Why doesn't every embryo become a baby in every IVF cycle !

IVF patients have many unrealistic expectations. In their hunger for a baby, they often become desperate and start assuming that IVF is a panacea for infertility.

They naively assume that if the IVF clinics has made top quality generating embryos in the lab then this embryo will become a kid after it's implanted in the uterus !

This would make my life so much easier if it were true! Then all I'd have to do is tell patients to pay my fees so they could take their baby home with them!

Putting aside the jokes, we must recognise that the success rate of IVF is restricted not by medical technology, but by the biological fact that human reproduction is inefficient. Let's not forget that even the most fertile couple takes a long time to conceive in their bedroom. Even if they have intercourse every day, only approximately 20% of couples will become pregnant in a month. This is known as the fecundity rate, and we also know that nine out of ten couples will take up to a year to become pregnant in their bedroom, regardless of how often they have sex.

This is why infertility is defined as a couple's inability to become pregnant in their bedroom after at least a year of trying. Even fertile couples must be patient in order to become pregnant, and travelling to an IVF facility does not change this fact. Of course, being a patient in your bedroom is more easier and more enjoyable (and far less expensive!) than being a patient in an IVF facility, but you really don't have a choice.

This is because the rate limiting factor for IVF cycle success is not the clinical therapy we provide, but the fact that after we produce the embryo and put it back into the uterus, we have no influence over whether or not it will implant. This is due to the fact that embryo implantation is still a grey area that we can't monitor or regulate. We do know that most embryos do not develop into kids, whether they are created in the laboratory or in the bedroom (in vivo) ( in vitro). This is due to the fact that most embryos have random genetic mistakes. Some of these are fatal, which is why these embryos stop developing and stop growing. The difference is that this happens in the privacy of a woman's bedroom, and she is blissfully unconscious of the number of embryos that die in her uterus each month.

In fact, IVF has been shown to boost natural fertility rates. Nature's fertility rate is at 20%, but in an IVF cycle for patients who are good ovarian responders, we can boost it to 40% by assisting the lady in producing many eggs and selecting the finest blastocyst to transfer.

While we can regulate the process of superovulation and how we grow the embryos in the IVF lab, we have no control over what happens to the embryos when they are transferred back into the uterus.

This is aggravating for patients, as well as doctors, because we want all of our patients to become pregnant as soon as possible, and it hurts our hearts when they don't, despite our best efforts!

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 !