What is the full form of IVF?

One of the commonest questions which patients ask is, "What is the full form of IVF?"

And because there's so much medical jargon around IVF, doing IVF treatment can be quite intimidating.

Let’s try to make sense of it by simplifying it. Now, IVF simply means In Vitro Fertilization, and the layperson’s term for this is Test Tube Baby. In Vitro = inside glass = outside the human body, and what this means is that we fertilize your eggs and sperms in the lab, to make inside our test tubes ( which are actually plastic petri dishes). This means that all we are doing is assisting Nature , so that we are accomplishing what would have normally happened in your fallopian tubes in vivo ( inside your body) after having sex, by doing this in the IVF laboratory. Once we have made an embryo, we then put it back into your uterus, where it implants if all goes well. An IVF pregnancy is exactly like a normal pregnancy, so it is actually fairly straight forward to understand this.

Don't get confused by all the jargon which you come across, because sometimes doctors take perverse pleasure in making things so complicated that patients get scared , and very reluctant to ask questions. It’s important that you understand the IVF process, because you must know exactly what you are expected to do, and should also be able to ensure that the doctor is doing everything properly by following best practices. This will ensure that you are in control ,  and can make sure that you get high quality medical care.

Leaving everything up to your doctor can be too expensive – especially if you are unlucky and end up in a bad IVF clinic !

You can download the IVF comic book free at https://www.drmalpani.com/pdf/IVF_COMIC_BOOK.pdf and this will help you make well-informed decisions !

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

The value of online IVF bulletin boards

Lots of IVF patients get confused, because doctors don't have time to answer their questions . They turn to the internet to try to find answers, but this often makes a bad problem even worse, because there are so many unreliable commercial websites online, which are trying to sell their services. Sadly, Google is not intelligent enough to differentiate between bad information and the truth, and because it wants to make money, it often promotes the websites of bad clinics who pay Google a lot of money for advertising on GoogleAdwords.

The good news is there are lots of kind IVF patients online, who have a lot of information , and who are happy to share that expertise with you. I'd strongly encourage you to check out online patient bulletin boards and community forums, which are designed for IVF patients, so that you can talk to other IVF patients , and use the information they share , so you're in a better position to make well-informed decisions.

Of course, not all the people who post on these bulletin boards are reliable or well-informed, so you do need to be careful. While they are great for providing emotional  support, they are often not well-informed about the medical details of IVF. This is why you need to be picky and choosy about what you read – don’t accept everything as the gospel truth !

However, online IVF communities are usually helpful and  supportive , because they're very empathetic. They've been there and done that, which is they understand the problems you're going through . They have no ax to grind, and no commercial interest either, because these are patients, just like you are, who will tell you, based on their own personal experiences, what you can do in order to maximize your chance of getting pregnant.

So, please, reach out to them for emotional support, and they will be able to help you during your IVF journey, which is quite likely to be full of ups and downs !

You can download the IVF comic book free at https://www.drmalpani.com/pdf/IVF_COMIC_BOOK.pdf and this will help you make sense of what you read on these forums !

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

The need for IVF information in Hindi , Marathi and other Indian languages

The internet is a very valuable resource for information on IVF, but the problem is that most of this is in English . This means that the vast majority of infertile couples in India don’t have access to reliable information on IVF.

Yes, Google translate does provide a work-around, but the quality of the translation leaves a lot to be desired. The grammar is poor, and there are still lots of errors.

There is a huge need for reliable information about IVF in local Indian languages today, and we need Indians to publish this.

Traditionally, Indian patients have been passive, and have depended upon doctors to do everything for them. However, there are lots of shady IVF clinics in India, who are happy to take patients for a ride. Why can’t Indian patients publish information about IVF and their experience ? This is very reliable, and patient trust other patients far more than they trust doctors !

Rather than curse the fact that you are infertile and are being forced to do IVF, why not put this to good use, and use your intelligence , experience and expertise to help other infertile women in India ? As you know, infertile couples are very vulnerable , and there are lots of dodgy IVF clinics who take advantage of their gullibility.

If Indian IVF patients don’t help each other, then who will ?

You can download the IVF comic book free at https://www.drmalpani.com/pdf/IVF_COMIC_BOOK.pdf and consider translating this into your mother tongue !

Finding support online – a guide for IVF patients

It can be very scary to go through your first IVF cycle because you don't know what to expect.  

You try to do your homework , so you can be better prepared, but you get completely confused by all the contradictory and conflicting information you get – and this true, whether it comes from family members or from online sources. Friends will share all kinds of horror stories about how someone’s aunt got cancer after doing IVF; or how a family member once told them about a cousin who put on 10 kg after doing an IVF cycle. A lot of this second information is based on hearsay and is unreliable, you're never sure who's telling you the truth , and whom you can trust.

