IVF Tales IVF doctors spin - how IVF patients can protect themselves from being taken for a ride

IVF doctors often take their IVF patients for a ride when the IVF cycle fails.

They do this because they're not very medically competent  themselves, but refuse to share the truth about their lack of experience and expertise with the patient . They protect themselves by spinning all kinds of stories and take advantage of the patient's vulnerability and ignorance.

They get away with this because patients don't bother to arm themselves with Information Therapy , and because they continue to trust doctors blindly , they believe everything the doctor says .

The doctor transfers the blame to the patient by cooking up all kinds of fanciful explanations as to why the cycle failed. They cloak this in impenetrable medical jargon, to hide the truth. For example, they claim that the high level sperm DNA fragmentation resulted in poor quality embryos; or that the “uterus was hostile”; or that the patient has “latent genital TB”. 

By blaming the patient for the IVF failure , they make matters even worse for the poor patient. Infertile patients have low self-esteem , and after the IVF failure , their self-esteem becomes even worse. The reality is that the reason the IVF cycle fails is because it was done in a poor quality clinic which couldn't create good quality embryos, ,but doctors refuse to be honest about this, and hide the truth by refusing to share embryo photos with the patient.

They then try to sell even more expensive treatment options, such as donor egg IVF and surrogacy, from which they can earn more money, even though these aren't the right treatment for the patient.

Rather than give up all hope and continue blaming themselves for their bad luck, all IVF patients need to do to get pregnant is to find a doctor who tells them the truth - a better doctor , who is transparent, open, answerable, accountable and respectful, rather than one who continues to lie to them.

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

How IVF patients can protect themselves from bad IVF doctors

 

IVF patients who've done an IVF cycle in other clinics are very reluctant to repeat another IVF cycle. In their mind , all doctors are created equal , so they are naturally skeptical about whether Dr Malpani is really any better than their prior IVF clinic ? Their unasked question is – What makes Malpani Infertility Clinic better than anyone else ?

Their confidence in IVF doctors has been shaken up . As we know, at the first consultation , every IVF doctor is in sell model. The doctor is on their best behavior , and is willing to make lots of tall promises  to lure the patient to sign up, so they can make money from the patient. However, when the cycle fails, they become unapproachable , and patients feel abandoned and cheated. They refuse to trust any other doctor, because they fail to realize that not all doctors are created equal.

One of the biggest reasons for their angst is that they feel the doctor has let them down. They don't share information with them; they don't provide satisfying explanations for why the cycle failed ; and they will offer additional options like using donor eggs or doing surrogacy, which sounds like upselling to the patient. These treatment options are much more expensive , and often not acceptable to the patients . Patients aren't fools. They know that they are being taken for a ride , because they can sense that the doctor is hiding the truth from them, now that the cycle has failed. Even worse, they realise that they were cheated because the doctor did not follow best global practices, and did not provide them with photos of their embryos.

This is why it’s very hard for us to explain to patients why we're better – a burnt child dreads the fire, and they are unwilling to try a new doctor, because they are disenchanted with the medical profession because of their poor experience.

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

 

When infertile couples are too tired to have baby making sex

 

One of the elephants in the room is that many infertile couples in modern metropolises are childless not because they have a medical problem , but because they just don't have the energy to be able to have sex at the right time . They are so busy and stressed out that they don’t have any energy left by the time they come home at night. All they want to do is eat, watch TV and flop into bed and sleep – and then they are forced to start the grind again the next day.

They can’t find either the time, energy or desire to have sex – and the problem is compounded when both partners are working ! The only time they can plan sex is on the weekends – but this is the time they have to do their weekly shores and perform their social obligations. Even worse, the wife’s “fertile time”  won’t always conveniently fall on the weekend either !

Here are four simple solutions you can use to overcome this problem.

1.       Have a quickie in the morning. You often have an early morning erection , and you can shower together , to set the mood . Plus, it’s a great way to stat the day !

2.       Use a lubricant such as liquid paraffin, which is sperm friendly.

3.       Use sexual toys to add spice back in your sex life

4.       Watch films which turn you on to get you in the mood.

Finally, remember that going to a doctor for medical treatment is expensive ! If you can seduce your wife, you'll save a lot of money, so hopefully that will incentivize you !

Making IVF affordable at Malpani IVF clinic through the EMI option

IVF treatment can be expensive and can create a considerable financial burden. This is the reason we have now tied up with CreditFair to offer interest-free EMI options to our patients.

This makes IVF much more affordable for patients who are not able to  pay up a large amount of money upfront , but can do so over a period of 6-9 months. Because your payments are spread out over a period of time , you can do the IVF now, and don't have to waste precious months waiting to be able to afford an IVF cycle . Not only is waiting extremely frustrating , your chances of getting pregnant keep on dropping as you get older. 

When you use the CreditFair EMI option, you don't have to bear any additional interest burden at all - we pay this for you. This means you end up paying exactly the same amount, but over a period of six - nine months, which makes it much more feasible for you to do your IVF treatment now, rather than having to postpone it.

