Friday, June 26, 2020

Want to start your IVF treatment now ? Please contact us !

Are you frustrated that your IVF clinic has still not resumed doing IVF cycles ? That they are refusing to treat patients because of this Coronavirus epidemic ?

We have good news for you !

Because we are an Boutique IVF clinic which does only IVF treatment, we have started treating patients and can offer you safe and effective treatment. You don't have to worry about getting infected because we do only IVF treatment, and don’t treat any patients who have the Coronavirus.

This allows us to safeguard you – and us as well !

Instead of wasting precious time waiting for this Coronavirus to end – and God only knows when this will happen, please feel free to contact us , and we'll be happy to start your IVF cycle as quickly as you want to get started !

The good news is you get highly personalized attention at our clinic, and we are proud of the fact that the quality of medical care we provide is as good as any IVF clinic anywhere in the world !

Please feel free to reach out for us for a free email consultation. Email me your rec

Please email me your medical records at so I can analyse these and provide you with the best medical advice !

This is my personal email id and all information is confidential. 

You can also call the clinic at 9867441589 . This is our whatsapp number !

How much will a second IVF cycle cost ?

Patients are getting better informed about IVF, and they realise that IVF doesn't have a hundred percent success rate. They know that they need to go through 2-3 cycles before they succeed, and because IVF is so expensive, they're very worried about how much the second and the third cycle will cost.

It’s important to ask these questions upfront , because many doctors will give discounts for the second and third cycle.

Some will offer packages for three cycles, and give a reduced rate for the subsequent cycles.

We offer a shared risk program, which means if you don't get pregnant in 4 cycles , we return all your money back to you.

Also, do remember that second cycles are usually much less expensive because we often  have been able to freeze embryos for you in your first cycle , and transferring frozen embryos after thawing them is much less expensive and much easier , you don't need to take any injections at all for superovulation.

 What to find an IVF clinic which respects your time and intelligence ?

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Wednesday, June 24, 2020

IVF patients and doctor shopping

Many IVF patients doctor-shop, but you need to understand the difference between cost , price and value so you can do this intelligently.

IVF patients are often very confused about the costs of an IVF cycle. Obviously , they want to save money , and they read all these full page ads, which talk about how an IVF cycle costs only Rs 25000 ! They are happy to sign up , because that's an amount they can afford.

However, they actually start the treatment, they end up spending more like Rs 200000, because the doctors keep on upselling them !

Sadly, IVF clinics aren't usually honest or transparent about the charges. They advertise a particular cost, but the final price which the patient ends up paying is a lot more , because there are all kinds of add- ons.  This is why patients often get sticker-shock when they need to pay the bill . The “take-home baby price” is far more than they had budgeted for !

IVF clinics know that after the patient has started the cycle, they are stuck and cannot back out. Doctors keep upselling and adding lots of new procedures. They convince the patient to buy this by claiming that these will improve their chances of success. This means patients end up forking out much more than they expected !

To add insult to injury, they don't get value for what they're spending ! These clinics don’t bother to even provide photos of the embryos to their patients, which is why the pregnancy rates in these clinics is exceptionally low. This means the cost of a baby is much higher for the poor patient, who ends up paying through her nose – a little at a time !

What to find an IVF clinic which respects your time and intelligence ?

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Tuesday, June 23, 2020

Price vs Value for IVF patients

Most IVF patients want the cheapest possible IVF treatment.

They naively assume that all IVF doctors are equally good, and that success rates are high in all IVF clinics. They are basically looking for a bargain, which is why they go doctor-shopping , and hunt for the cheapest IVF clinic.

Doctors are smart, and many  IVF clinics take advantage of this bargain hunting mentality of ignorant patients, who can’t look beyond the price.

They buy full page ads, and sponsored slots on TV talk shows. Their focus is on highlighting how affordable and cheap they are. They also offer all kinds of bargains and discounts to pure patient in, because they know that once the patient has started a treatment cycle, they cannot back out and are trapped.

Please remember that someone needs to pay for these expensive ads – and you are the sucker !

These ads are very misleading , because they lure patients in by quoting a low sticker price , and then add all kinds of add-ons once the treatment has started.

