Sunday, January 28, 2018

How doctors add stress to the poor IVF patient's life


Being infertile is bad enough, and an IVF cycle is stressful because you are never sure whether it's going to work or not. Not only is the uncertainty difficult to handle, the fact that it's so expensive just adds to your anxiety. While we can't reduce the uncertainty which plagues IVF , the tragedy is that IVF doctors often add insult to injury , by making the treatment unnecessarily stressful .

For one thing, they subject patients to lots of useless tests, which are completely unnecessary , because they don't change the treatment options we can offer to patients. They justify these by doing it under the garb of being " complete and thorough" . Not only do these tests consume a lot of time, they also waste a lot of money .

Also, if the results are abnormal ( as they often will be), then the poor patient is subjected to months of completely unnecessary treatment for "correcting " the red herring which was discovered. Doctors end up treating the abnormal test result, and not the patient ! A classic example of this is the diagnosis of tuberculosis , based on pointless tests such as TB-PCR or PAMP. These tests are plagued with false positives , so that patients are unnecessarily exposed to toxic anti TB treatment.

Even the IVF treatment cycle itself is made unnecessary complicated . Patients are made to come for scans and blood tests every single day. This is completely pointless , because we know that follicles are going to grow only at 1 - 2 mm per day, so that doing more frequent scans doesn't change the treatment protocol ! Of course, this strategy makes the doctor's clinic look very full , and this impresses patients, because they can see the doctor is extremely busy ! Many patients like this , because it is social proof that they've chosen the right doctor ! Their logic is - if there are so many patients waiting to see the doctor, isn't this a sign that the doctor is a good one ? This reassures them that they're at the right place, and their doctor is the best doctor !

 Many of them are also very impressed at how meticulous and thorough the doctor - after all, isn't more always better ? However, this just provides a false sense of security , because all this over testing doesn't change anything which the doctor can do for the patient in tangible terms, as regards improving the chances of success. Also, many doctors insist that the injections be taken at the clinic itself, so they are given expertly by the clinic nurse ! Again, this is completely unnecessary , and the poor patient is forced to waste time and money traveling to the clinic on a daily basis just to take the shots - something which she can easily do for herself at home ! Many doctors continue to prescribe painful IM progesterone injections , even though vaginal progesterone is more effective and much kinder ! This leaves the poor patient's butts so sore , that they can't move. The newest torture is adding the painful low-dose heparin ( Lovenox) injections on an empiric basis, the theory being that this helps to improve the chances of implantation by improving uterine blood flow, though this is completely speculative !

Finally, patients are subjected to all kinds of unnecessary restrictions such as bed rest after a transfer. This just makes the poor patient's life miserable, without improving their chances of success. I wish IVF doctors would learn to be kinder to their patients !

Need help in getting pregnant ? Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you !





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