Dr Malpani, why did my IVF cycle fail ?

This is one of the commonest questions patients ask me. Doctor, I did an IVF cycle at this other clinic and it failed - can you please tell me why ?

Obviously, the next thing I need to do is to drill deeper to find out more details about the medical treatment provided, so I can provide an intelligent answer.

I ask patients for more details about their IVF cycle. What were the meds which were used for
superovulation ? What was the dose used ? How many follicles did you grow ? How many eggs were collected ? What was the E2 ( estradiol) level in the blood ? How many embryos were transferred ? What was the embryo quality ? What was the endometrial thickness ?

Most patients look completely blank when I ask them these basic questions - and some even think I am crazy for expecting them to know the answers. A standard reply is - Our doctor never told us anything !

Sadly, very few clinics in India provide patients with any medical details about their IVF treatment. Many of them do not even have the courtesy to provide a simple treatment summary - let alone details of the number of eggs collected or embryos transferred.

I have to spend a lot of time trying to reconstruct the IVF treatment provided with the help of scraps of prescriptions and ultrasound scans - and this can be a very frustrating exercise. While the fact that the clinic does not provide these basic details is a black mark against the clinic, I feel patients are also equally responsible . After the treatment is over, there's very little patients can do - and that is why I feel patients need to ensure that the clinic routinely provides all patients with all these details before they start the IVF treatment !

If I were an IVF patient, I would just ask the IVF doctor one simple question before starting the IVF cycle - Do you provide photos of embryos for all your IVF patients ? And if the answer is no, I'd find another IVF clinic !