Tuesday, November 17, 2020

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.

Saturday, November 14, 2020

Monday, November 09, 2020

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 !




Friday, November 06, 2020

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


 

Wednesday, October 28, 2020

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 !

Tuesday, October 27, 2020

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 !





Monday, October 26, 2020

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


Saturday, October 24, 2020

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 !





Thursday, October 22, 2020

Pus cells in the semen - and how to make sense of the report

 

One of the common findings in a semen analysis report is the presence of a few pus cells per high power field ( pus cells/ hpf). The technical word for this is called pyospermia or leucocytospermia.
Pus cells are WBCs - white blood cells, and less than 5 pus cells / hpf is considered to be normal, but this finding is often highlighted in red as being abnormal, and this often causes both the doctor as well as the patient to worry.
The WHO Manual states that less than 1 million WBC per ml is normal, but the majority of labs never bother to measure the actual concentration of the WBCs - the technician simply eyeballs the sample and estimate this in terms of rounds cells seen in each visual field when scanning the samples through the microscope.
Patients are worried that these pus cells suggest they are suffering from an occult infection - perhaps a sexually transmitted disease ( STD) which they knew they had acquired in the past, and they are worried that they can transmit this to their wife.
They are also worried that this hidden infection can kill their sperm, or reduce their ability to fertilise the eggs.
Doctors are also happy to "treat" this abnormality by putting the man on antibiotics, because these are so easy to prescribe, and because this seems to be a logical thing to do. They hope these antibiotics will kill the bugs causing the infection, and this will boost the man's fertility.
The reason this is flawed logic is because the "pus cells" seen on a semen analysis report when checked through the microscope are simply round cells, which are misinterpreted as being pus cells .
When examining the semen under the microscope, it's very easy to identify sperm because they have a tail and are moving rapidly. However, seminal fluid also contains many other cells, including the epithelial cells which line the male reproductive tract, as well as sperm precursor cells.
Most laboratory technicians will report every round cell they see as a pus cell or a WBC , but most of these are actually immature sperm precursors, called spermatocytes or spermatogonia , which look exactly the same. However, most labs don't have the special stains needed to identify whether this round cell is a WBC or not , which is why they will report all the round cells as pus cells !
The doctor then promptly prescribes antibiotics, but this is a complete waste, because there was no infection in the first place, and antibiotics will not cause the sperm precursor cells to go away !
Patients end up wasting a lot of time and money on taking antibiotics . Some doctors will also send the semen sample to the microbiology lab to try to culture the microbe causing the purported infection. However, it's surprisingly difficult to culture the semen sample properly, because it's often contaminated with the commensals on the skin of the penis, such as E.coli , which causes further confusion !
The bottom line is if your semen report does show a few pus cells, please don't panic ! Please repeat it again, and ask the lab to do the special stains needed to check if these are actually WBCs.
Otherwise, your wife will keep on getting older and losing her fertility, while you waste time because of a poor quality laboratory, or a poorly informed gynecologist .

Friday, September 25, 2020

Why a Root Cause Analysis is often useless in patients with IVF failure



Many patients who fail an IVF cycle, want the doctor to tell them exactly why the cycle failed. They want the doctor to get at the root cause , and this is completely logical. After all, once the root cause has been identified, the doctor will be able to fix the problem, and the next IVF cycle will succeed.

Sadly, life doesn't work this way, because biological systems are complex, and it's not possible to get a simple answer to what seems to be a very simple question. This is because there are multiple interlocking parts , and it's not possible to tease them out individually to find out why a particular cycle failed.

The reality is we can't even find out why a particular IVF cycle succeeded, but obviously when it succeeds everyone takes that for granted , and no one asks us why the cycle succeeded. But just like we can't answer why a particular embryo implanted successfully, we can't answer why a particular embryo didn’t implant.