This is where online support groups and patient community boards can be so helpful, because IVF patients want to help other patients , and they can be trusted.

IVF why patients need to learn to tap into this wealth of information, which is available online for free . You can reach out to other infertile couples who've been there and done that, and who will provide you with all the support you require, with no hidden agenda or commercial interest. The spirit of camaraderie will help you realize that you are not alone !

Hopefully, over time, as you become more expert, you will be willing to contribute to these online bulletin boards and infertility forums as well, so that you can make use of your experience , and share it with other infertile couples.

You can download the IVF comic book free at https://www.drmalpani.com/pdf/IVF_COMIC_BOOK.pdf and this will help you make better decisions !

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

Why Indian IVF patients need to start blogging

IVF patients are understandably scared before doing their first IVF cycle because they have a lot of doubts , and don't know how to clear these. They've heard lots of horror stories, from poorly informed friends and family members , and their doctors don't have time to educate them as to what the reality is.

This is where blogs written by expert IVF patients can be so extremely helpful. They've been through IVF, and done their homework and their research. They understand the medical details and are happy to share their experiences online.

Because they are patients, they write a language which is clear and simple which you can understand because it's devoid of any medical jargon. They don't have an ax to grind , because they don't have a commercial interest , and not trying to sell anything. They're only trying to help make the journey of other IVF patients easier and happier. There are lots of great blogs available online, and I'd encourage you to check them out .

The tragedy is that these are in English, which means Indian patients don’t have access to information they can trust. This is partly because of the stigma which infertility still carries in India. This is why patients are reluctant to talk about their experiences openly, and this silence is what allows bad IVF clinics to flourish, because patients don’t share their experiences.

Hopefully , Indian patients will start publishing their own blogs in Indian languages soon.

The blogs below can help to inspire you – and you can use these as models and adapt and translate them !

The 2 Week Wait at http://the2weekwait.blogspot.com/

Jay has been through many IVFs, and is an articulate infertility advocate. I love her sense of humour !

Stirrup Queens at http://www.stirrup-queens.com/

This blog by Melissa Ford is as funny as the title suggests . It is a place you can connect with other infertile women who understand what you are going through !

Ever Upward at https://www.justinefroelker.com/ever-upward/

Reading this blog will make you feel like you are talking to a compassionate friend. Justine is a therapist, and combines both her personal experiences of IVF , as well as her professional expertise, to craft a compelling blog, which will teach you to to be kind to yourself !

Why do infertile couples waste money on repeated IUI cycles ?

One of the commonest treatment options for infertile patients is IUI or intrauterine insemination.

Now this is not because it's the right treatment option, but often this is the only treatment which a lot of gynecologists can offer , because all gynecologists now call themselves infertility specialists as well.

After doing a laparoscopy, this is the only treatment option which they can do, because  they have nothing else to offer.  Part of the problem is that they don't want to lose their patients by referring them to an IVF specialist , even though they know that IVF is the right treatment for them.

As a result , they end up doing repeated IUI cycles for their patients - and this is especially heartbreaking for patients who aren't going to benefit from IUI at all , because all their time , money and energy goes down the drain. Thus, IUI is a useless treatment for  patients with a low sperm count, but doctors are happy to advice this to them by explaining – we will improve your sperm quality by washing the sperm, and IUI is much better than IVF because it’s much less expensive !

Patients get older as they do cycle after cycle, and the cruel irony is that their chances of getting pregnant with IVF also goes down because of this delay ! Even worse, they start losing confidence in doctors, because they're not sophisticated enough to differentiate between an IVF specialist and a gynecologist who calls himself an infertility    specialist !

You can download the IVF comic book free at https://www.drmalpani.com/pdf/IVF_COMIC_BOOK.pdf
 and this will help you make better decisions !

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

When should you move on from IUI to IVF?

We often see lots of infertile patients who keep on doing IUI cycles , month after month. Sometimes they repeat this treatment at the same clinic, be

Often, they get fed up and change their  doctor – who ends up repeating the IUI treatment again, just because he is only a gynecologist and does not have the experience or the expertise or the lab facility to offer anything else.

Many patients know that they shouldn't be doing IUI at all, and that IVF is the right treatment for them, but because they can't afford to do IVF, they feel – Let’s at least do IUI rather than sit at home and do nothing at all.

This makes no sense to me, and there's no point in wasting money on repeated IUI cycles. The truth is that IUI has a success rate of 10% per cycle, and that most patients who are going to get pregnant after IUI will do so in three cycles.