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

What if everything you thought you knew about IVF is wrong ? The truth about IVF

 We're very happy to treat patients who know a lot about IVF, which is why we prescribe so much information therapy on our website . Our videos and IVF comic book are designed to educate and empower patients, so they understand more about IVF.

One of the problems is that when patients who have failed an IVF cycle in another clinic come to us, they often feel that they know a lot about IVF , because they've already done IVF treatment in the past.

The problem is that a lot of the things they think they know about IVF are wrong !

This is because their IVF doctor has never bothered to educate them , or explain the technical and medical details to them. Most doctors do a lot of unnecessary tests , and overtreat patients with unproven experimental approaches. Our approach is very different. It's much more simplified , more down-to-, earth and much more practical. We are frugal, and don't do unnecessary tests. We don't make patients waste money, and try to educate patients so they know exactly what to expect. We explain to them in advance what the right way of doing things is , and we share a written treatment plan well in advance , so there aren’t any surprises .

They are in control because they have been told exactly what's going to happen , and when and why. We also document everything we do , including giving photographs of embryos routinely to all our patients. This way, patients are in control of their cycle, and this gives them considerable peace of mind.

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

How sequential embryo transfers reduce IVF pregnancy rates

 

Many clinics do sequential embryo transfers for their patients , claiming that this helps to increase pregnancy rates. This means they transfer some embryos on day 3 , and then transfer some more embryos on day 5. Patients are happy because they naively believe that the more the embryos which are transferred, the better their chances of getting pregnant. They believe that this option allows them to have their cake and eat it too.

Actually, this technique is the hallmark of a poor quality clinic . The very fact that the clinic needs to do sequential transfers means they're not confident that they can grow embryos to day 5 in their IVF lab, so they are using this strategy to try to hedge their bets.

Also, this option actually reduces pregnancy rates . For one thing, it increases the risk of a multiple pregnancies because you're transferring too many embryos inside the uterus. If both the day 3 and the day 5 embryos implant , you would end up with a multiple pregnancy, which poses a huge risk to the newborn babies , because of the danger of prematurity .

Even worse, because the doctor has used up all your embryos for the fresh transfer, there are no spare embryos left for freezing. This means, if the cycle fails, you have to start a fresh cycle all over again, and this is much more expensive than doing a frozen cycle.

Sequential transfer reduces the overall cumulative conception rate , and the tragedy is that doctors are pushing patients into doing this because they are not confident about their lab.

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

How do I use the Malpani Baby Kit for Self Insemination ?

The Malpani Self Insemination Baby Kit has become very popular, and many couples are using it to treat themselves in the privacy of their bedroom.

 Here are answers to some queries patients have.

1. As per the instruction manual, we need to keep the semen in the container for 15-30 minutes to liquefy. Will that affect the sperm quality or motility in any way.

No

2. After the semen is collected in the container , should we store it a cool place until next 30 minutes or so until we start the procedure.

No. The cold is not good good for sperm. Please keep this at room temp 

3. Can my wife use the pipette to inject the sperm herself ? 

Yes

4. How do we make sure the pipette position is correct as i see its quite flexible and the position of the pipette can go wrong during insertion.

As long as its going in the vagina, that's fine . The sperm will swim and find their way through the cervix to the egg. They are deigned as effective guided missiles !

5. Can we use the pipette without the speculum . 

Yes, you can. The speculum is optional

Need help in getting pregnant ? You can buy the kit online at https://www.drmalpani.com/knowledge-center/resources/tools/self-insemination-kit-india

We take pride in how much our patients know about IVF

 

In our clinic , we take pride in our knowledge of IVF - not just in how much we know about IVF , but in how much our patients know about IVF .

You might wonder why that matters . After all, we are the medical specialists , and we are doing the treatment, so what difference does it make whether a patient understands what's going on or not?

The reason I think this is important is because IVF outcomes are always uncertain and unpredictable , and the pregnancy rate is never going to be a 100%. This is why patients need to understand the processes , so they have peace of mind that they've received high quality medical care.

No matter what the final outcome , they should never feel that they got a raw deal , or received poor quality medical care.

Patients need to take the path of least regret , and the more they know about the medical details of IVF treatment , the better they can ensure that their IVF doctor is doing exactly what’s right for them, by following global good practices , and doing things by the book .

However, if you don’t know what global best practices are, how will you be able to judge the competence, skills and expertise of the IVF doctor.

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

IVF doctors and the games they play with their IVF patients

 

Many patients continue to believe that the best doctors are the ones who do the most tests - and that the more expensive the test , the better the doctor !

They also naively believe that the best doctor is the one who does the most expensive treatments , and charges the most for these. After all, if he charges more , he must be adding some special value . And if other patients are willing to pay the extra he charges, this means that they also think that he is better than all the rest .

Many doctors are quite happy to play this game of one-upmanship. They want to prove that they are better than other doctors , which is why they will order the latest tests ( which are often the most expensive ones) . They do this not because these tests are actually helpful, but in order to show off to patients that they are up to date with the latest technology. They use tests which are supposed to assess the immune response, or to analyse reproductive genetics , and these are peppered with fancy medical jargon, which no one understands, which makes them sound even more impressive !