Smart patients don’t focus on only the price, but try to assess the value the clinic offers. This depends on the success rate of the clinic and how well they will take care of you, so please don't get fooled !

What to find an IVF clinic which respects your time and intelligence ?

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Thursday, June 18, 2020

Why do some doctors insist on doing a laparoscopy and hysteroscopy before an IVF treatment ?

Many IVF patients are advised to do a hysteroscopy and/or a laparoscopy before starting IVF treatment.

Now, this makes a lot of sense for the doctor because they can charge for every surgical procedure - and the more the procedures they do, the more the money they make. But the reality is that most of these operations are completely uncalled for, and they need to be used very selectively. Thus, it may make sense to do a hysteroscopy in case the ultrasound shows that you have a polyp, but if your vaginal ultrasound scan shows your endometrium is normal, then there's no justification to subjecting you to this surgery.

Yes, the doctor will claim it's a "minor procedure", but for a patient, every procedure is major. And remember that nothing in life is risk-free !

And definitely don't do let the doctor do a laparoscopy , because there's nothing in a laparoscopy which will change the IVF treatment plan. Yes, some doctors will clip a large hydrosalpinx if you have this, but again, this should not be done on a routine basis. And if your doctor insists that you have this surgery done before doing IVF for you, this is a red flag and you should find a better doctor.

What to find an IVF clinic which respects your time and intelligence ?

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Wednesday, June 17, 2020

How IVF doctors buy fame !

Patients are often not sure which IVF clinic to choose.

This is an expensive decision, and they know a lot depends on it.

Most of them naively assume that all IVF clinics are equally good. This is why they will select one using the following criteria:

  1. the nearest one;
  2. the cheapest one;
  3. the one their GP refers them to;
  4. the one their friend has told them about;
  5. the one which advertises;
  6. the one which offers free medical camps for infertile couples
Many select a clinic based on its brand name – what they think of as a famous and renowned clinic.

Sadly, the truth is a lot of these clinics purchase their renown – they don’t earn it because of their professional expertise !

They do this either by buying advertisements; or buying editorial space in newspapers, by hiring a PR agency, which ensures that their press releases are published in the media.

Today, unfortunately, everything in India - especially the media and the news - whether it's a TV channel or a newspaper - is up for sale.

This means that IVF clinics whose only focus is on making money will actually spend a lot of money on these activities, because it helps them to attract more patients.

The ethical doctors who take pride in their professional skills refuse to stoop to these low levels, which means they depend purely on their patient’s goodwill and word of mouth to attract more patients. This is a much slower process !

Corporate IVF clinics hire full time PR agents to make sure that their doctors keep on appearing on TV channels as well as newspapers. And the poor patients get fooled ! They are featured not because they’re good but  because they're paying for being featured !

What to find an IVF clinic which respects your time and intelligence ?

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Sunday, June 14, 2020

How Work from home will help make IVF treatment easier for infertile women

One of the impacts of the Coronavirus epidemic has been the reality that most people don't need to go to work daily ! Many executives can work effectively from home.

This is great news for women who want to plan their families, and not sacrifice having a baby at the altar of their career.

One of the problems with working in a high pressure corporate job was that when you wanted to have a baby and needed to take IVF treatment, it was very hard to take leave.

You had to get all kinds of permissions, and you had to explain to your boss why you were going to be absent.

Many managers were very reluctant to give this permission , because they felt that it would detract from your work, and affect their productivity.

Also, many women were reluctant to ask. They wanted to keep their infertility issue private and confidential, and weren’t comfortable sharing this with HR !

Also, they were worried that this absence would affect their chances of getting promoted, which is why they had to choose between  either sacrificing their career, or putting their baby-making plans on hold – at the cost of their fertility .

However, now that working from home is going to become mainstream, a lot of women can have their cake and eat it too !

They can plan their life the way they want to - and this flexibility is very helpful, because biology is no longer the sole determinant of your fertility !

What to find an IVF clinic which respects your time and intelligence ?

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Saturday, June 13, 2020

How IVF patients can keep themselves safe from COVID-19

 Now that the lockdown is gradually being lifted up and IVF clinics are starting to offer treatment, a lot of IVF patients are wondering whether it's safe for them to go for IVF treatment.

There are two things you need to keep in mind.