If you have done three IUI cycles that have gone well in a good clinic and still not got pregnant, then you've reached the point of diminishing returns, and there’s no point in repeating anymore IUI cycles.

Sure, you can continue wasting time, money, and energy on repeating IUI cycles, but actually you'd be better off stopping and thinking about moving on to IVF.

There’s a world of difference in the success rates of IUI and IVF , and IVF is far better because it allows us to make top quality embryos in the IVF lab and then transfer these into your uterus.

You can download the IVF comic book free at https://www.drmalpani.com/pdf/IVF_COMIC_BOOK.pdf

and this will help you make better decisions !

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

IVF injections, sore butts and bruised bellies

I've always been very impressed by how motivated, determined, perseverant IVF patients can be. Lots of them are petrified of taking an injection, and have never taken an injection before in their life.

However, because they want a baby so desperately , they're willing to take lots of injections during their IVF cycle and they learn to get used to it.

Some of these IVF injections can be extremely painful, and these include the progesterone injections, which American doctors love so much. These are given after the embryo transfer , to provide luteal phase support.

The other extremely painful injection is Clexane or low-dose Heparin, which seems to have become very popular with IVF specialists because it's supposed to increase implantation rates.

Not only do doctors seem to love giving injections to patients, patients also feel that the doctor is doing as much as possible for them by prescribing these “powerful” injections for them !

However, after going through an IVF cycle , their butt gets so sore and their belly gets so bruised thanks to all these shots, that very few patients are willing to go through another IVF cycle, which is why the drop out rate is so high. And even if they have the courage to subject themselves to the shots, their husbands will often put their foot down and refuse to allow them to do so, because they cannot bear to see their wife in so much pain.

 What breaks my heart is that none of these painful injections is really required at all for these poor patients. Progesterone is far more effective when it is administered as a vaginal pessary, but old habits die hard, and many doctors continue giving the painful IM shots for no rhyme or reason.

Similarly, there is no evidence that low-dose heparin improves embryo implantation rates, but the pharma companies have been selling them so aggressively, that doctors prescribe them mindlessly , because they love doing something “new and different” !

You can download the IVF comic book free at https://www.drmalpani.com/pdf/IVF_COMIC_BOOK.pdf

and this will help you make better decisions !

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

How can you find an IVF doctor you can trust ?

The most important ingredient when selecting an IVF clinic is actually an intangible one. It's not how posh the clinic is ; or how big their team of doctors ; or what their success rates are ; or how many ads they pay for in newspapers . It's actually a question of trust in the doctor - does the IVF doctor inspire trust or not?

This depends on intuition and gut feel, and the chemistry between the doctor and patient varies from patient to patient, which is why not all patients are happy with one particular doctor. As a patient, you need to spend time finding the one who is right for you.

The traditional of building trust depended upon a referral, and in the past, patients happily went to the IVF doctor their family physician referred them to. However, this route is extremely dangerous in this day and age , because of the kick-back system which has corrupted medical practice and is so widely prevalent.

A referral by other infertile patients is very helpful - especially if they've had a baby from that clinic,  because that's a living endorsement that the doctor is good.  However, this can be gamed as well, and lots of IVF clinics do unnecessary IVF treatment cycles for young patients who don’t need IVF in the first place – thus inflating their success rates. You need to confirm that the patient who is recommending an IVF clinic to you is well-informed  - just having achieved success is actually not enough !

Using a website to find out what the doctor's philosophy is very helpful as well. Does he take the time and trouble to educate you ? Is the website sensitive to your needs and wants ? Or is it all about the doctor tom-tomming about the celebrity patients she has treated ?

The problem is that because a lot of patients have burned their fingers  with poor quality IVF clinics, they are very reluctant to trust other IVF doctors, because they cannot differentiate between good and bad doctors, and lump all of them in the same bucket  !

You can download the IVF comic book free at https://www.drmalpani.com/pdf/IVF_COMIC_BOOK.pdf and this will help you make better decisions as to which doctor to trust !

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

Thank you Dr Malpani - from a proud IVF parent !

Hi everyone , just wanted to share my IVF treatment journey.

I never thought that I will face infertility problem as no one in my family has had an issue with fertility.

We are married for 7 years now and we started our treatment in our fifth year of marriage after trying to convince naturally for two years. Infertility itself is a very traumatic phase , and wanting to be parents is every couple's biggest dream.

We approached many gynecologist as IVF was not a welcome option to us, and we went through many treatments and surgeries, but the end result was disappointment. We were desperate to find a solution to our problem  and were suggested we explore IVF. 

