Sunday, March 31, 2019

The biochemical pregnancy scam.



Lots of IVF clinics claim to have very high pregnancy rates, and it often appears that practically anyone who does an IVF cycle in these clinics gets pregnant !
Sadly, most of them don't end up with babies !
This is because of the clever scam which these clinics run, where they give HCG injections routinely to all their patients after the embryo transfer.
The beauty about giving an HCG injection is that this injected HCG enters the blood stream and gets excreted in the urine . If patients do a urine pregnancy test or a blood test after this injection, it'll come back as positive, and they'll be delighted that the IVF cycle was successful !
However, the positive pregnancy test is not because they're pregnant, but because of the HCG injection which the doctor gave them. When the HCG level then drops, they say she miscarried !
However, the positive test gives patients false hope , because they feel that if they got pregnant once in that clinic, their chances of getting pregnant a second time is very high.
Sadly, patients aren't sophisticated enough to understand this, and this is how these clinics take their patients for a ride .
What to find an IVF clinic which respects your time and intelligence ?
WhatsApp us at https://wa.me/919867441589/






Saturday, March 30, 2019

Is LH the villain in IVF protocols ?

Why IVF babies have more problems



A lot of people worry that IVF babies are abnormal as compared to babies made in the bedroom . This is often based on press reports which say that IVF increases the risk of babies having medical problems . This is true , but we need to understand why !

This increased risk is applicable only when IVF gives rise to a multiple pregnancy . It's well known that multiple pregnancies increase the risk of prematurity, and preterm babies are at a much higher risk of a whole host of medical problems, such as retinopathy of prematurity, cerebral palsy or mental retardation.

This clearly means that it's not the IVF which increases the risk, it's the fact that it's a multiple pregnancy !

Now the risk of a multiple pregnancy is higher in IVF clinics which are irresponsible, and transfer more than one embryo at a time. This is why all good IVF clinics suggest that patients transfer only one embryo at a time.

The good news is that IVF singletons have exactly the same risks as bedroom singletons, and the chances of their having medical problems is not increased at all !

What to find an IVF clinic which respects your time and intelligence ?






Friday, March 29, 2019

Repeated IVF failure versus recurrent implantation failure



A failed IVF cycle causes a lot of heartburn . It's not just patients who get disheartened and disappointed, and doctors also wonder about what they can do differently the next time to improve the chances of success.

We need to differentiate between repeated IVF failure versus recurrent implantation failure. Recurrent implantation failure means good quality embryos ( usually, a total of 4 top quality blastocysts) have been transferred in the uterus over 3 cycles and yet have failed to implant.

There are many other reason for IVF failure - for example, because the embryos were of poor quality. If we know what the reason is, then this is something we can focus on and try to correct. Thus, if the reason for poor quality embryos is poor quality eggs because of advanced age, we can address this issue by suggesting the use of donor eggs.

However, for patients where we have transferred top quality embryos into a receptive endometrium, but the embryos stubbornly fail to implant, then it becomes a much more complicated issue , because we cannot determine why they are not implanting.

The reality is that we will have to call these unexplained implantation failures, because implantation is still a biological black box which we cannot control !

We need to understand our limitations , and this is why documenting the quality of embryos ( by sharing photographs with patients) is so important for determining what the next steps should be !


What to find an IVF clinic which respects your time and intelligence ?






When IVF is bad for you!

Thursday, March 28, 2019

The one thing you need to do before IVF




A lot of IVF patients ask me what they need to do in order to prepare for an IVF cycle.
Most of this is fairly common sense stuff , which they already know. They should be taking supplements , like folic acid. They should be fit, in good health, with the right BMI.  They should stop smoking, and stop drinking, and you don't really need a doctor to tell you this !
What I do tell them is I only want one thing from them - to come with lots of smiles - optimism and positivity always help !
The best way to acquire this is to have realistic expectations of IVF, so you understand what is in your hands; what's in the doctor's hands; and finally all the other stuff which we really can't control.
If you have realistic expectations , you're unlikely to be unhappy, no matter what the final outcome of the IVF cycle is . The process itself should be a happy and positive one, and you should have peace of mind that you've done your best.
The best way by doing this is by being well-informed, so that your stress levels are reduced, because you know exactly what's going to happen next !
This is why investing in Information Therapy is so valuable !

What to find an IVF clinic which respects your time and intelligence ?







Wednesday, March 27, 2019

Information Therapy for IVF patients



One of the reason IVF cycles can be so stressful is because patients are so poorly prepared for it.
For one thing, they have very unrealistic expectations , and they expect that they're going to get pregnant in the first cycle itself.
Now I understand that if every patient, in their heart of hearts, didn't think she was going to get pregnant, she would never even start an IFV cycle, but it's important to understand that IVF does have a failure rate.
Having realistic expectations helps to reduce your unhappiness in case the cycle fails, because you are prepared for the fact that it can take time to achieve your goal. IVF can be a very emotional journey , with lots of ups and downs , and having realistic expectations helps you manage the roller coaster better.
Much more importantly, if you've done your homework, you know exactly what's involved, and you will not worry about the so-called side effects which lots of friends will tell you about, because to know that IVF is safe.
You will be much more in control , because you will know what the doctor's doing , and will be  able to ask intelligent questions. You will be able to admire your embryos when your doctor shows them to you, so that no matter what the outcome, you will have peace of mind that you gave it your best shot - after all, what else can a human  do ?