Sadly, these tests are unproven, and patients don't realize they're being used as guinea pigs . Please remember that just because a test is new and expensive , this doesn't mean that the test is better . However, unless patients arm themselves with reliable information , they will not be able to ask the doctor intelligent questions, or push back when the doctor prescribes exotic and esoteric tests.

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

Painfree IVF - Why IVF at Malpani IVF clinic is painfree

 

One of the major concerns which IVF patients have is that IVF is going to be painful . All of us associate doctors with pain , and while all doctors say they're not going to hurt you , they all end up inflicting pain.

This is especially true for infertile couples – especially those who have had a HSG. They thought it would be a simple X-ray,  and X-rays aren’t associated with pain. However, a HSG can be extremely painful , and patients are completely unprepared for this , because no one has bothered to tell them the truth.

They find it very hard to trust any doctor after this, and it’s hard to overcome this trust deficit.

Similarly, IVF patients who've take Gestone injections after the embryo transfer find these are extremely painful because these are oily . And because patients need to take them daily, they can’t even sit down any more, because their buttocks are so sore.

We promise our patients that we are not unkind or cruel, and we've never given a single Gestone injection to any of our patients in the last 30 years. Yes, we do prescribe progesterone, but we do it in the form of vaginal pessaries, which is much kinder , and much more effective as well.

The only injections we use are water soluble , and patients can self-administer these themselves, which means they are easy to take and pain-free.

This is why we can confidently promise patients that they won't have any pain in our Clinic.

Video on the Testicular Rejuvenation Therapy scam for treating azoospermia due to testicular failure

 

Video on how IVF doctors add to the IVF patient's stress levels

 

How IVF doctors add to the IVF patient's stress levels

A good doctor is supposed to reduce the patient’s stress levels by providing them with reassurance but many IVF doctors end up increasing the patient’s stress . They put all kind of onerous conditions on them - that they need strict bed rest after embryo transfer ; they need to change their diet ; they need to stop going to work . All these prohibitions make a bad situation even worse , because lying in bed all day long makes the back hurt, and they feel powerless and helpless. Also, an idle mind is the Devil's workshop , and they keep on thinking negative thoughts when they are confined to bed. Their mind starts playing games with them , and if they fail to get pregnant , the doctor blame them for the failure by saying that the “embryo fell out” because they didn't take complete bed rest .

This is absolutely false and completely rubbish, but patients are emotionally vulnerable, and will accept everything their doctor tells them because they don’t know any better. Doctors compound the problem by refusing to be open and transparent when the cycle fails .

They transfer the blame to the patient by cooking up all kinds of fanciful explanations as to why the cycle failed, and cloak this in impenetrable medical jargon, to hide the truth. For example, they claim that the sperm count wasn’t good ; or there were many abnormal sperm forms; or the “uterus was hostile”.

By blaming the patient for the IVF failure , they make matters even worse for them. Infertile patients have low self-esteem , and after the IVF failure , their self-esteem becomes even worse. The reality is that the reason the IVF cycle fails is because it was done in a poor quality clinic which couldn't create good quality embryos, ,but doctors refuse to be honest about this, and hide the truth by refusing to share embryo photos with the patient.

 Don’t allow your doctor to take you for a ride. The best way to protect yourself is by investing in information therapy, so you know what is right , and can judge whether what your doctor is saying makes any logical sense or not.

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

 

How to make sense of a medical second opinion from IVF experts

When IVF patients get a second ( and third opinion ) , they are often very confused when the experts offer differing advice . They are not sure whom to trust, and will often go by the pedigree of the expert – his qualifications; whether he is “foreign returned”; or what his reputation is .

This is not a good idea , and it's much more important to follow what your heart tells you . Please learn to respect your own personal preferences , and don’t leave everything upto the expert.

The truth is that every expert will have their own prejudices, based on their personal experience, and not all of them are interested in looking after your best interests.

When you are confused, listen to what your own heart is telling you . You gut feel and intuition are important . When the answers are black or white , it’s easy to choose. However, the fact that they aren’t should actually be reassuring , because this means is that there are no right answers, and that whatever you choose will be right for you.

Don’t follow a path blindly just because some expert has endorsed it ! Rather than worry that you are not following one particular expert’s advise , you should be happy that you are following another expert’s advise ! Medical Science hasn't unable to come to a consensus for many areas, because few things in biology are black or white .

As a patient, take the path of least regret . Insist of dreaming only about happy outcomes , think about what you need to do to avoid bad outcomes, so you minimize your risks.

If you then choose for yourself, you will have peace of mind that you have done your best - and really that’s all anyone can do , because both IVF and life are uncertain and probabilistic.