One is that your risk of getting a coronavirus infection is extremely low because you're young, healthy, and asymptomatic, so please don't get paranoid !

Just take sensible precautions when you're traveling and you'll be absolutely fine.

I think it's also important that you choose the right IVF clinic !

Remember that standalone IVF clinics which only treat IVF patients are much safer for you, as compared to IVF clinics which are part of a large hospital which also treat COVID patients because your risk of getting infected inadvertently - either from the patients or from the staff - is that much higher.

We look forward to helping you to have a baby !

What to find an IVF clinic which respects your safety ?

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Friday, June 12, 2020

IVF patients and the Lockdown

The lockdown has been an extremely difficult time for all of us - especially for infertile couples who were all set to start their IVF treatment cycle.

Yes, IVF treatment is elective, but when you want to start, you want to do it immediately , because you want your baby as quickly as possible !

Maybe you've spent years thinking about your decision, convincing your family members, raising the money , and taking leave from work in order to do it.

Then , when you were finally ready to start, the government ordered a lockdown, and all your plans were crushed !

Each day during the Lockdown seemed like a week, because you know that your biological clock is ticking on, and unfortunately you couldn’t do anything about it , because IVF doctors were forced to stop IVF cycles, because of the crisis.

This period has been extremely difficult for IVF patients, and this is why we are very pleased that the Lockdown has ended. We understand that you are very keen to start your IVF cycles, and we look forward to treating you !

We have resumed our clinic, so please contact us and take an appointment !

We look forward to helping you to have a baby !

What to find an IVF clinic which respects your time and intelligence ?

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Thursday, June 11, 2020

IVF patients, the Lockdown and patience

The one thing IVF patients learn is patience !

No matter what you do, you seem to have to keep on waiting !

You have to wait for your cycle to start.

You have to wait till you find the right doctor.

You have to find a clinic which offer s a high success rate.

You have to plan your finances.

You have to convince your family members.

You have to take leave from work.

Because there are so many balls you need to juggle, you need a lot of patience !

And even when you do start the treatment, you need patience because you don't know whether the cycle is going to work or not.

And even  if the cycle works and you get pregnant, you still need patience because it's still another nine months to go before you actually have a baby.

This is why IVF patients, because they're so fed up of being patient, start becoming extremely impatient, !

This is especially true during the lockdown , which has forced them to wait , because of something which is outside their control. They had plans to start IVF, and they weren't able to execute them – and this can cause major heartburn !

The good news is that we have resumed our clinic and have started treating IVF patients !

We look forward to helping you to have a baby !

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Wednesday, June 10, 2020

Good news for IVF patients !

The lockdown was hard for all of us - specially for IVF patients !

In some clinics, many patients were forced to abandon their expensive treatment cycles half-way , while many others who were planning to start their treatment cycles in April and May found they weren’t able to do so.

They couldn’t travel, and IVF clinics were forced to shut down , because the government wasn't allowing elective medical treatment.

The good news is that we have resumed IVF treatments !

We have started treating patients and will be happy to treat  you, so there's no need to keep on waiting unnecessarily.

IVF patients are young , and you are at very low risk for getting infected with coronavirus. This is especially true in stand-alone IVF clinics like ours, which only treat IVF patients ! The risk will be higher in IVF clinics which are a part of COVID=19 hospitals, where you risk of getting infected inadvertently are higher.

So please don't get scared , and don't be fearful – your chances of getting coronavirus infection by coing to us are virtually zero.

Just use common sense precautions when travelling , and you'll be absolutely fine.

We are happy to continue to offer free email consultations, and a detailed customized treatment plan , so you know exactly how to proceed !

We look forward to helping you to have a baby - the wait is finally over !

What to find an IVF clinic which keeps you safe ?

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Thursday, May 28, 2020

Why immune testing for patients with repeated IVF failures and repeated miscarriages is a waste of time and money

Patients who have failed repeated IVF cycles even though apparently perfect embryos were transferred, are understandably upset, frustrated and distressed. They are looking for answers as to why they are not getting pregnant, and a plausible reason is that their body is "rejecting" their embryos.

