Saturday, November 21, 2009

What patients want from their IVF doctor !

Here's an email I received recently from a patient from the US. She has a baby after taking IVF treatment from our clinic 4 years ago, and is now looking to complete her family. She is in the US and is finding it hard to travel to India again because of her job .

Dear Doctor Malpani, I need your advise.....

I went to the doctor here for ICSI and it did not work.....I developed just 8 good eggs, 6 embryos, 2 were good and 1 was just OK, 3 of them were transferred on a day 3 (they were not good enough to transfer on day 5), and I am not pregnant.....

That was a reality check for me since I was positive that it will work for me again. I have to tell you..., whats a different between doctor's attitude here and what i had experienced in India....I only saw the doctor that I "picked" here twice, once during the first consultation and another time at the egg retrieval The transfer was performed by a different doctor since the doctor #1 was not at that office at that day....To me it is not acceptable but I have a feeling its how it works in US, it's just the way it is; no words of encouragement here, no one cares about the patient....
Now, I was on Gonal-F 1050, Luveris, and Genirelix. It was a very short cycle, it was something around just over a week, I had just about 8 eggs that developed very very quickly and the rest of the eggs that I had were not ready yet....
My first test before IVF was: FSH 11.4 mlU/ml and E2 37.6, I sent you e-mail about it earlier;
I had another test today and its: FSH 7.2 and E2 39.2 .....
I do not know if he dosed the medication wrong (since I had a few eggs, just some of them were ready and some of them were not there yet), or they may be messed up the test at the first time, or i am getting older, or all together.....
Any way, If I'll decide to do it again the doctor here suggested to try Lupron and birth control pills (something called micro dose...). However, he cannot tell me what I need , he basically said " you can repeat the ganirelix protocol or try Lupron micro dose with birth control pills; however, if you are not comfortable with Lupron, you can pick Ganirelix again".....that's basically our conversation.....

About embryos, we transferred 10c,10c, and 6 c, I have no idea about the thickness and actually do not know if I can find it out since I have no way of talking directly to the doctor, I am not even talking about communicating with the embryologist whom I only saw once by the way, which is what upset me the most.....all communications are done through the nurses who do not have any information, they are like translators between doctor and patient.

I requested the copy of all my records that will be mailed to me and I'll probably get it next week. I have a picture of embryos that were given to me prior the transfer but its not digital so I'll have to scan it first and then e-mail it to you.

The thing that really puts me down at this moment is not even the fact that I did not get pregnant, i understand that there is no 100% guarantee but the fact that I feel that the doctor did not try hard enough to even take me seriously or spend extra minute to think what might would work better for me. I do not need a doctor who puts me on "what ever" to see if it will work or not, or a doctor who will do what I'll tell him to do. I need a doctor who will tell me what I need to do and I believe its the case with the most patients. I know that not all doctors are the same here and I believe that there are many great doctors here in US but who knows where to find them and where is guarantee that the next doctor will not fall in to the same category.......

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