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

 

Testicular Rejuvenation Therapy for Treating Azoospermia because of testicular failure

The ability of IVF specialists to fool their patients continues to boggle my mind. One of the most frustrating unsolved problems in reproductive medicine is that of primary testicular failure . The man has azoospermia ( zerosperm count) because his testes do not work properly. Spermatogenesis ( sperm production) is impaired, and we do not know why and cannot do anything about this.

There have been many experiments with in vitro spermatogenesis, where researchers have tried to create sperm from sperm precursors (spermatogonia and spermatocytes) in the laboratory , but none of these have worked . These patients are understandably desperate, and there are plenty of quacks, homeopaths and ayurvedic doctors who will offer all kinds of treatments to fix their problem. The sad truth is that none of these work.

Today, IVF specialists have also joined the bandwagon , by offering “ stem cell injections “ into the testes for a colourfully named treatment called “ testicular rejuvenation therapy “. This is a big scam , and is just a way of making money from vulnerable patients .

Sadly, the ICMR , which is meant to regulate IVF clinics and stem cell therapy has chosen to turn a blind eye to this abuse.

These clinics are smart, and because they know that stem cell treatment is regulated, they continue doing it by using clever alternative names such as PRP ( plasma rich in platelets) , which is not regulated .

What they describe in their ads and their official marketing materials is very different from what they sell to emotionally vulnerable patients in their clinic. They also cleverly use "scientific research papers" published in poor quality medical journals ( which they pay to publish) to give them an aura of scientific respectability.

Because patients are desperate, they refuse to listen to the truth , and are happy to clutch at straws . They end up wasting their time and money , andend up poorer and wiser. The problem is that these dodgy clinics damage the reputation of the medical profession by making these tall claims, and increase the trust deficit between doctors and patients.

If you want to ensure you don’t get taken for a ride,please arm yourself with Information Therapy.

Why don't all doctors advice their patients to use the Malpani Self Insemination Baby Kit ?

The Malpani Self Insemination Baby Kit is extremely valuable in helping couples with unexplained infertility and childlessness because of sexual dysfunction to have a baby in the privacy of their bedroom , without having to spend money going to a doctor . Medical care is expensive , stressful and consumes a lot of time .

However, when patients ask their doctor about whether the self insemination kit is helpful or not, they often lie and say that using the self insemination kit is dangerous . They claim that there is a risk of infection , and using the kit can damage the sperm and result in babies with birth defects because it is an “artificial” procedure, and is being done without medical supervision.

It breaks my heart when doctors lie like this to their patients . Self insemination has been proven to be safe and effective , and thousands of babies have been born worldwide with this technique. The kit consists of medical grade equipment, which is sterile and disposable - it's exactly what we use in the IVF lab.

So why do doctor mislead their patients ?

I think this is because their income is threatened . If patients start using the Self Insemination Kit, they will lose the money they would otherwise have been able to change them for doing an artificial insemination , which is often the bread and butter for many gynecologists, and they don’t want this taken away from them.

Doctors need to learn to tell the truth to their patients . Lying is unprofessional and unethical , and while you can fool some of the patients some of the time , you can’t keep on fooling them all the time . I wish they would explain that while self insemination is safe and effective , going to a doctor has the advantage that a lot of the care is provided by the doctor , so that patients don’t have to make decisions for themselves . Some patients want the insemination to be done under medical supervision, and this is a perfectly legitimate reason to go to a doctor, but that doesn’t change the fact .

How to get a 100% pregnancy rate after IVF

The diagnosis of an IVF pregnancy is made by testing for the presence of the pregnancy-specific hormone, HCG ( human chorionic gonadotropin) which is produced only by the placental cells ( trophoblasts) . This is done either by testing the urine at home by doing a home pregnancy test ( HPT) , or by measuring the level of the HCG hormone in the blood . This is how IVF patients find out after an embryo transfer whether they are pregnant or not.

In order to increase their pregnancy rates, the sad truth is that many IVF specialists give their IVF patients HCG injections after embryo transfer , in order to fool them. This is the same injection which is used for triggering ovulation, and brand names  include Ovitrelle When their urine pregnancy test is positive, they are on top of the world, and very grateful to their doctor, because they believe the IVF cycle was successful. However, they are being cheated, but they don’t know this. The doctor continues giving them more HCG injections, to “support” the pregnancy, so their pregnancy test remains positive. However, when they do an ultrasound scan, they don’t find a pregnant,  because they were never pregnant in the first place ! The doctor tells them sorrowfully that even though the IVF cycle was “ successful” ( as proven by the positive pregnancy test), they have unfortunately, miscarried and need to try again ! Patients fall into this trap and keep on getting cheated, cycle after cycle. The doctor then starts advising more expensive options, such as surrogacy or donor egg, so that the pregnancy will continue to grow, and keep on enriching himself at the expense of the patient.

In other clinics, the doctor tells them they had a “chemical pregnancy”, and lures them into doing cycle after cycle in his clinic.

How can you protect yourself from this scam ? Always repeat the HCG blood test after 3 days. If it’s a viable pregnancy ( and not an factitious pregnancy created by the HCG injection), this level will double, and this is reassuring.