 This is why immune testing for patients with reproductive failure has become very fashionable recently. There is a long list of expensive tests which many labs now perform - and these include: DQ Alpha, Leukocyte Antibody Detection, Reproductive Immunophenotype, ANA (Antinuclear Antibody), Anti-DNA/Histone Antibodies, APA (Antiphospholipid Antibodies), Natural Killer ( NK) Cell Assay and TJ6 Protein. 

This mind -boggling range of catchy acronyms conceals the fact that no one knows whether the immune system is really responsible for the failure of the embryos to implant in these women. Many labs use different protocols to carry out these tests, which are still poorly standardized. This means that results for the same test from different labs vary widely, making interpretation very difficult. 

Also, intelligently interpreting these tests in individual patients is virtually impossible, because of the considerable overlap in the results in normal fertile women and those who are infertile, since many fertile women will also have abnormal results when subjected to these tests. Sadly, most labs do not bother to standardize their test results by doing them on normal fertile women. This means that if a woman who has had an IVF failure is subjected to these tests and has an abnormal result, her doctor happily jumps to the erroneous conclusion that he has now "diagnosed " the reason for the IVF failure, little realizing that the abnormal result could just be a "red herring", since "abnormal " results are often found in "normal " fertile women as well. (These are called " false positives " - test results which are abnormal ('positive'), even though the patient has no disease.)

 A false positive result causes needless anxiety, and will often lead to a situation in which the patient will have to undergo even more tests to prove or disprove the previous results. Remember that if your doctor performs enough tests on you, it is a mathematical certainty that he will find something wrong with you. And if he finds something wrong with you, he'll usually end up treating you - whether you need treatment or not !

Tuesday, May 19, 2020

The two major problems with TESA - testicular sperm aspiration

TESA is a simple technique by which doctors can extract sperm from the testes. It’s partly because it's so simple, that it's often been abused, misused and overused.
Thus, many doctors will do TESA unnecessarily , and extract sperm directly from the testes, even in men who have sperm in the semen sample. Not only is this cruel, it also adds needlessly to their expense – without improving the pregnancy rate ! They use all kinds of pretext to justify this TESE ( for example, by claiming that the sperm will be “fresher” or will have lesser DNA fragmentation, but this is rubbish !). The reality is they do this only so they can charge more money, but this is completely uncalled for ! TESA should only be used for patients with azoospermia. 

Secondly, a lot of doctors don't do the TESA properly , because they don't know how to do the procedure properly. Many urologists will still do an open biopsy, which is painful and unkind. Gynecologists don’t have the necessary expertise, and will often make only half-hearted attempts to suck out sperm from the testes. They end up doing only a fine needle aspiration, and then because they haven’t sampled the tissue properly, it’s misreported as "no sperms are found". This can be misleading, because you actually need to take multiple samples properly and suck out testicular tissue in order to examine the entire testes. If this is not done properly, patients can be misled and made to use donor sperm, and this can be unfortunate. 

What to find an IVF clinic which respects your time and intelligence ?
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Saturday, April 18, 2020

Why cheap IVF clinics are more likely to cheat you !

There seems to be a spurt of IVF clinics all over the country, and, you will often find one at every corner. Many doctors believe that IVF is a very profitable line of business and they want to join the bandwagon to make money. 
Unfortunately, patients aren’t able to differentiate between good clinics and bad clinics. 
They think of IVF as being a commodity service , and naively believe that all clinics are equally good. 
Patients look for convenience, which means they want clinics which are close to where they live as well, and they prefer cheaper ones as well.
What they forget that these are often the clinics which are much more likely to cheat them , because they are more focused on increasing volume and profits , rather than providing high quality medical care. 
Until patients learn to ask the right questions, the number of patients who are going to get cheated will keep on increasing progressively !

What to find an IVF clinic which respects your time and intelligence ?

Friday, March 06, 2020

Head versus heart in IVF

Many educated patients find it very hard to deal with IVF failure, especially when the cycle was perfect, and the doctor transferred a top quality blastocyst into the uterine cavity when the endometrium was receptive.
After all, the doctor did everything possible, and the blastocyst looked perfect, the endometrium was 8 mm and trilaminar, the transfer went smoothly and the doctor was really optimistic !
So then why did the cycle fail ?
The reality is they understand that medical science doesn't have the answers to all their questions, but they find it very hard to accept this.
Because they are educated , they expect that medical science will have all the answers.
However ,  we need to accept the limitations of medical technology . After  all, when we put an embryo back in the uterus, we can't monitor or track or control what is happening to it. This is a microscopic ball of living cells, and implantation is a biological process which is notoriously inefficient !
The problem is these patients are emotionally very vulnerable , and don't want to accept the truth that not everything is in our control !
They want answers, which is why sometimes doctors end up manufacturing them , just to keep them happy, by running additional expensive genetic tests and offering experimental expensive unproven treatment. Sadly, this doesn't help them reach their goal at all, and just ends up making them waste money !