We came across the Malpani Infertility Clinic website and went for a consultation, and meeting the Doctor Malpani couple changed our life all together. Not only did our dream come true , but we were also very educated about the whole process. IVF treatment demands patience , as we had to go through disappointment too.

But our utter faith and patience has definitely got us the happiness we had been waiting for. Now we are blessed with a baby girl,she is six months old.

I had conceived in my third transfer, and the first two failed IVF attempts left me all broken and disheartened . But, as the saying goes , where there's a will there's a way, I kept my spirit up, and went for my third transfer immediately the next month after the failure of my second transfer - and now have a gorgeous princess in my hands ! 

This was my journey from infertility to now being a mommy by the help of IVF treatment.
I would like to especially thanks Doctor Malpani couple for their constant support.

Yes , I would once again like to point out that a few of us have been unfortunate and have not been able to conceive naturally , but science has developed a lot can help couples like us to experience the happiness of Parenthood.

Purabi Vijay Kumar

[email protected]

Answers after IVF failure

When an IVF cycle fails, patients want answers !

It’s natural to feel disappointed, sad and angry, because you are now back to square one – even after spending all that time, money and energy ! And what happened to all the reassurances which the doctor offered, saying your embryos were perfect and that you were “definitely going to get pregnant” ? Was it all just a lie ?

Please take a break and give yourself time to grieve and recover ! The truth is that many women who have had a failed IVF cycle will be successful on a second or even a third cycle. While success can never be guaranteed, some of the problems which were discovered during the IVF treatment can be corrected , to help make the next cycle more successful.

This is why you want your doctor to be able to tell you exactly what went wrong, so you can fix it and have a baby in your next attempt. Unfortunately, this is surprisingly hard to do, simply because there are so many biological variables in an IVF treatment cycle, that it's not always possible to pinpoint what the exact problem was.

Not only is every patient unique, the problem is that IVF cycles in the same patient will also vary from one month to another. This is why it’s very difficult to extrapolate based on the results of just one cycle.  However, patients don't understand that biological systems are messy, that we don't have the same kind of accuracy and precision which we do when dealing with computer programs and bank accounts.

In any case, far more important than asking, "Why did the cycle fail?", a far better quality question is, "What did we learn from this cycle?" And even more importantly, "What can we do differently in the next cycle to maximize our chance of getting pregnant?"

The truth is that if you ask good questions, you're likely to get good answers ! And because IVF technology has improved so  much, even if we can’t always identify problems, we are surprisingly good at finding solutions by bypassing problems in the IVF lab  !

You can download the IVF comic book free at https://www.drmalpani.com/pdf/IVF_COMIC_BOOK.pdf

and this will help you understand more about the IVF process, and why it fails sometimes.

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

IVF success rates, statistics and probability

One of the major problems which plagues IVF treatment is the uncertainty surrounding it , because you can never be sure whether your IVF cycle is going to work or not. This is where the concept of probability is so important.  Patients need to understand what their chance of success are, so they can decide how many times they want to try IVF.

The trouble is that's very hard to apply probability statistics to IVF for two reasons. One is because it's so personal – after all, the success rate is not just a number ! It's something which affects your entire life, which is why  it's very hard to view it objectively in a detached fashion.

The other problem is that the law of small numbers applies. Statistics aren't very reliable when they are applied to small numbers , and this is a big problem with IVF cycles, because it's very hard to draw conclusions based one patient's experience with one or two cycles.

Finally, the fact that there are so many biological variables which affect the results of IVF makes interpreting these numbers extremely hard - not just for patients , but for doctors as well.

This is why both doctor and patient need to sit together , so they can decide what's right for the patient.

You can download the IVF comic book free at https://www.drmalpani.com/pdf/IVF_COMIC_BOOK.pdf

and this will help you make better decisions !

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

Orgasms during an IVF cycle

It's not uncommon for IVF patients to have an orgasm during their IVF cycle ; and during the two-week wait after the embryo transfer. This is often involuntary , and happens during their sleep. They wake up , and many start to panic , because they are worried that the orgasm is going to harm their embryo.  Their fear is that the uterine cramping will cause the uterus to expel the embryo.
This can be quite embarrassing, and they are ashamed to discuss this with their doctor.

The reason for the orgasm is because of the increased blood flow to the clitoris during this time. Your hormonal levels of estradiol and progesterone are very high at this time, and this increases pelvic vascularity . This results in  pelvic congestion and clitoral turgidity , and minor mechanical stimulation could trigger an orgasm.

