IVF is a complex process , and the success rate is not 100 percent, which is why every patient wants to know what they can do to maximize their chances of having a baby.
There are three important variables - the patient , the doctor and the laboratory. Let's look at them one by one.
As far as the patient goes , it's great if the patient is young with good ovarian reserve, because she's going to grow lots of eggs , so we can make lots of embryos for her. Of course there's very little one can do about a patient's age, which means we will still treat older patients, and those with poor reserve as well. Even these patients can improve their chances of success by doing their homework , so that they can spend time and energy in selecting the best IVF clinic , and preparing themselves optimally for their IVF cycle.
The doctor has an important role to play , not just in advising the patient as to what their treatment options are, but also in selecting the optimal superovulation protocol , to maximize the egg yield and optimize the endometrial environment , thus improving the chances of implantation . The doctor also has a key role to play in counselling the patient and providing emotional support, so that she has realistic expectations, and has the courage to be emotionally resilient and to bounce back even if the cycle fails , because it may require 3-4 IVF cycles before the patient has a baby. Also, the doctor should be flexible enough so that he can optimize the protocol for each individual patient , rather than use a rigid one size fits all for everyone. Also, the doctor needs to be technically skilled for doing both the egg collection as well as embryo transfer, and each egg and every embryo should be treated as an individual patient. Also, it's important that the doctor be ethical, and not mix and match donor eggs and donor sperm , simply in order to inflate their pregnancy rates.
Finally, the embryologist is the unsung hero of IVF treatment, because the IVF lab is the heart of the IVF clinic . We can give him good eggs, and it's his skill which converts these eggs into high quality embryos in the lab. A full-time experienced and expert embryologist is the key to IVF success, and smart patients ensure that the IVF clinic they select has a great embryologist heading their lab.
If all these three variable are favourable, then the success rate jumps dramatically . Now if you have a young patient with lots of eggs, then even if the doctor and the lab is bad, you will still get pregnancies, because the patient can compensate for both of these. This is why even bad IVF clinics continue to get pregnancies, because they attract a lot of young patients , by advertising aggressively, and offering bargain low-cost rates. They make up for their poor quality by doing large volumes , which means they will have lots of successes , even though their percentage success rates are low.
Similarly , even if you have a patient with poor ovarian reserve, but the doctor and lab are good, this can compensate for poor egg quality. This is what can make a world of a difference , specially when you're dealing with a challenging patient. While many clinics will refuse to treat these patients, because they don't want them to affect their success rates, good clinics will be happy to show their mettle by treating these difficult patients. In some clinics, the doctor may be good , but the lab could be bad, because they have to depend upon a travelling embryologist. This can reduce their success rates dramatically.
The trouble is that it's very hard for the patient to make out what's happening in the lab, because all they know is that their cycle has failed, but they don't have enough data to be able to determine the reason for the failure, because the clinic does not share medical records or embryo photos, which means patients are left groping in the dark.
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