Now it's very tempting to do lots of tests to find out what the “ underlying reason “ for the failure is . There are lots of complex expensive tests available, and doctors love doing these ! They include operations such as a hysteroscopy to check the uterine cavity, and an embryo biopsy to do a genetic analysis of the embryo. And these tests seem to make a lot of logical sense as well. After all , if you transfer an embryo into the uterus and it doesn’t implant, clearly this means there’s either a problem with the embryo or with the endometrium , and we just need to run tests to find out what the problem is, so that we can fix it and prevent a failure, the next time around.

Now, just because it sounds logical doesn't mean that it's feasible. The sad truth is that while it's easy to do the tests, interpreting them is extremely hard , simply because there's so much overlap between the results in fertile patients and infertile patients – and even in the same patient from one cycle to another . Most of these tests are unreliable and give inconsistent information, which actually ends up misleading both the doctor and the patient . They then go around chasing red herrings , which don’t help.

A classical example for this is a positive TB PCR test for the endometrium. Now this is positive in lots of fertile women as well , but fortunately they have enough sense not to do the test ! Now , when this test comes back as positive in a patient with a failed IVF cycle the doctor is delighted and says - See, this was the reason the cycle failed ! We have pinpointed the cause of the failure, and once we treat this, your next cycle will succeed. The patient is also pleased that the doctor has been so thorough and careful in identifying the problem and treating it.

 However, the ugly truth is that this abnormality wasn't the reason for the failure at all. It’s just an incidental finding, which doesn't actually affect embryo implantation at all. However, it’s hard to explain the concept of false positives and base rates to patients, because this is a complex and difficult topic, and most doctors don’t understand this themselves.

This is why most doctors will just mindlessly do the tests. They are happy to do these, partly because that's what their patients expect – and partly because it helps them to make even more money, even though they know in their heart of hearts that these tests are quite useless.

Now , every once in a while, the doctor will “ treat “ the abnormal test result and then do an IVF cycle and the patient will get pregnant. And in the doctor's mind - and the patient’s as well - the patient got pregnant because the doctor did the test , made the right diagnosis and corrected the abnormality.

However, this can be extremely misleading, because it's easy to confuse correlation with causation . The truth is that it's quite likely that even if the “ abnormality “ hadn't been treated , the patient would have got pregnant in the next cycle because IVF success is often a matter of randomness . Just being perseverant and patient is often all that it needed – there’s no need to change the treatment protocol if the cycle went well.

After all, human reproduction is not efficient, and even a fertile couple doesn't have a 100% chance of getting pregnant in the bedroom in the first month when they try . This doesn't mean that they change partners or do anything differently in the second month !

Unfortunately, this is not something which patients understand , because they expect instant gratification and 100% success rate when doing IVF .

And sadly, doctors aren’t  willing to share the truth with them , because doctors want to provide answers – after all , this is what patients expect, and they want to be seen as omniscient experts !

So rather than spend a lot of time explaining why we can't find out what the root cause is , and why running more tests is a waste of time and money, doctors are happy to pander to the patient's demand to do the tests.

This just adds to the confusion – after all, the more the tests you do , the higher the probability that some will be abnormal ! This is why these mindless battery of tests are so harmful. They cause the patients to waste a lot of time, money and energy on treating completely irrelevant abnormalities, which are of no clinical importance whatsoever.

The good news is that you don't need to do a root cause analysis because we have so much experience in treating patients who failed IVF cycles in the past. Empirical therapy works extremely well, so that instead of wasting time asking unimportant irrelevant questions which the doctor can't explain, you need to focus on what is in the doctor's control .

Make sure the doctor transfers a top quality blastocyst, and gives you photos of your embryos – this is all what the doctor can control. But do remember that after the doctor has made the embryo and put it back in your uterus, he has no control over whether it's going to implant or not, because embryo implantation is still a blackbox.

Not everything is within our control , and that's something which both doctors and patients need to come to terms with . A little bit of humility and a little bit of patience are invaluable .

