Why Do IVF Success Rates vary so much amongst clinics ?

In the case of most surgical operations, the treatment outcome is pretty much the same, regardless of who the doctor is and the hospital you select.  And therefore, when experienced and competent surgeons perform various routine operations such as tonsillectomy and appendectomy in an expert manner, their patients will have no complications and will go home cured.

However, when it comes to IVF treatment, the situation is completely different- this is because of the complexities involved in it. Not only does it require high levels of clinical expertise, but sophisticated IVF lab services as well. There are a number of biological variables involved in this treatment and this is what leads to a wide variation in IVF success rates.

The success rates of IVF at the best clinic can be upto 4 times higher than the worst.

There are a number of reasons for this variation:

• The experience as well as the expertise of the IVF doctor is one and of the most significant reasons for this difference. Good doctors have mastered the art of superovulating patients, and can tailor the regime according to the patient’s ovarian reserve, rather than following a mindless “ one size fits all protocol”. IVF success rates are dependent on the embryo quality; in turn, this is dependent on egg quality. An expert doctor is able to get good quality eggs even from older patients with poor ovarian reserve. In the case of younger patients, the doctor’s expertise may not make much of a difference, as these patients are able to grow eggs well, regardless of the protocol used .
• However, it’s different in the case of difficult patients – for example, patients who have poor ovarian reserve or polycystic ovarian disease. Here, the superovulation protocol used by the doctor can makes all the difference between IVF failure and success
• The IVF lab plays a very important role in the treatment. Unfortunately, this is one area where many IVF clinics tend to take shortcuts. Most clinics don’t employ a full-time embryologist. They have sub-standard equipment; and they never follow routine quality control measures such as checking the pH of the culture medium and checking the temperature and CO2 level in the incubator. Many embryologists don’t have the expertise to perform the ICSI procedure properly. Most  don’t have to ability  to grow embryos to the blastocysts stage; and many are not good at vitrifying embryos.

Unfortunately, it isn’t difficult to take ignorant patients for a ride, and these clinics consistently take advantage of the gullibility of their patients. These poor patients they end up failing multiple cycles. The only thing they need is treatment from a good doctor at a good IVF clinic that has a good IVF lab that will be able to make good quality embryos for them.

When Clinics Use a Sieve to Select Patients

One more major variable is that of patient selection. Some clinics are very smart and in order to maintain high success rates, they cherry pick patients and will treat only the ones that have a good prognosis. Contrastingly, there are clinics that don’t sift their patients and will treat everyone who comes to them, regardless of how slim their chances are. They ensure that these patients are counseled properly and that they have realistic expectations.

And then there are the clinics at the opposite end of the scale – these clinics will purportedly “ treat” even those patients whose chances of getting pregnant are zero. They go through the motions of doing IVF for them, just in order to squeeze money out of them.

Being Well-Informed Matters

It can be extremely difficult for a patient to figure out which clinic is good, bad or ugly. The only way to get over this problem is that you should be well-informed, so you can ask intelligent questions. This will help you identify which clinic offers the facilities they require, to maximize their chances of getting pregnant. Of course, this can happen only with a certain amount of effort and researching- but when your IVF cycle succeeds, it’s well worth the effort.

Need more information? Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you!