This technique is how unscrupulous and unethical IVF doctors get all their patients pregnant, and have a 100% IVF success rate ! The truth is that HCG is used only to trigger ovulation prior to egg collection, and has not role to play after the embryo transfer , and I hope this information helps to protect you from being taken for a ride !

Video on how to get your husband pregnant !

 

How to get your husband pregnant

 No, this is not the latest advance in IVF technology or a miracle of medical science !

The diagnosis of pregnancy is made by testing for the presence of the pregnancy-specific hormone, HCG ( human chorionic gonadotropin) which is produced only by the placental cells ( trophoblasts) . This is done either by testing the urine at home by doing a home pregnancy test ( HPT) , or by measuring the level of the HCG hormone in the blood . This is how IVF patients find out after an embryo transfer whether they are pregnant or not.

 If you want your husband to be diagnosed as being pregnant, all you need to do is to get his urine pregnancy test to come positive . You just need to give him a a HCG injection , and because this HCG in the injection will go through his bloodstream and into his urine , his Urine Pregnancy Test will come back as positive , which means he is pregnant !

 Now I am not suggesting you give your husband a HCG injection , but the sad truth is that many IVF specialists give their IVF patients HCG injections after embryo transfer , in order to fool them . When their urine pregnancy test is positive, they are on top of the world, and very grateful to the doctor, but this is just a way of cheating them. The HCG level drops , because they were never pregnant in the first place, and them the doctor tells them sorrowfully that even though the IVF cycle was “ successful” ( as proven by the positive pregnancy test), they have unfortunately, miscarried and need to try again !

This is how unscrupulous and unethical IVF doctors get all their patients pregnant, and have a 100% IVF success rate ! The truth is that HCG is used only to trigger ovulation prior to egg collection, and has not role to play after the embryo transfer .

 

The teratozoospermia ( abnormal semen form) racket for "diagnosing " male factor infertility

A common racket we are seeing these days is for every semen analysis test to be reported as having teratozoospermia - the technical term for a large number of abnormal sperm forms/ shapes.

The truth is that most lab technicians don't actually know how to check for sperm morphology properly.

I suspect that they don't even bother to do this properly, and just report every semen sample as having a large number of abnormal forms to maximise their work load !

After all, when the report is abnormal, the doctor can triumphantly point out to this abnormality, and claim that this is the reason for your infertility !

The patient is very pleased that the doctor is intelligent, and has been able to diagnose the reason for his infertility ! 

The doctor will now prescribe lots of useless medicines - and some will even advice that the patient undergo ICSI treatment , which is expensive.

While ICSI is the only correct treatment for patients who actually do have teratozoospermia, the problem is that the diagnosis itself is incorrect in the first place !

Before accepting this diagnosis, please go to a reliable lab and insist that they give you a slide of your stained sperm, so you can be sure they have actually checked for sperm morphology properly . This is a time-consuming test, which takes a lot of expertise, and most labs cannot do this properly.

IVF video -busting the myth of bed rest after the embryo transfer

 

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Making sense of early pregnancy scans - part 2

When you can see your baby on the vaginal ultrasound scan, you are going to be very excited because you are one step closer to your dream of having your own baby.
However, the truth is that not every pregnancy results in a baby - and this is as true of IVF pregnancies as bedroom pregnancies. About 15% of all pregnancies will miscarry, and IVF does not reduce the risk of a miscarriage. These are usually first trimester miscarriages. 
Sometimes we can see the baby, but can't see a heartbeat. Please don't panic ! This is quite normal when the scan is done early, because the baby is very small, and it takes time for the heartbeat to appear. Often the doctor will advice you to repeat the scan after 1 week. However, if the baby measures more 5 mm ( this is called the CRL , or the crown-rump length), and we can't see a heart beat, this suggests the baby is dead. This is called an IUFD, or an intrauterine fetal death ( missed abortion). Read more at http://www.drmalpani.com/early_pregnancy_scans_atlas.htm
The commonest reason for this is a genetic abnormality in the fetus, and this is Nature's defense mechanism, to prevent the birth of an abnormal baby. While these defects are often random, they are commoner in older women. This is because the eggs of older women have more genetically abnormalities, because they have "aged" and have genetic defects, which cannot be screened for.
There is no need to do a D&C for this. This can cause Asherman syndrome ( intrauterine adhesions). Read more at www.drmalpani.com/knowledge-center/articles/asherman. Ask them to terminate it medically with mifegest and misoprostol. There's no point in doing a genetic/ chromosomal study of the fetus/ products of conception, because this provides us with no useful clinically actionable information.
Even if you do miscarry, don't get disheartened. The fact you have conceived in the past ( even though you did miscarry) means your chances of having a healthy baby in the future are excellent.
For most IVF patients, the scans will be normal. We do them to reassure you that all is well, so you can relax and start enjoying their pregnancy. Please add your scan images to your embryo photos in your baby album !
Need help in getting pregnant ? Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you !

