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While
there are many great IVF clinics in India which provide high quality medical
care , it is also equally true that the number of bad IVF clinics which provide
very poor quality medical care is much larger.
This
is partly because practically every gynecologist can now call themselves an IVF
specialist. They are very happy to set up an IVF clinic , as IVF treatment is
seen as being prestigious and very profitable . These doctors have no
experience and expertise in doing IVF. They have not been adequately trained ,
and many of them attend a 3-day workshop to get a certificate/ diploma, and
then start calling themselves IVF specialists.
Patients
aren’t able to differentiate between good doctors and bad doctor partly because
they have been taught to blindly trust doctors .
They
fail to ask the questions which they need to , in order to protect themselves
from bad IVF doctors . This is why it's so important that the government become
proactive , and take a step in making sure that IVF clinics meet basic quality
control standards . The ICMR has started doing this , and while this is a step
in the right direction , the fact of the matter is that this ICMR registration
is purely voluntary , and doesn't have any teeth.
The government
has been sitting on the ART Bill to regulate IVF clinics for over 20 years now
!
Today,
even if a patient gets cheated by a bad IVF clinic, all he can do is complain
vocally, but can’t take any concrete action.
The problem
with bad IVF clinics is they harm good IVF clinics, by damaging the reputation
of all IVF clinics. And when good IVF doctors turn a blind eye to the shenanigans
which bad clinics resort to, this makes a bad problem even worse.
Once
a patient has been cheated, they don’t trust any IVF doctor, and thus deprive
themselves of a chance of getting pregnant.
This
is why it’s so important that patients be proactive and learn to do their
homework for themselves. This is a critically important decision , and you can’t
leave it up to someone else.
The good news is you don’t need to become a doctor yourself in order to find the right IVF clinic - you just need to learn to ask the right questions ! This has become much easier to do now, because there is so much high quality , reliable information about IVF available online. Check out www.drmalpani.com
Every
good IVF clinic routinely provides embryo photos to all their patients. This is
tangible documentation that they have provided high quality medical care – and clinics
who care about their reputation do this proactively. If the clinic you have
short-listed doesn’t do this, this is a red flag, and you should walk out as
soon as possible, and find a better clinic !
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The
best way to maximize your chances of IVF success is to minimise your chances of
IVF failure . This is the classical Inversion rule popularized by Charlie
Munger, because it’s easier to identify what the causes of IVF failure are,
rather than identify the causes of IVF success.
This
is partly because IVF is a complex process , with many variables and moving
parts, which means it’s hard to pinpoint why a particular cycle succeeds . Many
things needs to go perfectly for the embryos to implant – and there is also a
huge component of luck, which we can’t measure !
For
example, if an IVF cycle fails , and if you know ( for example ) that the
endometrial lining was thin, or the ovarian response was suboptimal, or the embryo quality was poor , you can identify the reasons for the failure and then treat these
underlying reasons . This means that your next IVF cycle, you will reduce the
chances of failure , and therefore automatically improve your chances of
success . As Warren Buffett often says, The best way to make money is to make
sure that you don't lose it !
This
is exactly the same philosophy which IVF patients need to follow .
Thus,
if you are taking treatment at an IVF clinic which doesn't do blastocyst
transfers routinely, you will automatically increase your chances of failure , because
the implantation rates of blastocysts are higher as compared to Day 3 embryos.
This is a medical fact which every doctor knows , but unfortunately , because
every IVF clinic is not capable of growing embryos to the blastocyst stage in
their IVF lab ( because they don’t have the expertise to do this, or because
their lab is not well equipped , they take shortcuts , and reduce the patient’s
chances of success.
Similarly,
if your IVF clinic does not have a full time embryologist ; or if the IVF
doctor doesn't have their own laboratory ( and needs to do the IVF procedures
in another clinic); or the doctor and embryologist have to travel to the clinic
to do your procedures, this is a red flag that this is not a full-service IVF
clinic, and you are going to increase your chances of failure .
The lack
of coordination between the clinic and the laboratory reduces your chances of
success, and this is the reason why satellite IVF clinics ( manned by “ travelling
“ embryologists and itinerant IVF specialists have a much poorer success rate.
The
problem is that patients aren’t sophisticated enough to understand the truth,
and these clinics lie to their patients. They do not bother to provide patients
with a photograph of their embryos, which means they happily continue taking their
patients for a ride .
Your
IVF treatment is too important for you to leave everything up to your doctor !
