Saturday, November 28, 2020
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.
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 .
Tuesday, November 17, 2020
The teratozoospermia ( abnormal semen form) racket for "diagnosing " male factor infertility
Saturday, November 14, 2020
Search all our IVF videos instantly !
We have created over 100 videos on IVF to help you understand more about IVF treatment. You can now search the entire library online to find the topic of your interest with just one click !
https://talk2videotest.web.app/drmalpaniclinic
Monday, November 09, 2020
Making sense of early pregnancy scans - part 2
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.
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 !
Get A Free IVF Second Opinion
Dr Malpani would be happy to provide a second opinion on your problem.
Consult Now!