Wednesday, August 24, 2016

Why is it so easy to fool IVF patients?

I just did a consultation with a patient who had done three IUI cycles at a local clinic. She'd got pregnant in each and every IUI cycle, but had apparently miscarried. Now this seemed a little fishy to me - after all, it sounded too good to be true. An IUI cycle has a pregnancy rate of only 10% per cycle, so how come her doctor managed to get got pregnant in every cycle ? And how come she miscarried every time? Something smelled wrong.

When I reviewed the results , I realized that when she said she got pregnant, this meant her beta HCG blood test was positive, as was her urine pregnancy test. Now this was only because she did the tests after her doctor gave her an HCG injection ! The doctor would give all her IUI patients a HCG injection to induce ovulation, and would continue giving the HCG injections every 3-4 days during the luteal phase. The mystery was finally solved - this was why her HCG results were always positive. The doctor would give her a HCG injection , and then draw the blood test for checking her HCG level the next day. This is why she had so many false positives - her doctor was just taking her for a ride.

To add insult to injury, the doctor would repeat the HCG injection after the first HCG blood test was positive, as a result of which her periods kept on getting delayed , and she kept on hoping that she was pregnant each time.  Even worse, her doctor told her, " I am getting you pregnant, which means my treatment is 100 % effective. You are miscarrying every time , and we need to test you for what the reason for your recurrent pregnancy losses are." This doctor kept on fooling this patient - who was a highly educated intelligent software professional with a B.Tech degree.

So why is it so easy for doctors to fool IVF patients ?  Part of it is because they're desperate. If anyone tells them that they can get them pregnant, they suspend their intelligence, and are happy to clutch at straws.  Patients have been taught to trust their doctors, which is why they don't bother to come to counter check what the doctor's telling them . This emotional vulnerability means that their common sense often takes a back seat.  Even worse, there are lots of doctors who are willing to take advantage of the gullibility of these patients, therefore will mercilessly cheat them left, right and center.

In fact, this doctor then went on to do an IVF cycle for this poor patient using exactly the same tricks. She told her, " Congrats -  your HCG's positive and you're pregnant, but you have miscarried again, which means you now need donor egg surrogacy in order to get pregnant ! Given how many doctors prey on the infertile patient's desperation, it's hardly surprising that patients don't trust doctors any more !

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