Sunday, November 06, 2016

Why did this IVF patient receive such poor quality care ?

I received this email from a patient.

Greetings!! I am a regular follower of your blogs and appreciate the importance you give to availability of free information to your patients. I want advice from you regarding my failed IVF cycle here in Delhi,

I am 34 years old and went through my third IVF cycle in a renowned Delhi clinic. My second IVF cycle which happened earlier this year was a success (transferred 2 AA embryos on day two), however, it ended in a miscarriage at 7 weeks due to detection of no heart beat.

I underwent my third IVF cycle recently and was given the prognosis of poor ovarian reserve. My AFC on day two  typically lies between 10-11. I was given gonal-F (350 IU) for 11 days and 10-12 eggs were retrieved, out of which only 2 were deemed good enough (AA quality) to be transferred. Since only my two embryos were good enough,  2 (AA quality) donor eggs were fertilized using my husband's sperms and they were transferred as well. The doctor told me that sometimes through 'co-culturing'  of both mine and donor eggs,chances of implantation increases. So in total 4 embroys (all grade A) were transferred on day 2. My endometrium lining was described as 'beautiful' and 'perfect' by the doctor.

As a rule the clinic does embryos transfer only on day 2. They has also used special 'GLUE' which would increase the implantation chances. According to them, they had done all best they could do to maximize pregnancy in my case. But still, I fail to understand why my IVF failed....when everything looked so perfect.

I seek your valuable advice  as I am feeling very helpless and dejected. 

Can you identify all the reasons why this patient received poor quality treatment ?

Here are the red flags which show that this doctor is taking her for a ride.

A patient can have either 10 eggs or 12 eggs - you cannot have 10-12 eggs !  Why is her doctor fudging numbers ?

There is no medical technique for grading egg quality - eggs are either mature or not.  Her doctor seems to be making up these " AA quality " grades !

No good doctor will ever transfer embryos from both a patient's eggs and donor eggs at the same time - this is against the ICMR rules !

Using embryo GLUE sounds very clever, but has never been shown to work. It just allows the doctor to charge a lot more.

Finally, no good doctor transfers embryos on Day 2 !

The biggest tragedy is that it continues  to be so easy for IVF doctors to take even intelligent patients for a ride !

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