Your embryo is safe in your uterus - like a pearl in an oyster

 

Even in this day and age , IVF patients still have all kinds of myths and misconceptions about embryo implantation . They worry that drinking tea or wine will damage the embryo; or that strong smells will reduce the chances of their embryo implanting. They want to know what foods they can take in order to increase the chances of embryo implantation , and that “hot” or “ cold “ foods will reduce the chances of pregnancy.  Sadly, a lot of these myths are propagated by clueless aunties; unreliable websites; and even doctors, who advice patients to take “strict bed rest” !

These are all myths. Let’s not forget that embryos implant  routinely in the uterus of fertile women all the time – after all, this is what they were biologically designed to do. When fertile women have sex in their bedroom , they don't know when they ovulated or when the embryo fertilized , and this makes absolutely no difference to their chances of getting pregnant.

Your embryo is not going to “ fall out “ of your uterus if you walk around !

Just because we have done IVF for you doesn't change anything at all as far as implantation occurs . The uterus is designed to allow for embryo implantation , and once your embryo is inside your uterus , it is safe , like a pearl in an oyster . You should stop obsessing about dos and donts  because none of your actions will either increase or the decrease the chances of your getting pregnant .

Please carry on with your life, and don’t make a bad situation worse by unnecessarily adding to your stress levels or by restricting your daily normal activities.

The abnormal sperm morphology racket for over-reporting teratozoospermia

One of the newest rackets we're seeing is that a lot of men are being reported as having male factor infertility due to abnormal sperm morphology - what is technically called teratozoospermia.

The irony is most lab technicians have no idea at all as to how to actually check for sperm morphology. There is a WHO Manual for Semen Analysis, which describes this process in great detail, but the vast majority of Indian labs don’t follow these guidelines, because it is very time-consuming and needs a lot of expertise.

To report sperm morphology properly, the sperm need to be stained , and the shape of each individual sperm ( for at least a total of 100 sperm) tallied. The technicians don’t have the ability to follow this, so they just take shortcuts. The biggest racket is they report the majority of sperm as being abnormally shaped – and label the patient as having teratozoospermia, without providing any details !

This scares the patient, because they start believing this means they will end up with having abnormal babies . Also, doctors now blame this abnormality as being the reason for the infertility, and will misdiagnose them as having Male Factor Infertility because of teratozoospermia. They will either treat them with some medicines ( which don’t help at all, but waste the patient’s time and money), or force them to do ICSI ( especially if it’s an IVF lab). 

This is completely uncalled for , so  please go into the details of the report and insist that you want to see the details of the abnormal sperm report. Just saying that there are 97% abnormal forms is completely unacceptable, and suggests the lab is incompetent and shoddy.

In any case, you should repeat it again from a better lab, which has the required expertise to do a semen analysis properly.

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

Making sense of early IVF pregnancy scans

IVF patients are very excited when their beta HCG is positive - they are finally pregnant, and can now start dreaming of holding their longed-for baby in their hands in a few months. 

However, the truth is that not every pregnancy results in a baby - and this is as true of IVF pregnancies as bedroom pregnancies. About 15% of all pregnancies will miscarry, and IVF does not reduce the risk of a miscarriage.

This is why we do ultrasound scans - to confirm your pregnancy is healthy.  Here is a simple flowchart to help you make sense of how the doctor interprets your pregnancy scan results.

Please note that all early pregnancy scans need to be vaginal ultrasound scans - abdominal scans don't provide enough details to make the right diagnosis. Vaginal scans are safe and will not hurt your pregnancy.

If the scan is done very early, the doctor will not see a pregnancy ( gestational) sac on the scan, because it's either too small, or it's not in the uterus ( if you have an ectopic pregnancy). Scans should only be done after  your HCG level is more than 1000 mIU/ml - doing it before this is pointless, because it's too early to see the sac.

If the doctor can see a pregnancy sac in the uterus, but cannot see an embryo/fetus inside the pregnancy on the scan, this is no reason to panic. Sometimes this is because the sonographer may not be skilled, or the machine may not provide enough  resolution. You should then repeat the scan after a few days - preferably at a more advanced scan center.

If the size of the gestational sac is more than 18 mm, and the doctor can't see a fetal pole, this is bad news and suggests you have an intrauterine fetal death. This is called an anembryonic pregnancy ( missed abortion). Read more at http://www.drmalpani.com/early_pregnancy_scans_atlas.htm

The commonest reason for a miscarriage is a genetic abnormality in the fetus, and this is Nature's defense mechanism, to prevent the birth of an abnormal baby. While these defects are often random, they are commoner in older women. This is because the eggs of older women have more genetically abnormalities, because they have "aged" and have genetic defects, which cannot be screened for.

Do NOT do a D&C for this. This can cause Asherman syndrome ( intrauterine adhesions). Read more at www.drmalpani.com/knowledge-center/articles/asherman. Ask them to terminate it medically with mifegest and misoprostol

Even if you do miscarry, don't get disheartened. The fact you have conceived in the past ( even though you did miscarry) means your chances of having a healthy baby in the future are excellent.