What to find an IVF clinic which respects your time and intelligence ?







Tuesday, March 26, 2019

IVF as a safety net



A lot of infertile couples are very reluctant to do IVF because they think that it signals the fact that they are failures.
They think of this as a stigma - that because they have not been able to make a baby in their bedroom, they need assistance from a doctor in order to get pregnant - something that people do routinely all the time , without any help at all.
This is why they are emotionally upset when they find that they require assisted reproductive technology in order to get pregnant.
However, the right way of looking at IVF is to appreciate the fact that at least they now have treatment options ! IVF creates a safety net for them, which means we can help them to have a baby , when nature lets them down.
And IVF is really not artificial ! All we are doing is assisting them , so that what's not happening in their bedroom , we're doing for them in the laboratory.
This is why infertile couples need to change the way they perceive the problem and re-frame it.
Stop thinking that you have failed at making babies, but just accept the fact that you need a little bit of assistance to get the pregnancy kick-started ! Assistance is something which all of us require throughout our lifetime, all the time, so why be ashamed of this ?

What to find an IVF clinic which respects your time and intelligence ?







Monday, March 25, 2019

Doing IVF for social reasons



In the past, IVF was purely a medical procedure , which was done only for medical reasons. 

Thus, IVF was restricted for infertile couples, who couldn't have a baby in their bedroom, for various reasons such as blocked fallopian tubes , or a low sperm count. IVF allowed us to do in the lab what was not happening for them in their bedroom , because nature had let them down.

Today, however, women often want more control over their bodies. They want to have a baby quickly , so they can move on with their lives.

They aren't willing to be patient and wait until nature takes its own course, especially because a lot of these young career professionals get married at a later age.

Even though they know that they can get pregnant in the bedroom if they wait, they also understand that human reproduction is not a very efficient enterprise, and they want to accelerate the efficiency. This is why they opt for IVF, so they can have a baby more quickly.

They find this a very cost effective use of their resources, because time is at a premium for them, and they want to optimize their use of it.

This is the new indication for doing IVF - patient preference driven IVF for social reasons, which is perfectly acceptable. Do you agree ?

What to find an IVF clinic which respects your time and intelligence ?






The three things you need to bring to an IVF cycle.

Sunday, March 24, 2019

Day 3 vs Day 5 transfer , if there is only a single embryo



If you have only a single embryo, should you do a transfer on Day 3 or Day 5 ? This is a common dilemma which both patients and doctors face , and there are pros and cons for both approaches.

After all, if you have only one embryo, then why bother to wait until day five? Why not put it back on day three , and hope that it implants? Isn't a bird in the hand worth two in the bush ? After all, if it's going to implant, then isn't the uterus as good as the IVF lab ?

Yes, this makes intuitive sense, and lots of IVF clinics push for a Day 3 transfer, because they can proudly tell the patient that at least we managed to do an embryo transfer for you. If it didn't implant, that's your bad luck !

The problem with this approach is that because these patients are poor ovarian responders, the chances of their embryos being genetically abnormal (even though they look fine on Day 3), is actually very high.  This is because the chances of their eggs ( and therefore their embryos having genetic problems is high).

This means the odds are that these embryos most likely won't implant. Now, if they don't implant , patients will have lost valuable diagnostic and prognostic information, which they could have got if they'd continued growing them to Day 5. If the IVF cycle fails after a Day 3 transfer, they are never sure show what the reason for the failure was. However, if they try growing the Day 3 embryo to Day 5, and if it arrests in vitro, then at least they have documented the fact that the problem is with the embryo ( because of the poor egg quality) , which means it's easier for them to make a decision to use donor eggs for the next cycle, rather than continue trying to use their own eggs pointlessly.

This is why our advice is to do Day 5 transfers only ! However, this is an option only is you are taking treatment at a high quality IVF clinic , which has a great IVF lab , and which provides photos of embryos routinely to all their patients.

What to find an IVF clinic which respects your time and intelligence ?






Monday, March 18, 2019

New research shows that PGT does not improve pregnancy rates

Making difficult decisions - a guide for IVF couples

Repeated IVF failure versus recurrent implantation failure


.

A failed IVF cycle causes a lot of heartburn . It's not just patients who get disheartened and disappointed, and doctors also wonder about what they can do differently the next time to improve the chances of success.

We need to differentiate between repeated IVF failure versus recurrent implantation failure. Recurrent implantation failure means good quality embryos ( usually, a total of 4 top quality blastocysts) have been transferred in the uterus over 3 cycles and yet have failed to implant.

There are many other reason for IVF failure - for example, because the embryos were of poor quality. If we know what the reason is, then this is something we can focus on and try to correct. Thus, if the reason for poor quality embryos is poor quality eggs because of advanced age, we can address this issue by suggesting the use of donor eggs.

