Saturday, October 18, 2014

The embryo scope as a marketing gimmick

 Most doctors unfortunately are quite happy to take advantage of the fact that patients are dazzled by medical technology. They are easily lured by claims of the “newest and latest” advance, and lots of doctors take pride in the being the first to offer the newest IVF toy, claiming that using this will improve success rates dramatically. Patients have short memories, and there is a new technology being promoted every few years, depending upon what is fashionable.

The flavour of the month seems to embryoscopy, and many IVF clinics are proudly promoting this, saying that this is now the “state-of-the-art” technology which will improve IVF pregnancy rates.

So what is the embryoscope ? It’s a type of incubator that has a built-in camera, which is capable of taking pictures of your embryo several times an hour. These pictures are then combined to create a time-lapse video showing the embryo’s development at every stage, so that the embryologist can assess embryo development more precisely and select the best embryos for transfer.

An embryoscope is expensive, and in order to recover the cost, IVF clinics feature their latest buy prominently in their advertising materials and on their website. They use this in order to differentiate themselves from the competition, by offering technology which is “more advanced” than the others. Patients are quite clueless, and are easily swayed by these claims because they are not sophisticated enough to separate the wheat from the chaff. They happily cough up Rs 30000 more , so that the doctor can use the embryoscope for their embryos, with the hope that this will improve their chances of success.

The dirty secret is that these clinics cheat patients by claiming to use the embryoscope for them, but never do so in reality. Let me explain.

Each EmbryoScope has the capacity to culture only up to 72 eggs or embryos from a maximum of 6 patients at a time. These need to be observed over a period of 5 days ( for a blastocyst transfer) which means that one embryoscope can typically be used for only one patient every 5 days.  Thus, if there are 3 egg collections daily, the embryoscope will be fully blocked in a 2 day period for a total of 5 days. This means that the embryoscope cannot be used for another patient who is cycling at the same time.  Embryoscopes are expensive, and most clinics have only one.  This means that if a busy clinic is telling all the patients who are cycling at the same time that they are using an embryoscope for each of them, they are clearly lying !

How can you make sure you are not being taken for a ride ? Remember that the purpose of an embryoscope is to take a video of your embryos as they develop in vitro. If the clinic tells you that it is using an embryoscope for you ( and charging you extra for this), then you need to insist that they give you a video of your embryos, so you can verify this. The embryoscope automatically provides a video output, and you should ask for a copy of this, so at least you have documentation that an embryoscope was actually used for your care ( even though using this does not improve your pregnancy rates). This  is a simple method by which you can ensure your doctor is not charging you extra for a procedure they are not using for you.

Want to make sure you are not being taken for a ride by your IVF doctor ? Please send me your medical details by filling in the form at so I can guide you sensibly!

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