is important that IVF patients empower themselves with Information Therapy and scram from such IVF scams the minute they notice anything amiss.
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