What to find an IVF clinic which respects your time and intelligence ?

Do’s and don'ts after the embryo transfer.

Lots of patients are very worried that they will do something stupid after the transfer, which will reduce the chances of their embryo implanting, and cause their IVF cycle to fail.
These anxieties usually falls into the category of foods which they eat; (hot foods or cold foods); or physical activity. For example, they are scared that lifting weights , or the bumpy ride on Indian roads may dislodge the embryo.
This is why many doctors are happy to give them a long list of do’s and don'ts. Mother-in-laws and mothers and aunts will also chime in, with many old wives' tales. And friends who are pregnant will be happy to add their 2 cents !
The truth is that the natural place for an embryo is the uterus – it’s its natural sanctuary ! An embryo in a uterus is like a pearl in an oyster – it’s safe and secure and nothing you can do can dislodge it, so you really don't need to worry.
Remember that an IVF pregnancy is exactly like a natural pregnancy – the only difference is that you happen to know there is an embryo in your uterus ( which fertile women who are having baby making sex don’t !)
Whether the embryo spends five days in the test tube in the IVF lab, five days in your fallopian tube inside the body doesn't matter – once it reaches the uterus, it’s safe.
Of course, whether it will implant or not is not something we can control – that’s still a biological process we cannot influence as yet !

What to find an IVF clinic which respects your time and intelligence ?
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Wednesday, February 26, 2020

What should a patient do when IVF doctors disagree ?

Infertile couples are often very confused when they go to IVF doctors , because they get widely varying different opinions , and they're not sure whom they can trust.

There are many reasons why IVF doctors don’t agree with each other.

For one thing, our IVF technology is still not perfect, which means we still cannot even make an accurate diagnosis, and have to label many couples as having “unexplained infertility” because we cannot clearly and accurately identify the underlying problem.

Because no one really knows what the truth is, everyone interprets tests the way they want, based on their experience and preconceived notions, and there’s no right answer !

The second big problem is that there are two important variables which influence the diagnosis and treatment of infertility. One is called the “ trying time” -  how long an infertile couple has been trying to get pregnant; and the second is the fact that the”  natural history “ of untreated infertility is unpredictable.

Thus, even infertile couples who haven't been able to get pregnant for five years, could still perhaps get pregnant on their own, if they continue trying.

This is why the individual doctor's personal preferences are going to influence what the doctor advises the patient, because they are so swayed by their personal experiences and anecdotal success stories.

Thus, some doctors are aggressive , and will advise IVF for everyone, whereas others are much more conservative , and will want to explore simpler options first, before advising IVF.

Patients need to recognize this subjectivity, and find a doctor whose preference and philosophy matches theirs !

What to find an IVF clinic which respects your time and intelligence ?
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Tuesday, February 25, 2020

Please don't abandon your embryos !

As IVF technology gets progressively better, we're able to grow more eggs and create more top quality embryos. Now we can't transfer all the embryos at a time, because of the risk of a multiple pregnancy, which means patients are left with supernumerary (spare ) embryos. We encourage all patients to freeze their spare embryos , because each embryo is worth its weight in gold.
Our technology for freezing and storing embryos using the technology of vitrification has become so good that survival rates after thawing are practically 100%, which means the pregnancy rate with these embryos is as good as with fresh embryos !  And the cost of doing a frozen –thaw cycle is much less because it's so much simpler and easier – you don’t need to take any injections at all !
So if you do have spare embryos, please freeze them. Yes, freezing will add to your cost up front, but it's a very worthwhile investment.
And the bonus is that if you do get pregnant with your first transfer, you can use your frozen embryos for your next baby, to complete your family !

