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It both amazes and dismays me how poorly informed IVF patients are, even after they have completed an IVF cycle .
I know this because I
offer a free second opinion by email on our website at www.drmalpani.com. Patients ho have
failed an IVF cycle can send me their IVF medical records , so I can review
them and guide them as to what they can do to maximize their chances of success
in the next cycle.
I
request them to send me photographs of their embryos, so I can assess the
quality of their medical care . After all, the only tangible deliverable an IVF
Clinic can provide is embryos, and top quality embryos means your clinic did a
good job with your medical treatment.
After
all, the only thing an IVF clinic can do is make embryos. Whether they implant after the
transfer is not something which anyone can control, because embryo implantation
is still a Black Box which we don’t understand well.
Embryo
quality is tangible , and because it can be objectively documented as a photo, it’s reliable and can be
trusted.
However,
patients often reply to my request by saying – The doctor did not give us a
photograph of the embryos ; I did not know that the doctor was supposed to give
me photos of my embryos. Even worse, they will send me a photograph of the
ultrasound scan which the doctor did while doing the ultrasound-guided transfer
. The reason this upsets me is because this clearly means they don’t understand
what embryos look like .
This
means that not only did they not bother to do their research before starting
their IVF treatment, their doctor did not bother to educate them , and has
chosen to hide information from them, for reasons best known to him.
I
worry when doctors aren’t transparent – what are they hiding, and why ?
This
is why patients need to address the problem of Information asymmetry
proactively .
Please
do your homework before you start your IVF cycle , rather than kick yourself
after the cycle has failed , that you didn’t take the time and trouble to get
the information you required from your doctor !
And
if you want to know what embryos look like , check out www.drmalpani.com/knowledge-center/ivf/embryos
IVF patients are often confused as to whether they should look for information online for themselves.
After all, we all know that half knowledge is dangerous , and that it’s not a good idea to try to treat yourself . After all, your doctor is the medical expert – why not let him make all the decisions ? After all, he comes highly recommended – and aren’t you paying him enough ? Why not let him do his job, instead of trying to second guess him ?
Many husbands discourage their wives from spending time on the Internet , because they feel that get completely obsessed with this exercise. They waste so much time online, looking for information - and then get completely confused , because so much of the information is unreliable and contradictory . They often end up worse off than before they started searching, because they don’t know whom or what to trust !
Also, internet positive patients often end up irritating doctors , who feel that patients are trying to act extra smart . They don't really want to answer the patient’s questions , because this takes them too much time and energy .
The truth is that you need to learn how to search the Internet properly .
Reliable information is invaluable , because it reduce your stress levels .
A huge problem which plagues IVF is the uncertainty which surrounds it, and this creates a lot of anxiety , because you don't know what is going to happen next . The fear of the unknown often puts patients off from even starting an IVF cycle, because of all the horror stories they have heard about side effects and complications.
Also, even if you do screw up your courage and start the cycle, you are often flying blind during your treatment, because the doctor often refuses to share information, and being in the dark can be very uncomfortable ! Is your cycle going well ? Can the doctor do something to improve your chances ? Is it only the assistants who are making all the medical decisions ?
On the other hand , if you are well informed , you are in control, because you know what's happening , and what to expect next. You can have intelligent discussions with your doctor , and ask intelligent questions . Remember, Knowledge is Power, and it’s much easier to deal with the ups and downs of the IVF roller coaster ride if you know what to expect.
The secret is to become a well-informed internet searcher, and it's helpful to remember that not all websites are created equal .
If you are looking for reliable information on IVF , please go to www.drmalpani.com.
This is information we have authored personally , and I can guarantee you that this information is easy to understand, updated and reliable
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 !
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Need help? We provide a second opinion on all infertility issues. Please send us your medical details by filling in the form at https://www.drmalpani.com/free-second-opinion so that we can guide you better.
Need help? We provide a second opinion on all infertility issues. Please send us your medical details by filling in the form at https://www.drmalpani.com/free-second-opinion so that we can guide you better.
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Need help? We provide a second opinion on all infertility issues. Please send us your medical details by filling in the form at https://www.drmalpani.com/free-second-opinion so that we can guide you better.
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If your IVF lab transfers embryos on Day 2 or Day 3, this is a red flag, and suggests the lab is incompetent, and doesn't have confidence in its ability to grow embryos in vitro
Embryologists scare patients by saying - " Keeping embryos for two more days in lab is risky. When there are only a few embryos , growing them to blastocyst may be suicidal , as none of them may survive"
The truth is that embryos don't and can't commit suicide. It's the poor conditions in a bad lab which kills them. These labs can't grow embryos well in their incubator
If they can't grow them well to Day 5, then it's highly likely that when they grow them to Day 3, these embryos are already compromised because of poor culture conditions, and are unlikely to implant. However, if they don't implant after the transfer, the clinic can blame the patient for the "failed implantation", and thus pass the buck !
Don't let the IVF clinic bully you ! Yes, there is a risk they may arrest in vitro and you may not end up with any embryos to transfer, but it's best to know this in advance, rather than spend the 2ww in pointless suspense.
More importantly, it will tell you that the IVF clinic you chose was incompetent, and you can then spend time finding a better clinic !
And it's true that some Day 3 embryos do implant, and it's also true that not every blastocyst is going to implant, but the probability of a blastocyst implanting is much higher !
Doesn't it make sense to maximise your chances ? Rather than reduce them because the lab is incompetent and doesn't have any confidence in its skills to culture embryos to Day 5 ( something which all good labs do routinely )
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 !
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Each mature follicle normally contains 1 eggs, which means if you had 10 follicles on the ultrasound scan, you would expect the doctor to retrieve 10 eggs .However, if the number of eggs the doctors collects is much less than the number of follicles, this is the analysis you need to do to try to figure out what happened
Before the egg collection, you need to find out how many mature follicles there are on your ultrasound scan , and what your blood estradiol ( E2) level is. Tragically, we find that many doctors don't bother to share this information - and patients don't even ask . This ignorance can be a huge problem , and that's why you need to be actively involved in your treatment . Ask these questions during each scan, rather than after you find out that the doctor wasn't able to retrieve as many eggs as expected, because by that time, the damage has already been done
This
can happen when the follicles rupture before he gets around to doing the egg
collection. This can happen when clinics schedule a large number of egg
collections in one day, as a result of which they start running late.
Another
reason for not getting any eggs is called Empty Follicle Syndrome . This is an
iatrogenic problem, and occurs if the HCG injection is not given properly . You
can read more about this distressing situation , which is preventable, at
They
can get away with this unethical and illegal practice because patients are
clueless . This lie allows them to maximize their income , because they can collect
fees from both the patients.
The
tragedy is that clinics routinely get away with this , which is why you need to
be actively involved in what's happening to you during your treatment.
The
more the eggs you get, the more the embryos you will have , and this will maximize
your chances of getting pregnant !
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