Please remember the Serenity Prayer

God grant me the serenity to accept the things I cannot change;
The courage to change the things I can;
And the wisdom to know the difference.

Good doctors don't waste time looking for problems - they look for solutions ! 

Thursday, September 24, 2020

What infertile couples need to do to make the right decisions for themselves



One of the hardest things about infertility treatment is making the right decisions.

Indian patients expect their doctors to make medical decisions for them . After all , doctors are medical experts , and that’s what they charge their professional fees for – to give their opinion. Most patients aren't sure they know enough to be able to make the right decision for themselves, which is why they would much rather outsource it.

Many Indian doctors are happy to be paternalistic and to make these decisions for patients , because they think patients aren’t able to make such complex decisions for themselves.

However, mature doctors understand that human reproduction is a very personal and a private affair, and there is no one single right answer for every couple.

This is why they ask their patients for their inputs . However, patients are often not confident enough to speak up . And sometimes some of them wonder why the doctor is asking them their opinion - after all , isn't the doctor supposed to tell them what to do !

This creates even more tension in the room, leaving both patients and doctors unhappy and dis-satisfied.

 Now, making decisions depends on both finding out the right facts, as well as listening to your feelings. For learning more about infertility and your treatment options, please go to www.drmalpani.com. There’s a wealth of updated, reliable, authentic, trustworthy medical information created by IVF specialists, and written for patients. These facts will also allow you to ask your doctor more intelligent and pointed questions.

 However, as far as listening to your feelings goes, that's something which only you can do for yourself. Yes, this is complex, partly because you've never had to make such difficult decisions in the past, and partly because this is not a decision you can make in isolation . You also need to think about your spouse's opinion, and get buy in from the rest of the family , especially for decisions such as adoption, which you may not have the freedom to make by yourself.

 Having said all this, please remember you're not the first couple in the world who is being confronted with this problem. Other people have dealt with it successfully , and your chances of being able to do so are excellent as well.

Please don't get disheartened ! Finding an empathetic doctor ; talking to friends and family members ; and a therapist or counselor can help you sort out your options , so you make a decision which you're at peace with . Remember you're going to have to live with the consequences of this decision for the rest of your life, so please use your head, your heart, your soul and your guts when deciding.

 There is no wrong decision – you just need to find the one you are comfortable with !

 

Wednesday, September 23, 2020

Cost Effective Baby Making at Home using the Malpani Baby Kit



 The Malpani Baby Making kit is an extremely cost-effective option for couples who can't get pregnant because of sexual dysfunction; because of unexplained infertility; and those who have problems with scheduling intercourse during the fertile time because of their work commitments.
While going to a doctor for treatment is always an option, this can be extremely expensive.
You need to go to the doctor multiple times during one cycle , and the costs add up very quickly. Also, because the success rate is not 100%, you may need to repeat your treatment over many months .
To add insult to injury, not only are doctor’s visits are expensive , so are the ultrasound scans and the actual insemination procedure, because doctors charge a pretty penny for their services.
And let’s not even talk about the embarrassment and dignity of lying on the examination table, with your legs up in the air , with all kinds of strangers coming and going , without a thank you or by your leave ! 
The Malpani Kit costs less than one visit to the doctor , and because you can do three inseminations in one cycle , this allows you to maximize your chances of getting pregnant quickly.

You can buy the Self Insemination Kit online at https://www.drmalpani.com/knowledge-center/resources/tools/self-insemination-kit-india


Sunday, September 20, 2020

Why waste money and time going to a doctor when you can make a baby using the Malpani Baby Kit in your bedroom ?



 Many infertile couples automatically assume that if they can't get pregnant on their own, they're going to require medical attention , and seek out a gynecologist for assistance.
While this is true for many couples, there are also lots of others who can solve the problem for themselves in the bedroom using simple medical tools, especially when the problem is a mechanical one  of their being unable to deposit the semen in the vagina.
Part of the of the problem is most doctors will not explain this simpler option to them , because treating patients is their only source of income, and they can't afford to give away their trade secrets.
This is why the Malpani Baby Making Kit is such a valuable option - especially for couples who can't get pregnant because of sexual dysfunction . 