What to find an IVF clinic which respects your time and intelligence ?
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Monday, February 17, 2020

Why testing for failed embryo implantation in IVF patients is useless

One of the big problems with IVF is the uncertainty which surrounds it – no one knows which cycle will work, or why perfect cycles fail.
What makes a bad problem even worse is that patients have unrealistic expectations of the technology. Sadly, doctors compound the problem by pandering to the patient's demands. They offer to provide answers by running many expensive, complex, exotic and esoteric tests, even though they know the reality is that these don’t provide any useful information.
This is because embryo implantation is a complex biological process, which we cannot control and we cannot monitor, and we still don't know which embryo will implant , and which ones won't.
Doctors are worried that if we tell the patient the truth – that we don’t have all the answers – that patient will no longer respect us . This is why we subject them to the “latest and newest”  tests, to demonstrate that we're trying to figure out exactly what the problem was.
However, this just means that we're taking the patient for a ride, because we don’t tell them to truth about the limitations of these tests, and that they won’t change their treatment options.
Yes, the patient ends up  spending a lot of money, and this is good for doctors because they can charge more, but the test results don’t provide any useful answers , which means the doctor remains in the dark – but he can cloak his ignorance using fancy medical jargon !

What to find an IVF clinic which respects your time and intelligence ?

Friday, February 14, 2020

IVF Video : Empiric therapy in IVF

IVF Video : Why are IVF patients scared of finding out more about IVF ?

IVF Video : Treatment for recurrent pregnancy loss

IVF Video : The donor egg IVF option

IVF Video : Third party reproduction and the movie, Good Newwz

IVF Video : Why eggs are more important than the sperm or the uterus in IVF treatment

IVF Video : Please ask your IVF doctor questions!

IVF VIdeo : Why the IVF hormones don't cause cancer or early menopause !

IVF Video : Making sense of the semen analysis report

IVF Video :" How IVF failure can lead to success !

IVF Video : Why young professional women should explore the option of egg freezing

IVF Video : Blastocyst transfers maximise IVF pregnancy rates

IVF Video : Should infertile couples go to gynecologists ? or IVF specialists ?

IVF Video :Is your IVF clinic a full-service IVF clinic?

IVF Video : What infertile women need to know about their AMH levels

IVF Video : Frozen eggs are a better option for donor egg IVF

IVF Video : The AMH blood test can help women to track their fertility

IVF Video : Why single embryo transfers ( SET) have a higher pregnancy rate

IVF Video : Day 3 or Day 5 Embryo Transfer. Which is better?

IVF Video : IUI क्या होता है ? | Intra-Uterine Insemination Explained in Hindi

IVF Video : Self Inflicted Infertility

IVF Video : HOW TO GRADE EMBYOS in (hindi)

IVF Video : Learning from a failed IVF CYCLE

IVF Video : Donor Egg Vs Surrogacy

IVF Video : Preimplantation Genetic Diagnosis and Preimplantation Genetic Screening Explained in Hindi

IVF Video : Career Vs Baby

IVF Video : 4 things, all Infertile Couples are fed up of Hearing


IVF Video : 5 Things Every Infertile Couple Wishes their Friends knew about Infertility


Tuesday, February 11, 2020

Why IVF doctors disagree

Infertile couples are often very confused when they go to IVF doctors , because they get so many different opinions , and they're not sure whom they can trust.
There are multiple reasons for why IVF doctors will often give widely varying opinions.
For one thing, a lot of our technology is still not perfect, which means we cannot make an accurate diagnosis in reproductive medicine. This is why two different doctors will interpret the same test result in diametrically opposite ways !
Also, we need to remember that making babies involves a couple, which means the fertility of a couple will be the sum of the fertility potential of both the partners . This is why answers are never in black or white - they are always shades of grey ! It's possible that if an "infertile man" marries a very fertile woman, he will be able to get pregnant.
Also, time plays a key role is the final outcome . Trying time - the time for which an infertile couple has been trying to get pregnant is a very important dynamic variable, which means the way we treat a recently married couple is very different from the way we treat one who has been trying for more than one year - even of their test results are identical !
The problem is that the natural history of fertility is difficult to interpret, because we all know infertile couples who  haven't been able to have a baby in the bedroom for five years, who still get pregnant on their own, for no clear reason. Of course, if they got pregnant after the doctor's "treatment", he is going to take all the credit. These anecdotal success stories bias the doctor, and his individual personal preferences are going to influence what he advises his patient. Some doctors are aggressive and will advise IVF for everyone, whereas others are much more conservative - and patients need to recognize this difference !