However, for patients where we have transferred top quality embryos into a receptive endometrium, but the embryos stubbornly fail to implant, then it becomes a much more complicated issue , because we cannot determine why they are not implanting.

The reality is that we will have to call these unexplained implantation failures, because implantation is still a biological black box which we cannot control !

We need to understand our limitations , and this is why documenting the quality of embryos ( by sharing photographs with patients) is so important for determining what the next steps should be !



What to find an IVF clinic which respects your time and intelligence ?
WhatsApp us at https://wa.me/919867441589/





Saturday, March 16, 2019

Why sophisticated IVF patients love technology - and how this can hurt t...

Why IVF babies are at increased risk as compared to normal pregnancies



A lot of people worry that IVF babies are abnormal as compared to babies made in the bedroom . This is often based on press reports which say that IVF increases the risk of babies having medical problems . This is true , but we need to understand why !

This increased risk is applicable only when IVF gives rise to a multiple pregnancy . It's well known that multiple pregnancies increase the risk of prematurity, and preterm babies are at a much higher risk of a whole host of medical problems, such as retinopathy of prematurity, cerebral palsy or mental retardation. 

This clearly means that it's not the IVF which increases the risk, it's the fact that it's a multiple pregnancy . Now the risk of a multiple pregnancy is higher in IVF clinics which are irresponsible, and transfer more than one embryo at a time. This is why all good IVF clinics suggest that patients transfer only one embryo at a time.

The good news is that IVF singletons have exactly the same risks as bedroom singletons, and the chances of their having medical problems is not increased at all !


What to find an IVF clinic which respects your time and intelligence ?






Tuesday, March 12, 2019

A free solution for reducing IVF stress!

When IVF is bad for you !


While IVF can be a very effective treatment option for infertile couples,  the sad truth is that it sometimes causes more harm than good.

Thus, many IVF doctors push unproven and untested tests and treatments on their patients. These are disguised in the garb of being the "latest technological advance", but actually serve only to improve the  clinic's profits, and not the patient's pregnancy rates. However, patients are desperate, and unethical doctors are happy to take advantage of the patient's vulnerability.

Over the last 30 years, we have seen many of these "advances" come and go. They were introduced with a lot of fanfare, but died a slow death, when it was learned that they did not help to improve IVF success rates. Sadly, these caused a lot of harm to patients who served inadvertently as "guinea pigs" !

The list is long - and doesn't seem to get any smaller, because there will always be new solutions to take the place of the discredited ones.

These include:
 - treatment of "luteal phase defect" - a diagnosis which has turned out to be a mirage
- Growth Hormone treatment for poor ovarian responders
- Endometrial scratching
- Coculture
- Laser assisted hatching
- Immune Therapy
- Testing for NK cells
- PGD/PGT
- ERA

Patients need to become more proactive, and not get carried away by stuff, just because it is the "newest and latest". In fact, in medicine, old remains gold, because it has stood the test of time !

Want to find an IVF clinic which respects your time and intelligence ?
WhatsApp us at https://wa.me/919867441589/





Monday, March 11, 2019

Bed rest is bad for IVF patients.



One of the myths which continues to plague IVF patients is that of bed rest. This has been propagated for decades, and everyone tells them to rest after doing a transfer. It's often not just their mother-in-law and friends - it's often the doctor ( and nurses) as well ! 

This makes absolutely no sense , because bed rest is actually bad for patients. It adds to their emotional stress , because an idle mind is the devil's workshop. When they rest in bed, they think all day about what could potentially go wrong, and how they will cope if the pregnancy test comes back as negative. It's bad for their physiology as well, because their backs hurt ; their muscles  become weak , and blood flow to the uterus actually decreases.

This is why we encourage patients not to take any bed rest at all, and to continue to lead a normal life ! After all, they aren't really patients - they are healthy women , and we are just helping them to kick-start their pregnancy ! Once the embryo is transferred into the uterus, it is as a safe as a pearl in an oyster. Embryo implantation is a biological process, and will progress normally and naturally, irrespective of physical activity.


What to find an IVF clinic which respects your time and intelligence ?






The misdiagnosis of PCO

Wednesday, March 06, 2019

New research shows that PGT does not improve pregnancy rates


The latest craze in IVF clinics in India today is to promote PGT ( preimplantation genetic testing). This is an expensive test, which allows us to check the chromosomes of an embryo, so we can transfer only the chromosomally normal embryos back into the uterus.

Now, logically, this makes a lot of intuitive and scientific sense. After all, what's the point of transferring genetically abnormal embryos into the uterus. And if we have a test which allows us to test whether or not the embryo is chromosomally normal, then doesn't it make sense to use it? Why should we worry about the cost if it improves pregnancy rates ?

Sadly, not only does it add to the costs, it also does not improve success rates, as proven by this paper published in the respected journal, Human Reproduction, in Sept 2018, from one of the world's leasing IVF academic centers in Brussels.

https://academic.oup.com/humrep/article-abstract/33/9/1767/5063306

If your doctor pushes you into doing PGT, or suggests that it will improve your chances of getting pregnant, please share this reference with him !

Iatrogenic infertility

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