Please don't panic or worry if this happens. Your embryo is safe in your uterus, just like a pearl in an oyster. It’s not going to get harmed because of the pelvic contractions. Please don’t feel guilty or worried that this has reduced your chances of success.

You can download the IVF comic book free at https://www.drmalpani.com/pdf/IVF_COMIC_BOOK.pdf

so you can stop worrying !

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

The cost of IVF failure

Many patients are understandably worried about the cost of an IVF treatment cycle , because it's so expensive.

However, one of the things you need to factor in is the cost of IVF failure. What does  this mean?

It’s tempting to cut corners and go to the cheapest clinic ; or the one closest to you, even if it doesn’t have much experience or expertise. However, the risk of your IVF cycle failing is much higher in these clinics, and if your IVF cycle fails, you will actually end up spending much more !

Not only will you have wasted your money on your first cycle, you will have to pay more for a second cycle – and you'll have wasted a lot of precious time and energy as well. Even worse, you may abandon the idea of IVF treatment altogether, because your confidence levels - both in yourself as well as in IVF doctors - will go down considerably.

That's why you need to consider the total lifecycle cost of doing IVF treatment - the total cost you will have to pay in order to have a baby. This may require multiple cycles, and you need to factor in the money you spend; your  emotional energy; and the time as well, because the longer you wait to have a baby, the older you're going to be, and the less you're going to be able to enjoy being a parent !

You can download the IVF comic book free at https://www.drmalpani.com/pdf/IVF_COMIC_BOOK.pdf

and this will help you reduce your risk of IVF failure !

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

Why making IVF decisions can be so hard

Sometimes the medical decisions which infertile patients need to make can be very simple , because there really aren't too many options. Thus if your tubes are blocked , your only treatment option is IVF , so your only decision is which IVF clinic to select.

On the other hand, you may find that you have lots of treatment options , and you then need to decide what's right for you. Thus, if you are older, you may be able to get pregnant with your own eggs, but you know that your chances of getting pregnant with donor eggs are much higher .

You are not sure which is the right decision. Should you go for donor eggs, because it has a higher success rate ? Or should you continue trying with your own eggs because you want to transmit your own DNA to your child?

These are not decisions a doctor can make for you - you need to make them for yourself, and they can be very tricky. It can be even harder when both husband and wife are not on the same page , and they disagree with each other . You will have to sit and discuss this thorny issue, until you find a decision which both of you are pleased with.

You need to use your head , but you need to listen to your heart as well, so take your time when making such an important decision !

You can download the IVF comic book free at https://www.drmalpani.com/pdf/IVF_COMIC_BOOK.pdf

and this will help you make better decisions !

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

Why IVF patients need to make their own decisions

One of the hardest things for IVF patients to do is to make decisions. When their IVF cycle fails, they are not sure whether they should use their own eggs; or donor eggs; or donor sperm; or surrogacy. It can be very confusing , and because patients are not medical experts , they want a doctor to make these decisions for them.

However, these decisions shouldn't be made by doctors , because it's such a personal choice , and will affect the rest of the patient's life. Yes, it's very easy for the doctor to tell the patient what to do, but the patient cannot abdicate this responsibility and allow the doctor to make these decisions.

The job of the doctor , as a medical professional, is to make sure that he offers all the choices to the patient , and makes sure that the patient does not make the wrong choice -  a choice based on incomplete or incorrect medical information . However, the truth is that   there are no right or wrong choices – whichever choice the patient makes is the right choice for her. Patients have to decide for themselves, and the job of the doctor is to be supportive and offer non-directive counseling, so they can do what they feel is right for them.

The reality is that it can be very hard to make some of these decisions. Because of the dramatic advances in reproductive medical technology, there is a dazzling variety of choices in front of the patient , and this can be very confusing. Patients are often paralysed because they don’t know how to select the right one. They can use donor eggs, donor sperm, donor embryos , or do surrogacy. There’s a wide choice of mix and match options, and patients are not sure what to do,

They expect the doctor to make this decision for them, because he is the medical expert, but often these are very personal preferences, and the doctor is not a mind reader. That's why it's the patient's responsibility to explore all the options, understand the medical facts , and then apply their own mind and decide , based on their personal preferences , what to do.

You have to use your head and you have to use your heart as well, because you need to live with the consequence of the decision. The reality is that the decision you make is right for you. There is no right or wrong decision. Every decision has pros and cons, you need to weigh this, you need to be systematic about it, and more importantly you need to have peace of mind that you've thought about it and made the decision which both your head and heart said was right for you.

You can download the IVF comic book free at https://www.drmalpani.com/pdf/IVF_COMIC_BOOK.pdf

and this will help you make better decisions !

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