Tuesday, October 13, 2015

Is your IVF doctor fooling you ?

I get lots of requests for a second opinion from patients from all over India.  For example, one patient wrote -

Hi Dr My wife had a 3 day transfer on July 3 2015.Her pregnancy continued for 22 days, but then there was a bleeding on 22nd day...followed by decrease in B HCG after significant rise from 17th day till 22nd day. We have visited our IVF specialist team they told they will do it in next cycle...but they have not done any  IVF transfers till now...They say that endometrium is not thick...optimum thickness should be 8...and it is 6 now, this happened on 30th September, now they have given medicines for withdrawal bleeding and they are saying that they will plan it in next cycle with frozen embryos ... Are they going in right direction ...or are they fooling me ?

This is the kind of email which raises lots of red flags about the quality  of IVF treatment which this patient has received. There are lots of holes in the story, and it's very hard to fill in the gaps.

Was this truly a pregnancy ?  Or was this a IVF pseudo-pregnancy created by giving the patient a  HCG injection, to make the pregnancy test come out positive ?

Was the lining fine in the earlier cycle ? If so, what has happened to it now ? and why ?
I am also not happy that they have not shared a treatment plan with the patient. They seem to be providing information in dribbles, in a very disorganised fashion, and this is going to create trust issues for the patient !

I always assume positive intent, and my first request is to ask the patient to provide me with more details. I need only two things - photos of the embryos ; and a printed treatment summary from the IVF clinic ?

If these are not available, this means the quality of care was poor ( until proven otherwise). This is because every good IVF clinic routinely and proactively provides embryo photos  and a treatment summary, whether or not the patient asks for it. Any clinic which does not is not following standard medical treatment guidelines, and maybe cutting corners.

Want to confirm you are getting good quality IVF care ? Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you !

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