You don't need to pay the doctor to artificially inseminate you, when you can to the self -insemination for yourself !
The Kit allows them to bypass the problem in the privacy and convenience of their bedroom, which means it’s much less expensive !
Also, they don’t have to undergo the embarrassment and expense of having to go to a doctor to solve such a simple problem . 

Self-help is the best help after all !
Doctor’s visits can be expensive, because you need to go to the clinic many times in one cycle – and you may need to repeat the treatment over many cycles.
 This option of doing the self insemination for yourself can be extremely empowering and very satisfying , because you are now back in control, and don’t have to depend on the doctor to help you to make a baby !

You can buy the Malpani Baby Making Kit online - for less than the cost of a medical consultation with a specialist. And since it's been designed by IVF specialists with over 50 years of experience, we can assure you it's safe and effective.


Why Baby Making Kits are so cost effective !



 While it's reassuring to remember that in case your infertility is due to a medical problem, you can always go to a doctor to seek medical help , the fact still remains that going to a doctor is an expensive exercise.
You need to pay the consultation fees; you need to pay for the medicines; you need to pay for the scans and the treatment; and you need to take time away from work and make excuses for being absent.
Also, doctor’s clinics can be scary and intimidating. They poke and prod you; force you to assume highly undignified positions;
 disregard your privacy; and every time you go, there is a new stranger who asks you personal questions, which you are fed up of answering. All this can be embarrassing and discomfiting as well.
This is why seeking medical attention is not something which any sensible patient looks forward to . This is especially true when you have a problem of sexual dysfunction – one which you can fix for yourself , and don't necessarily require all the bells and whistles which doctors provide .
Sadly, doctors will not explain this self-help option to you, because doing an insemination helps them do earn their living, which is why they will not provide you with information about simpler , less expensive alternatives, which you can do for yourself .
This is why the Malpani Baby Kit is so valuable for patients who want to try getting pregnant for themselves, without having to suffer the indignities of repeated medical visits.

Saturday, September 19, 2020

How impotent man can have a baby in their bedroom using the Malpani Baby Kit



One of the problems of being infertile because of erectile dysfunction ( impotence) is that these men can’t stop thinking of themselves as failures . They can't even do such a simple thing like making a baby in their bedroom - something which millions of men have been doing since time immemorial !

The problem is compounded by the fact that their wife will often blame herself. She will feel that her husband does not find her sexually attractive, which is why he is not able to get an erection when have sex with her.

This can be hard to come to terms with - specially for many young successful professional men who are so used to getting everything they want in life. They are smart; they do well in exams; they get the job which they want ; and marry the wife they want to. Then when they find that they can't get their wife pregnant because they aren't able to have sex with her, their self-esteem takes a big toss , and they start wondering whether they are good for anything at all. 

This actually makes a bad problem worse, and becomes a self-fulfilling negative vicious cycle. Since the commonest reason for the situational erectile dysfunction is psychological, this gets worse over time. 

It's the elephant in the room, which neither partner is willing to bring up, because it's such a touchy and sensitive issue.

This can create an existential crisis, because this is the first  time in their life they are being forced to come to terms with their own biological frailty – that not everything is in their control.

One option is to seek medical assistance, but this is expensive and time consuming - and extremely embarrassing as well !

The good news is that the Malpani Baby Making Kit now gives them back control, so they can resolve this problem for themselves, in the privacy and comfort of their own bedroom

Taking back control ! Self Insemination Baby Making Kits for women with vaginismus



One of the problems of being infertile because of vaginismus is that women can’t stop thinking of themselves as failures . They can't even do such a simple thing like making a baby in their bedroom - something which millions of women have been doing since time immemorial !