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

Malpani Baby Self Insemination Kits - Video to help infertile couples to treat themselves

 

Why it's easier to treat unexplained infertility rather than to diagnose it. Video on Unexplained Infertility by Dr Malpani

 

The paradox of unexplained infertility - treatment is easier than diagnosis !

Whenever infertile couples go to the doctor, they expect him to make a diagnosis , so he can tell them what the reason for their infertility is. They know that once that's been established, the doctor can treat this and they can have a baby.

The reality is that we can't always find the cause for infertility in some couples. This is true in about 1 in 10 couples, and they are diagnosed as having unexplained infertility . This is really a non-diagnosis, and this frustrates patients. They feel the doctor is useless because he can't even find out what their problem is. Their biggest worry is that we can't find out what the problem is , how will we able to treat it ?

The reality is that the diagnosis of unexplained infertility just means that our technology is not good enough to pinpoint where the problem is. The good news is that our technology is good enough to bypass any problem !  At the end of the day , we shouldn't care about problems – we should only care about solutions ! 

Unexplained infertility simply means that all the basic tests have been done , and everything has been found to be is fine. In fact, you should be happy that everything is normal, so don’t get upset please ! 

Even though we have not been able to find out exactly what the problem is, but we can still increase the chances of your egg and sperm meeting, so we can give you a baby. Treatment options include IUI and IVF , and there's no need to get distressed or upset if you are young, as the success rates for treating unexplained infertility are very high.

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

Queries about using the Malpani Baby Kit for Self Insemination

Patients often have many questions about how to use the Malpani Baby Kit for Self Insemination.

Here are the answers.

" We are planning for baby due to painful sex. We are trying home insemination. Through Youtube , we tried with a syringe last time . What we observed is almost all the liquid injected into vagina was coming out along with the syringe when it is pulled out. While surfing we came across your video and we are planning to buy your DIY kit. Have a few queries could you please provide your inputs.

1. With your kit ,when we insert the speculum ,won't it cause burning or pain inside vagina ? In that case can we use lubricant provided in your kit to apply on speculum or please suggest how to loosen vagina. I don't get lubrication properly.

You don't need to use the speculum if you don't want to. It's easy to insert the soft plastic pasteur pipette deep into your vagina . This will automatically deposit the semen near the cervix.

2. Through the pipette should we drop semen near the cervical opening or should insert pippet slightly to cervix opening.

Near the cervix is fine. Sperm can swim and will find their way to the cervical mucus, so please don't worry about this

3. With my previous experience injecting through a syringe I noticed almost all liquid came out of vagina, what should we do to make semen stay inside vagina.

Lie down with a pillow under your hips for a few minutes after the insemination

Leakage is normal . This happens after sexual intercourse as well, because the vagina is a closed blind tunnel/sheath

4.After sperm ejaculation how long the sperm should be kept outside, I mean should we wait before inserting into vagina after semen collection.

15 min is enough for it to liquefy

5. Is it necessary to get naturally lubricated inside vagina and get orgasm during this process ?

No, there is no relationship between sexual arousal, orgasm and fertility

5. Can the kit be delivered to my hometown which is small taluk in Karnataka.

Yes

You can buy the  Malpani Baby Kit for Self Insemination. online !

The endometrium and infertility - what every infertile couple needs to know about the uterine lining

For an infertile couple, it can be quite scary to go to a doctor , because doctors use a lot of medical jargon .

Many of these are difficult long words, which are hard to pronounce, and which they have never heard before. The problem is compounded by the fact that most doctors never bother to take the time and trouble to explain the meaning of these terms.

One of these foreign words is the endometrium . Yes, this is quite a mouthful, but it’s just the scientific word for the inner lining of the uterus . Endo means inside , and metrium means uterus , so don't get confused .

If you are willing to be patient and do your research for yourself, it's very easy for you to get up to speed , because understanding the problem of infertility and its treatment is not very complicated.

After all, you only need four things to have a baby – normal eggs, uterus , sperm and fallopian tubes.

If there is a problem with the uterus lining or the endometrium, then this is easy to diagnose, using vaginal ultrasound scans.

The endometrium gets shed during the menstrual period as the menstrual flow, and at this time, the lining is thin. The uterine lining grows in response to the estrogen produced by the follicle during the follicular phase. Prior to ovulation, the  endometrium is about 8 mm in size, and trilaminar in texture. This is reassuring, and suggests normal endometrial function.

In case the lining is thin, or distorted on the scans, this suggests there may be a problem with the endometrium , and the doctor can do a hysteroscopy to confirm this. Many of these problems - for example, an endometrial polyp, are easy to fix , provided you don’t allow the doctor to bulldoze you by using a lot of fancy medical terms which are designed to confuse you, rather than enhance your understanding.

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

Tubal (ectopic) pregnancy - so near and yet so far !

Being infertile is bad enough, but one of the biggest tragedies is when you get pregnant, but the pregnancy is not in the uterus , and is lodged in the fallopian tubes. This is called an ectopic or tubal pregnancy. Implantation just a few centimetres from the right place can make such a big difference !

