Saturday, December 14, 2013

Dr Malpani helps patients understand why their IVF cycles have failed


One group fails because of some intrinsic medical problem which they have , such as poor ovarian reserve or a damaged endometrium.  This means that even though the quality of care which they have received is superb , their chances of getting pregnant are poor, because of their disease. These poor prognosis patients have taken treatment at good IVF clinics . Their medical documentation is excellent; they have photographs of their embryos ; and they have a sound understanding of their problem, because their doctor has explained their problem to them properly.

While we can repeat the IVF cycle again for these patients, the option which has a higher success rate for them usually involves third party reproduction, such as using donor eggs for patients with poor ovarian reserve ; or surrogacy ( for those with a damaged lining).

On the other hand , we often see patients who have failed IVF cycle because they have received extremely poor quality medical care . Typically , these patients don't know much about what was done to them during the cycle . Their medical documentation leaves a lot to be desired , and they don’t have any photographs of their embryos . Their doctor refuses to sit down and critically review and analyse the failure with them, so that they can learn from it. He usually brushes off their queries by offering them platitudes such as - It's all in God's hands . More sophisticated doctors label the problem as being one of "failed implantation" - which really does not mean anything at all , because it's just a waste-paper basket diagnosis which does not add any value as it does not offer any insight as to what should be done differently in the next cycle, to improve the chances of success !

Interestingly, sometimes these patients have received poor quality care at highly reputed centers . This is because their care has been mismanaged . This is especially common in patients with polycystic ovarian disease ( PCOD), for example, where the doctor is so worried about the risk of hyperstimulation he ends up triggering the hCG shot too early, as a result of which the patient gets poor quality eggs and poor quality embryos. The doctors then blame the egg quality for the failure . However, this is actually an iatrogenic problem , which arose because the HCG injection was not timed properly. These patients are gratifying to treat , because if they are superovulated carefully and monitored properly, they have an extremely good chance of getting pregnant !

Not sure why your IVF cycle has failed ?

Please send me your medical details by filling in the form at and I'll be happy to provide a free second opinion !

Taking treatment at a world-class clinic will maximise your chances of success and give you peace of mind you did your best !

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