This can be hard to come to terms with - specially for many young successful professional career women who are so used to getting everything they want in life. They are smart; they do well in exams; they get the job which they want ; and marry the husband they want to. Then when they find that they can't get a baby, their self-esteem takes a big toss , and they start wondering whether they are good for anything at all. 

This can create an existential crisis, because this is the first  time in their life they are being forced to come to terms with their own biological frailty – that not everything is in their control.

The good news is that the Malpani Baby Making Kit now gives them back control, so they can resolve this problem for themselves, in the privacy and comfort of their own bedroom

Free Highly Accurate Medically Tested Fertility Calculator

 


When you are using the Malpani Baby Kit for doing your self-insemination, it's very helpful to know what your peak fertile days are , so you can do the inseminations on those days to maximise your chances of getting pregnant quickly.You can use the Free Malpani Clinic Online Fertility Calculator to determine your peak fertility dates.

  • You can choose to get the fertile days for the next 3 months to over the next 1 year.

  • Once you have the dates, you can set up FREE EMAIL REMINDERS

  • The Calculator calculates your most fertile days based on the fact that:
    1. Ovulation occurs 14 days before the next menstrual period is due.
    2. Fertility peaks on the day of ovulation and for 4 days prior to this.
These are the days you should do your insemination
Please share these with your husband, so you are both prepared - physically and mentally as well. 

 We can do this automatically for you at https://myfertiletime.in/fertility_calculator.php


Friday, September 18, 2020

Malpani Clinic's Free Automatic Fertility Calculator !



  • Use the Malpani Clinic Online Fertility Calculator to determine your peak fertility dates.

  • You can choose to get the fertile days for the next 3 months to over the next 1 year.

  • This is helpful for couples who want to time "baby-making sex".

  • Once you have the dates, you can set up FREE EMAIL REMINDERS

  • The Calculator calculates your most fertile days based on the fact that:
    1. Ovulation occurs 14 days before the next menstrual period is due.
    2. Fertility peaks on the day of ovulation and for 4 days prior to this.

 We can do this automatically for you at https://myfertiletime.in/fertility_calculator.php

Why you don’t always need to go to a doctor to make a baby



Most couples can happily make babies in their bedroom. While this is true for about ninety percent of the couples who are fertile, unfortunately, there will be a minority who are not able to get pregnant on their own.
For example, they could have sexual dysfunction such as vaginismus or erectile dysfunction , and this can be frustrating , because they know that this is a simple hurdle to solve , but don't know what to do about it .
It can be quite embarrassing , frustrating and expensive to go to a doctor to fix this issue. It would be so much easier, kinder and better if you can do this in the privacy of your own bedroom !
The good news is we now provide you with the Malpani Baby insemination kit so you can solve your problem for yourself.
Think of it as being able to perform Baby-Making Sex , without the inconvenience and expense of having to go to a doctor ! This can be empowering because you can now take control, and are no longer dependent on the doctor.

We look forward to helping you to have a baby !

Thursday, September 17, 2020

The Malpani Baby Making Kit is designed by IVF specialists to help you to have a baby !

 


The reason the Malpani Baby Self Insemination Kit is very thoughtfully designed is because it consists of exactly the same medical grade equipment we use in our IVF laboratory when we do IVF .

This is what makes the Malpani Baby Kit so special – and this is why it’s such great value for money.

Some users get intimidated when using it for the first time, because everything seems so strange and new , but the reality is that it’s surprisingly easy to use.

The instructions we provide are comprehensive, and our kit is packed with thoughtful products to make your life easier, such as individually packed sperm friendly lubricants in test tubes, in case you have difficulty producing a sample on demand .

Our sterile jars for semen collection have a very wide mouth , which means it's much easier for you to be able to collect a semen sample , without any spillage, rather than trying to collect your precious sperm in a narrow glass bottle, which most probably is dirty , and will kill all the sperms.