The risk of an ectopic pregnancy is higher in infertile women , because often their tubes are partially damaged ( even though they are open, they may not be functioning properly). Sadly, we can't prevent this.

You can have an ectopic pregnancy even after doing IVF , because even though we're transferring the embryo directly in the uterus, it can travel backwards into the fallopian tubes and get stuck there.

The problem with an ectopic pregnancy is that the fallopian tube is not designed to allow a baby to grow , and if the diagnosis is delayed, the tube can actually rupture, and this can be a life-threatening complication .

This is why it's so important to monitor the early stages of pregnancy in infertile women. You should test for pregnancy as  soon as possible . The doctor will monitor you by checking your blood HCG levels and doing ultrasound scans , so that we can make a diagnosis as early as possible.

The good news is that if this is done in a timely fashion, we can kill the ectopic pregnancy with a simple methotrexate injection, so you don't need a laparoscopy , forget about open surgery. The bottom line is that an ectopic pregnancy is a problem which is easy to treat , if diagnosed in time.

The tragedy occurs when the doctor fails to consider this possibility, which is why patients need to be well-informed, and ask the doctor to rule out an ectopic. This can be tricky, because the symptoms of both an intrauterine pregnancy and an ectopic pregnancy are exactly the same, which is why you need to be proactive, and ask for the blood tests and scans.

Read more at http://www.drmalpani.com/knowledge-center/articles/ectopic

Busting the myths and misconceptions about IVF

How to compare different IVF Clinics and make the right choice ?

IVF clinic in Mumbai - Malpani Infertility Clinic

About genetic testing during pregnancy | Relation of genetics and Infertility

Points to know about birth defects | Do sperm defects cause birth defects?

How to increase your Sperm Count? | Correlation between sperm count and infertility

Frustration of a Failed IVF Cycle | How to manage stress of Failed IVF?

How to be a good IVF patient ?

Sexual dysfunction can cause childlessness | Erectile dysfunction

Day 3 or Day 5 Embryo transfer?

Everything about follicular tracking ultrasound scan | Ovulation tracking

Symptoms after an Embryo Transfer Cycle | Early IVF pregnancy signs and symptoms

Overview of Asthenospermia | Semen Analysis | Male Infertility

What are Pus Cells in Semen Sample ? | Semen analysis | Male infertility

Teratozoospermia - Meaning, Diagnosis and Treatment options | Male infertility

How can you find a trusted IVF Doctor ? | How to select the best IVF clinic ?

One important question to ask your IVF clinic

Assisted Reproductive Technology (ART) Regulation Bill explained by an IVF specialist

Why did my IVF treatment fail ? How can you make it right next time?

Why choose IVF Treatment ? | What are the advantages of IVF Treatment ?

Which is the better option: Artificial Insemination (IUI) or Self Insemination at home ??

Free Second Opinion for all infertile patients | Malpani infertility clinic

Step by step instruction of DIY insemination kit in Hindi

Step by step instruction of DIY self insemination kit | Malpani baby kit

Why I love answering IVF patient's questions

 

One of the commonest complaints which patients have about doctors is that they aren't willing to answer their questions.

For me, it's exactly the opposite , so if you want a doctor who is happy to clear your doubts, please talk to me. I love answering patient’s questions because these keep me on my toes. 

Having to explain to patients means I need to simplify complex medical topics and strip them of jargon, so patients understand what I am saying.
More importantly , these questions help me to empathize with my patient , because I'm not a mind reader , and I don't know what their worries and anxieties are. If they ask questions, I can resolve these, and patients appreciate this reassurance. 

Patients want openness and transparency, and if I can clarify matters for them, they don’t have to spend sleepless nights about a doubt which I could clear up if they'd asked me the question directly. 

Finally, your questions also help me to generate content for my website , because if one patient has a query, it’s quite likely that others will have this too, and if I can answer these online, I can help many of them. 

Remember that the word doctor is derived from the word, “docere”, which means to teach ! And I love prescribing Information Therapy – it’s free, and has no side effects !

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

Why I think aloud when talking to my IVF patients

I often think aloud when formulating the IVF treatment plan in front of my patients. 

Now this might sound surprising, because most patients expect their doctors to be expert oracles who tell them what to do.

I do this deliberately,  because then they can see my thought processes , and on what basis I have made my decisions. 

Medicine is a complex science, and the outcomes of IVF are always unpredictable, 

When they can follow my logic, they know on what basis I have chosen a particular option for them. Making my reasoning open and transparent is helpful, because it allows patients to share in the decision-making process.

They can ask me why I prefer a particular treatment plan, as compared to its alternative. It also encourages them to offer me additional options to consider, so they can provide their own inputs.

Because I'm thinking aloud, I have to be clear and cogent in my logic, because I need to explain this to my patient. This sharpens my thinking, and makes the patient much more involved and engaged in what's happening to them.

It also shows I respect them, and expect them to participate as partners in their treatment.

This strategy helps me to demystify IVF for them, and they can see I am being thoughtful and analytical when formulating a personalized treatment plan for them. 

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