Saturday, October 12, 2019

The biggest risk of doing IVF

IVF patients are anxious before starting an IVF cycle, and it's easy to understand why. IVF is an expensive treatment, where the outcome is uncertain, and no one is sure whether the cycle will succeed or not. Also, they are worried about the risks of taking all the injections, because they are scared about their side effects.
However, they worry about the wrong things ! The truth is that IVF is a safe , tested and effective treatment, provided it's done in a good clinic .
The biggest risk is one patients are often unaware of - choosing the wrong doctor.
The reason most patients are blissfully clueless about this is because they naively assume that all doctors are created the same.  Also, they don't think they're competent enough to differentiate between a good doctor and a bad doctor, and are happy to go to the one who is nearest/cheapest/ has been recommended by their GP .
This is the biggest mistake they make, because if you end up in the clutches of a bad doctor, not only will you end up wasting a lot of money, you also actually end up running the risk of unnecessary complications , such as high-order multiple pregnancies , or ovarian hyperstimulation syndrome ( OHSS) .
Please do your homework before you sign up for an IVF cycle !

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Friday, October 11, 2019

Why do perfect IVF cycles fail?

Often an IVF cycle goes perfectly , and the doctor is happy with the medical process. He has transferred a top quality blastocyst; the transfer was smooth; and the endometrium was 8 mm and trilaminar.
However, even though everything seems to be perfect, the IVF cycle may still fail.
Patients then feel  cheated and upset ! After all, if the cycle was perfect and the doctor was so happy and hopeful, then why didn't it work?
What they forget is that when we call a cycle perfect, we only refer to the medical tangibles  which we can measure. Our technology is still not good enough to allow us to assess all the hundreds of variables which influence implantation.
Thus, we look at the morphology of an embryo and grade it, but we can't check its genetics. Similarly, while we can see that the endometrium is thick and trilaminar on an ultrasound scan, this doesn't necessarily mean that it's receptive, and we don't have the tests to be able to assess this.
It's because our technology is limited that a perfect IVF cycle doesn't always end in a pregnancy.
This is something we need to learn to live with, because reproductive science is still not perfect.

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Thursday, October 10, 2019

Why does the IVF technique mostly result in twin pregnancies?

This is a very common misconception.
Part of the reason is that twins are far more memorable than singletons. This is specially true if the birth of the twins has happened after many  years of infertility , because of IVF.
On the other hand, singleton IVF pregnancies are not very memorable - and infertile couples will often not even share the information that they did IVF to get pregnant.
Also, multiple pregnancies after IVF used to be much commoner in the past , because many IVF clinics would transfer multiple embryos at one time. They didn't have very good success rates, and  in order to increase the chances of success, they would put many embryos in the hope that at least one would stick ! The problem was that if multiple stuck, patients would end up with multiple pregnancies.
This is an outdated practice today, because the complication rate with a twin pregnancy is higher. While many infertile couples are excited about the possibility of getting twins , because they think of this as an " instant family in one cycle", and while it's true that a twin pregnancy is better than not getting pregnant at all, the truth is that this is  not in your baby's best interests.
Global best practices recommend that you should transfer only a single blastocyst at one time , and freeze the rest. This way , the cumulative pregnancy rate is higher, and it's much safer for everyone !

Friday, October 04, 2019

Is IVF treatment stressful?

This depends on two important variables - the patient , and the clinic.
All patients who go through an IVF cycle are anxious , because they are concerned whether their cycle will work or not. They aren't sure  whether it will work the first time, or how many cycles they'll have to do , because they know that the success rate of IVF is not 100%. This uncertainty and anxiety obviously makes each cycle stressful . This is especially true of the two week waiting ( 2ww) period, because no one knows what's happening to the embryo which has been transferred into the uterus.
However, those patients who are well informed , and who have realistic expectations, because they have take the time and trouble to understand what an IVF cycle involves, find it much easier to cope with the emotional roller coaster ride, because they know that IVF is safe and effective are

The second variable is the clinic. Some clinics are very hands on , and will provide a lot of personalized attention to each individual patient. We don't have any assistants, and take care of all our patients ourselves. However, most large clinics are assembly line operations, who don't really care about the patient's state of mind . They needlessly add to the patient's stress, because of the long waiting times they subject patients too, and because the senior doctor is never available, and the care is delegated to inexperienced juniors.

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Thursday, October 03, 2019

IVF video in Hindi - 7 STEPS OF IVF (आई.वी.एफ. प्रक्रिया के 7 आसान चरण)

Is IVF painful?

Not if you do it in a good clinic !

Yes, IVF can be extremely painful in some clinics -  especially the ones who use intramuscular progesterone injections to provide luteal phase support after the transfer.
These are oily injections, which need to be given deep intramuscularly , as a result of which the patient's muscles become so sore and hard that they can't even sit on their backside !

These clinics are extremely unkind , and don't care about the comfort of their patients.
Clinics such as ours are much kinder, and we've never used intramuscular progesterone injections.

We do use progesterone , and give it in the form of vaginal suppositories . These doesn't cause any pain at all, which means there's no reason why an IVF cycle should be painful.  In fact, they are far better than the progesterone shots, because vaginal absorption of progesterone is much better than through the intramuscular route.

Also, we do our egg collections under general anesthesia. This is a short procedure, and patients have no pain at all, because they are fast asleep !

We take pride in being kind to our patients !

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Wednesday, October 02, 2019

Why do IVF clinics refuse to share medical records with their patients ?

Why are IVF doctors so secretive about the medical details of the IVF treatment they provide to their patients?
I often see patients who have failed IVF cycles, and we're quite happy to provide them with a second opinion.
However , it's very frustrating when I find they don't have any medical details at all of what treatment was offered to them.
The big problem is that there's a lot of secrecy about these medical details , and doctors refuse to share this.
I think this is partly because they want to hold on to their patient, and believe that if they don't give them their records, they will not be able to go to another doctor !
This is illegal and unethical. The medical records are the patient's property , and the patient has a legal right to be given these. After all, the patient has paid for their treatment , and there's no reason why doctors cannot give them their records.
If they want, they can keep a copy for themselves , for their data analysis, but they have to give the originals back to the patient. This is a legal liability on the part of the doctor , and any doctor who doesn't do this is a bad doctor.
I sometimes wonder the IVF clinics which don't routinely and proactively provide records have something to hide ? One possibility is that they provide poor quality treatment , and are ashamed of this, which is why they aren't willing to be open and transparent.

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