You can buy the kit online at https://www.drmalpani.com/knowledge-center/resources/tools/self-insemination-kit-india

We look forward to helping you to have a baby !

Why the Malpani Baby Insemination Kit is such great value



I was very interested to see the Mosie Baby website and the Mosie Baby Self Insemination Kit they sell. This contains two self insemination syringes , and a single semen collection cup , so couples can do a self insemination for themselves as home. They designed this based on their personal experience with having a baby, and wanted to help other infertile couples based on what they had learnt.

What I find interesting is we been selling a similar self insemination  kit for much longer ! However, we never branded it or marketed it so cleverly, and we need to fix this problem !

Ours is far better , because we provide three sterile disposable broad mouthed medical grade containers for semen collection – exactly the ones we use in the IVF lab. It is far safer and better to use a new container for every semen sample, rather than try to reuse a container by washing it. Water is sperm-unfriendly, and soap / detergent kills sperm.

 Also, our product is far better designed, because instead of using syringes for doing the insemination ( not something which syringes were designed to do, which is why when a doctor does an insemination, they use a plastic sterile disposable catheter with it), we provide sterile disposable medical grade Pasteur Pipettes. These are much easier to use, and are specifically designed to handle semen samples . This is exactly the same product our embryologist uses in the IVF lab when handling your semen.

Also, because we provide 3 Pasteur Pipettes in each kit, you can do more inseminations in a single cycle , and this increases your chances of getting pregnant . Also, we are much less expensive – our cost is about one third the cost  of the Mosie Baby Kit !


Wednesday, September 16, 2020

Having a baby at home using the Malpani Baby Self Insemination Kit

 


One of my patients directed me to the Mosie Baby Kit on the Mosie Baby website, and I was very impressed.  This is a kit which has been designed by an infertile couple, so they could do a self insemination for themselves , and it’s far better than using a turkey baster, but I think it's extremely expensive. At about 89 US dollars for a single kit ( which allows for only two inseminations in one cycle, it’s not something which Indian couples will be able to afford.

Our kit is much less expensive - and allows for 3 inseminations per cycle !

Also, while they provide specially designed syringes for handling the semen, and these are definitely better than the regular syringes which you can buy in the pharmacy , these are still inferior to the sterile plastic medical-grade sperm-friendly Pasteur pipettes which we provide in our Malpani Baby Self-Insemination Kit.

And while they claim their kit is good because it is designed by an infertile  couple , please remember that ours has been designed by IVF specialists with over 30 years of experience, who have helped thousands of couples to get pregnant !

We look forward to helping you to have a baby !

Tuesday, September 15, 2020

Preimplantation Genetic Screening / Diagnosis | PGD | PGD (in Hindi)

A guide for Male fertility treatment | Male infertility explained in the best way

0:07 / 8:12 Miscarriages after IVF - Why do they occur and how to prevent them ?

Mosie Baby Kit vs Malpani Baby Kit for Home Insemination



 I was very happy to see the Mosie Baby website , where they sell the Mosie Baby Kit for doing a self insemination at home. The reason I liked it is because it's been thoughtfully designed by an infertile couple , who have used it for themselves .
It’s packed with a lot of information , which will be very useful for patients who are doing home inseminations to have a baby.
We have been selling a Home Insemination DIY Kit for many years, and are now going to re-name our boringly named Self-Insemination Kit ( what else did you expect a doctor to call this ?) as the Malpani Baby Kit.
The good news is our kit offers much better value for money !
Not only is it much less expensive than the Mosie Baby Kit, it is better designed , because instead of using a syringe for doing the insemination , we use the exact same sterile disposable non-toxic plastic pipettes which we use in the IVF lab for handling sperm samples.
These are medical grade products, and by using these , your chances of getting pregnant at home increase considerably !
We look forward to helping you to have a baby !

Get A Free IVF Second Opinion

Dr Malpani would be happy to provide a second opinion on your problem.

Consult Now!