What to find an IVF clinic which respects your time and intelligence ?

Monday, February 10, 2020

The problem with IVF tests

A big problem with IVF is the uncertainty which surrounds it, because no one knows which cycle is going to work.
Patients have unrealistic expectations of IVF technology, and when the cycle fails, they demand scientific answers for why it failed !  And doctors compound the problem by running even more tests, in order to "diagnose" the cause of the failure.
However, the reality is that they're not able to do this because embryo implantation is a complex biological process, which we cannot control and we cannot monitor. After all, there is no way of being able to track the fate of a microscopic ball of cells once we put it back into the uterus !
The truth is that don't know which embryo will implant and which one won't - and we need to have the guts to share our ignorance and uncertainty with our patients.
However, IVF doctors are worried that if we tell the patient the truth , they will no longer respect us . This is why researchers manufacture a lot of very expensive , esoteric  and exotic tests , in order to demonstrate to the patient that we are trying to figure out exactly what the problem was !
However, the reality is we're just taking the patient for a ride ! When patients spend a lot of money, this is good for the doctor, but these tests don't provide any useful answers , because they are experimental and unproven.

What to find an IVF clinic which respects your time and intelligence ?

Friday, February 07, 2020

If you have only two embryos, should you transfer both of them ? or should you transfer one and freeze the other one?

If you have only two embryos, should you transfer both of them ? or should you transfer one and freeze the other one?
This is a common quandary for patients with a poor ovarian response !
If you have 2 top-quality blastocysts, what should your strategy be ? Should you transfer one and freeze the other ? Or transfer both together?
If you put both together, you increase your chance of getting pregnant in that cycle - but this is an unfair comparison - after all, you shouldn't compare apples to oranges !
You should compare transferring two embryos at one time , with transferring one embryo at a time in two consecutive cycles.
And the pregnancy rate with transferring a single embryo in two consecutive cycles - a sequential single embryo transfer ( SET) is actually better , because you need to add the chances of getting pregnant in two cycles.
The cumulative conception rate with two SETs is better that transferring two embryos in a single cycle.
The risk for the babies is also less, because you don't have to worry about the problem of preterm births because of a twin pregnancy

What to find an IVF clinic which respects your time and intelligence ?
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Thursday, February 06, 2020

Should you do a Day 3 or a Day 5 transfer if you only have a single embryo ?

Should you do a Day 3 or a Day 5 transfer if you only have a single embryo ?

 If you have lots of embryos, then it makes sense to grow them up to Day 5 ( blastocyst stage) because the embryologist can then select the ones which are growing the best , and transfer these, to maximise your chances of implantation.

Suppose you only have a single embryo on Day 3? Should you transfer on Day 3 ? Or should be willing to wait till day five? Now, this is a dilemma, because if you wait till Day 5 and it arrests in the lab, you'll have no embryos to transfer.  Many patients - and doctors - will say, "A bird in the hand is worth two in the bush," so we might as well put it back inside the uterus , even though the uterus may not be the best place for a Day 3 embryo. After all, why take a chance? And if it's going to implant, it may very well do that.

This is especially true for poor quality IVF clinics, which aren't very sure about their laboratory conditions, and don't want to take a risk . They want to transfer the embryo back into the uterus as quickly as possible , because this way they can tell the patient, "Well, we transferred an embryo , which means we did our best. And if it didn't implant, that's your bad luck."

However , if you have the courage, you should be willing to wait till Day 5. If it develops to a blastocyst in vitro, it has a better chance of implanting. And if it is going to arrest, I feel it's better it does so in the lab for the following reasons.
1. This spares you the agonising 2 week wait , and you don't have to live in unnecessary suspense and uncertainty. False hope can be cruel !
2. While this option causes short term pain, it helps you make more intelligent decisions about what to do in your future IVF cycles . Thus, it's easier to come to terms with the fact that you maybe better off using donor eggs, rather than trying IVF again and again with your own eggs.

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