Friday, March 06, 2020

Head versus heart in IVF

Many educated patients find it very hard to deal with IVF failure, especially when the cycle was perfect, and the doctor transferred a top quality blastocyst into the uterine cavity when the endometrium was receptive.
After all, the doctor did everything possible, and the blastocyst looked perfect, the endometrium was 8 mm and trilaminar, the transfer went smoothly and the doctor was really optimistic !
So then why did the cycle fail ?
The reality is they understand that medical science doesn't have the answers to all their questions, but they find it very hard to accept this.
Because they are educated , they expect that medical science will have all the answers.
However ,  we need to accept the limitations of medical technology . After  all, when we put an embryo back in the uterus, we can't monitor or track or control what is happening to it. This is a microscopic ball of living cells, and implantation is a biological process which is notoriously inefficient !
The problem is these patients are emotionally very vulnerable , and don't want to accept the truth that not everything is in our control !
They want answers, which is why sometimes doctors end up manufacturing them , just to keep them happy, by running additional expensive genetic tests and offering experimental expensive unproven treatment. Sadly, this doesn't help them reach their goal at all, and just ends up making them waste money !

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

Do’s and don'ts after the embryo transfer.

Lots of patients are very worried that they will do something stupid after the transfer, which will reduce the chances of their embryo implanting, and cause their IVF cycle to fail.
These anxieties usually falls into the category of foods which they eat; (hot foods or cold foods); or physical activity. For example, they are scared that lifting weights , or the bumpy ride on Indian roads may dislodge the embryo.
This is why many doctors are happy to give them a long list of do’s and don'ts. Mother-in-laws and mothers and aunts will also chime in, with many old wives' tales. And friends who are pregnant will be happy to add their 2 cents !
The truth is that the natural place for an embryo is the uterus – it’s its natural sanctuary ! An embryo in a uterus is like a pearl in an oyster – it’s safe and secure and nothing you can do can dislodge it, so you really don't need to worry.
Remember that an IVF pregnancy is exactly like a natural pregnancy – the only difference is that you happen to know there is an embryo in your uterus ( which fertile women who are having baby making sex don’t !)
Whether the embryo spends five days in the test tube in the IVF lab, five days in your fallopian tube inside the body doesn't matter – once it reaches the uterus, it’s safe.
Of course, whether it will implant or not is not something we can control – that’s still a biological process we cannot influence as yet !

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Wednesday, February 26, 2020

What should a patient do when IVF doctors disagree ?

Infertile couples are often very confused when they go to IVF doctors , because they get widely varying different opinions , and they're not sure whom they can trust.

There are many reasons why IVF doctors don’t agree with each other.

For one thing, our IVF technology is still not perfect, which means we still cannot even make an accurate diagnosis, and have to label many couples as having “unexplained infertility” because we cannot clearly and accurately identify the underlying problem.

Because no one really knows what the truth is, everyone interprets tests the way they want, based on their experience and preconceived notions, and there’s no right answer !

The second big problem is that there are two important variables which influence the diagnosis and treatment of infertility. One is called the “ trying time” -  how long an infertile couple has been trying to get pregnant; and the second is the fact that the”  natural history “ of untreated infertility is unpredictable.

Thus, even infertile couples who haven't been able to get pregnant for five years, could still perhaps get pregnant on their own, if they continue trying.

This is why the individual doctor's personal preferences are going to influence what the doctor advises the patient, because they are so swayed by their personal experiences and anecdotal success stories.

Thus, some doctors are aggressive , and will advise IVF for everyone, whereas others are much more conservative , and will want to explore simpler options first, before advising IVF.

Patients need to recognize this subjectivity, and find a doctor whose preference and philosophy matches theirs !

What to find an IVF clinic which respects your time and intelligence ?
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Tuesday, February 25, 2020

Please don't abandon your embryos !

As IVF technology gets progressively better, we're able to grow more eggs and create more top quality embryos. Now we can't transfer all the embryos at a time, because of the risk of a multiple pregnancy, which means patients are left with supernumerary (spare ) embryos. We encourage all patients to freeze their spare embryos , because each embryo is worth its weight in gold.
Our technology for freezing and storing embryos using the technology of vitrification has become so good that survival rates after thawing are practically 100%, which means the pregnancy rate with these embryos is as good as with fresh embryos !  And the cost of doing a frozen –thaw cycle is much less because it's so much simpler and easier – you don’t need to take any injections at all !
So if you do have spare embryos, please freeze them. Yes, freezing will add to your cost up front, but it's a very worthwhile investment.
And the bonus is that if you do get pregnant with your first transfer, you can use your frozen embryos for your next baby, to complete your family !

