Sunday, April 29, 2018

How IVF patients can deal with unwanted advice


Most women going through an IVF cycle are extremely well informed because they spend so much time on the internet reading up about the problem. Also, they have finally found an IVF  doctor whom they're happy and comfortable with , who gives them all the medical advice they need and they are happy to follow this.
However, just because they are infertile, it seems that everyone else has an opinion about what they should and should not be doing ! Just because they have been able to have a baby in their own bedroom, they think they are fertility experts, and are qualified to advice infertile couples !
They tell them what precautions they need to take ; and give them a long list of do's and don'ts, because on their extensive personal experience with baby-making.
Many IVF patients find this extremely frustrating , because this often diametrically opposite to the advice which their doctor has given them.   Now if someone you love gives you well-meaning advice because they care for you, then you should listen to them respectfully - and ignore what they say, if it  makes no sense to you. But if the person is a pushy nosy-parker, who keeps on intruding - for example, a neighbour who insists that you should be on bed rest for 14 days after the embryo transfer, because that's what her sister-in-law's best friend who got pregnant after doing IVF in the USA was told to do , then you can ask them a simple question to put them in their place, "Please show me your MD degree certificate."
The problem is that because you are emotionally very vulnerable, you are quite likely to follow what anyone tells you , even if it's illogical. After all, what harm can it do not eat papayas for a week ?  And the amulet which your friend got for you from the famous fertility temple in Kerala ? Why not wear it cover all your best - after all, science doesn't have all the answers, and most women are  quite happy to clutch at straws.
The problem is that all this conflicting advice can drive you batty - and if you don't get pregnant, you may end up blaming yourself - was it because of the heavy suitcase I lifted that my embryo fell out of my uterus ?
At the end of the day, you need to invest in Information Therapy, so that you are confident about what you  know, and don't get carried away by the old wife's tales and myths and misconceptions which still surround IVF.
You can download the IVF comic book free at www.slideshare.net/malpani/ivf-comic-book
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 !





Wednesday, April 25, 2018

Does IVF cause premature births ?

This is a common concern many patients have.

Please remember that IVF pregnancies are the same as natural pregnancies, so they aren't at increased risk of prematurity.

It's not the IVF which causes the prematurity - it's the multiple pregnancies ( which are commoner in IVF because some IVF clinics transfer many embryos at a time) which increases the risk - after all, the uterus was designed to handle only one baby.

This is why we suggest that patients transfer only a single embryo !

How the overdiagnosis of TB harms infertile women

A patient sent me this email

I had Laparoscopy 4 months back, was diagnosed with TB PCR, and now I am 5 Weeks Pregnant. My concern is should I continue the medicines prescribed by the doctor? will it cause any birth defect in the baby if i consume the medication like cleft lip ? or will I lose the pregnancy if i don't have the medicines, please advise.

These TB PCR tests are very unreliable ! They are plagued by the problem on false positives - read more about this at http://blog.drmalpani.com/2015/03/laboratory-tb-versus-genital-tb.html

Sadly, most gynecologists are routinely treating all their infertile patients with anti-TB drugs based on their ignorance.

This is why this poor patient is now trapped between a rock and a hard place. She never needed the antiTB drugs in the first place, but is in a dilemma now !

The irony is that her doctor will conclude that it was the antiTB drugs she prescribed which caused her to get pregnant - while the truth is that she got pregnant inspite of the antiTB medicines !

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 !




Saturday, April 07, 2018

Implantation dysfunction


When patients fail repeated IVF cycles, the "diagnosis" their doctor offers them is - Implantation Dysfunction .
However, this is really just a waste paper basket diagnosis - it does not provide any useful actionable information . It's a mouthful, but it's just a description of the fact that their embryos have consistently failed to implant for an unknown reason.
Making a diagnosis - and receiving one - often gives both patients and doctors a lot of comfort, because they feel that once they have been able to put a name to the problem, they will be able to tackle it better. Sadly, this is often just a delusion !

Thursday, April 05, 2018

Laparoscopy and IVF - before, after or never ?



Before referring a patient for IVF to an IVF clinic, many gynecologists will insist on doing a laparoscopy . They justify this using all kinds of pretexts. saying" We will get a chance to check your pelvis, so we can clip your tubes, if needed, or burn any endometriosis." Their justification is that doing this will improve the patient's chance of getting pregnant with IVF. This is false, but poor patients don't know any better. They feel that if they are going to spend so much money on IVF, they might as well spend a little bit more on the laparoscopy, if this will improve their IVF success rate !

Removing small fibroids and cysts is pointless, and does not affect IVF treatment, which is why they are best left alone !

In fact, a lot of IVF doctors will also refer their patients back to their gynecologists for a laparoscopy , because they follow a "You scratch my back and I'll scratch yours" model - " If you send patients to me for IVF , then I will send them back to you for a laparoscopy so that both of us are happy." Of course, the poor patient is the only one who is a loser in this entire business. This is why it's important that patients need to learn to speak up and ask, " How is the laparoscopy going to change anything?"

Obviously , if it doesn't, then please say No ! There's no such thing as a minor procedure or minimally invasive surgery - any surgical procedure carries risks. In fact, a laparoscopy can reduce your chances of getting pregnant with IVF, because overenthusiastic surgeons can reduce your ovarian reserve while cauterizing endometriosis ! 

Lots of gynecologists also want to do laparoscopies for patients who have failed an IVF cycle, saying, " If we do a laparoscopy we'll be able to figure out what the reason for the failure is."  Again, this is just not true, but unfortunately patients aren't assertive, and they're not well informed enough to be able to ask intelligent questions. Sometimes they agree, simply because they are so desperate because their IVF cycle has failed. They agree with anything their doctor says, without realizing that it's not going to help them - it just causes them to waste their money.

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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