You
need to be proactive , and the good news is there is plenty of high quality
reliable accurate medical information available at www.drmalpani.com
Also, the Indian Government is finally taking cognizance of the fact that many bad IVF clinics are cheating IVF patients , and has started to provide some kind of oversight by asking IVF clinics to register with the ICMR. While it’s true that not every registered IVF clinic is necessarily good , it is definitely true that any IVF clinic which is not registered with the ICMR is not good . Thus , if your IVF clinic is not enrolled with the ICMR, this means they don’t meet the basic requirements every IVF clinic should be able to provide to its patients . Stay away from such clinics please !
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You know
that it's very important to find an experienced IVF doctor to make sure that
you maximize your chances of IVF success .
IVF
is an expensive treatment which requires a lot of coordination between the clinician
and the laboratory . However, thanks to the lack of regulation in India, any
gynecologist can set up an IVF Clinic and call themselves an IVF specialist , even
after doing a two day workshop and getting a “diploma in IVF”.
The
Government doesn't provide any oversight , and refuses to take any action to
protect vulnerable IVF patients , who get exploited by doctors who take
advantage of their ignorance and gullibility.
Ignorance
can be expensive, and doctors end up fooling patients , who unfortunately allow
themselves to get fooled because they not done their homework . They aren’t
able to differentiate between a good IVF Clinic and a bad IVF clinic . This is
partly because patients underestimate their ability and intelligence to
understand the nuances of IVF treatment ; and this is also partly because patients
still continue to blindly trust their doctor . This is fine if you end up in a
good IVF clinic , but can be extremely dangerous if you end up in a bad IVF
clinic.
This is why it's so important you verify that the doctor deserves your trust , rather than to give it away blindly . The Government has started taking steps in the right direction , and the ICMR has started initiating some degree of quality control by enrolling IVF clinics to ensure they have the required equipment. Unfortunately , this is still voluntary , and because there is no law , many clinics continue doing IVF without being registered with the ICMR . This is not in the patient's best interest , so a simple question which you can ask your IVF clinic is – Are you enrolled with the ICMR ?
Every
good IVF clinic highlights their ICMR enrollment number on their website , and if the
clinic doesn't have an ICMR enrollment for whatever reason , then you
shouldn't be going there .
Now
, there is no certainty they will provide high quality medical care just because
they have an ICMR registration , but the absence of an ICMR registration is
definitely a red flag !
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While it’s true that IVF cycles can fail because of medical reasons such as poor quality eggs or a poor uterine lining, in India the commonest reason for IVF failure is the poor quality of medical care provided by the IVF clinic .
Many
IVF clinics don’t have the experience and expertise to superovulate the patient
to retrieve enough good quality eggs; and their lab isn't able to do a good job
with making top quality blastocysts, because they don’t have a full-time
embryologist.
This
is a huge problem in India , where there is no quality control or regulation,
and any gynecologists can call themselves an IVF specialist and start doing IVF
!
This
is the reason why so many patients continue to fail IVF cycles in India . Their
doctors doctors provide suboptimal care , and unfortunately patients are not
sophisticated enough to be able to differentiate between a good IVF clinic and
a bad IVF clinic .
They
naively believe that all clinics are equally good, and often end up going to
the clinic which provides the cheapest treatment ; or the one which is closest
to them ; or the one which publishes the biggest ad in the newspaper ; or the one
their GP refers them to; or the one which provides free counselling camp in
order to acquire more patients.
This
becomes a very expensive mistake – because they end up being penny-wise and pound-foolish
.
The
success rates of these IVF clinics is very poor, and to add insult to injury, the
doctor blames the patient for the IVF failure , and instead of acknowledging
responsibility that they provided poor quality care !
They
then start doing many more expensive test in order to determine why the IVF
cycle failed – and these include useless tests such as ERA ( endometrial receptivity assay) and PGT ( preimplantation genetic testing) , which allow
them to earn even more money. Patients often become desperate when their IVF
cycle fails, and these clinics then start suggesting to the patient that they
need to use donor eggs to surrogacy in order to get pregnant. This is terrible
medical advice, because it is completely wrong, but it’s very profitable for
the doctor !
The
underlying problem is that it’s difficult for a patient to differentiate
between a good clinic and a bad clinic, because the websites of the clinic all
look the same, and they all make the same kind of claims of being the best clinic,
with the highest success rates !
The one
single question you need to ask before paying your fees for your IVF treatment
is to confirm that the clinic does only blastocyst transfers , and provides
embryo photos routinely and proactively to all their patients . This is such a
simple question to ask - and it's so easy to find the answer ! This will ensure
you don't waste money going to a clinic, and this is one simple free way to maximize
your chances of IVF success !
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