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Monday, February 17, 2020

Why testing for failed embryo implantation in IVF patients is useless

One of the big problems with IVF is the uncertainty which surrounds it – no one knows which cycle will work, or why perfect cycles fail.
What makes a bad problem even worse is that patients have unrealistic expectations of the technology. Sadly, doctors compound the problem by pandering to the patient's demands. They offer to provide answers by running many expensive, complex, exotic and esoteric tests, even though they know the reality is that these don’t provide any useful information.
This is because embryo implantation is a complex biological process, which we cannot control and we cannot monitor, and we still don't know which embryo will implant , and which ones won't.
Doctors are worried that if we tell the patient the truth – that we don’t have all the answers – that patient will no longer respect us . This is why we subject them to the “latest and newest”  tests, to demonstrate that we're trying to figure out exactly what the problem was.
However, this just means that we're taking the patient for a ride, because we don’t tell them to truth about the limitations of these tests, and that they won’t change their treatment options.
Yes, the patient ends up  spending a lot of money, and this is good for doctors because they can charge more, but the test results don’t provide any useful answers , which means the doctor remains in the dark – but he can cloak his ignorance using fancy medical jargon !

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

Friday, February 14, 2020

IVF Video : Empiric therapy in IVF

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IVF VIdeo : Why the IVF hormones don't cause cancer or early menopause !

IVF Video : Making sense of the semen analysis report

IVF Video :" How IVF failure can lead to success !

IVF Video : Why young professional women should explore the option of egg freezing

IVF Video : Blastocyst transfers maximise IVF pregnancy rates

IVF Video : Should infertile couples go to gynecologists ? or IVF specialists ?

IVF Video :Is your IVF clinic a full-service IVF clinic?

IVF Video : What infertile women need to know about their AMH levels

IVF Video : Frozen eggs are a better option for donor egg IVF

IVF Video : The AMH blood test can help women to track their fertility

IVF Video : Why single embryo transfers ( SET) have a higher pregnancy rate

IVF Video : Day 3 or Day 5 Embryo Transfer. Which is better?

IVF Video : IUI क्या होता है ? | Intra-Uterine Insemination Explained in Hindi

IVF Video : Self Inflicted Infertility

IVF Video : HOW TO GRADE EMBYOS in (hindi)

IVF Video : Learning from a failed IVF CYCLE

IVF Video : Donor Egg Vs Surrogacy

IVF Video : Preimplantation Genetic Diagnosis and Preimplantation Genetic Screening Explained in Hindi

IVF Video : Career Vs Baby

IVF Video : 4 things, all Infertile Couples are fed up of Hearing


IVF Video : 5 Things Every Infertile Couple Wishes their Friends knew about Infertility


Tuesday, February 11, 2020

Why IVF doctors disagree

Infertile couples are often very confused when they go to IVF doctors , because they get so many different opinions , and they're not sure whom they can trust.
There are multiple reasons for why IVF doctors will often give widely varying opinions.
For one thing, a lot of our technology is still not perfect, which means we cannot make an accurate diagnosis in reproductive medicine. This is why two different doctors will interpret the same test result in diametrically opposite ways !
Also, we need to remember that making babies involves a couple, which means the fertility of a couple will be the sum of the fertility potential of both the partners . This is why answers are never in black or white - they are always shades of grey ! It's possible that if an "infertile man" marries a very fertile woman, he will be able to get pregnant.
Also, time plays a key role is the final outcome . Trying time - the time for which an infertile couple has been trying to get pregnant is a very important dynamic variable, which means the way we treat a recently married couple is very different from the way we treat one who has been trying for more than one year - even of their test results are identical !
The problem is that the natural history of fertility is difficult to interpret, because we all know infertile couples who  haven't been able to have a baby in the bedroom for five years, who still get pregnant on their own, for no clear reason. Of course, if they got pregnant after the doctor's "treatment", he is going to take all the credit. These anecdotal success stories bias the doctor, and his individual personal preferences are going to influence what he advises his patient. Some doctors are aggressive and will advise IVF for everyone, whereas others are much more conservative - and patients need to recognize this difference !

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

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