Avoid these common mistakes if you are planning to undergo a second IVF cycle if your first cycle failed

 

If you've been trying for a long time to have a child IVF can help. You go in with your eyes wide open and your expectations high, and you follow your doctor's advice and hope to come out of it with a baby in your arms. When your IVF cycle doesn't work out your hopes are dashed, you don't know what to do next.

If this has been your story, then you need to know that there is still hope. All is not lost. The fact that you didn't have a baby doesn't mean you should give up on having a baby. There is still hope for you.

Why did your IVF cycle not work? It's important to know why it didn't work out.

First of all, you need to know that the chance of getting pregnant after one embryo transfer is only about 40% to 50%."  we need to look at the cumulative pregnancy rate, which is very high after three transfers.

You also need to know why you didn't get pregnant and how to make your second try even better. It's also important to talk to your doctor and find out how likely it is that you will get pregnant after your next cycle.

For your Second IVF Cycle,  keep three things in mind:

1. Is there a medical reason for another IVF cycle?

2. You are mentally and emotionally ready.

3. The financial consequences 

When it comes to IVF, we need to know that repetition is the key to success, so we need to look at the total number of embryo transfers at the end of three embryo transfers.

This is what you should do right away after a cycle doesn't work out for you

Have a long talk with your IVF doctor before you try again with IVF. This will help you figure out why your first cycle didn't work. Before and during the second IVF cycle, it is important to know if the causes are the same, and if they can be fixed. It also helps to know what changes need to be made before and during the second IVF cycle.

There are many things that affect how many IVF cycles you and your partner can have. When we want to transfer embryos again and again, we need a lot of embryos from one egg pick-up. If we have a lot of embryos from a lot of eggs from one IVF cycle, then even one cycle can be enough for you.

So, from a medical point of view, you can have as many IVF cycles as you are mentally and financially prepared for.

If you've made the brave choice to go through with another cycle, it's important to get things right and avoid some of the most common mistakes, like:

- There is nothing wrong with looking up IVF information on the internet. However, you should not spend too much time looking up IVF information on the internet. But obsessing over what Google says about how many Embryos to transfer, how to get pregnant quickly, and so on, isn't going to help. Google can't be a doctor. It can, however, give you information about your health that you don't want to know, which can make you nervous. If you want to have a good IVF treatment, you don't want to be stressed.

- It's never a good idea to stay in bed after having an IVF procedure, but that doesn't mean you can't. You see, when you move around, you give all of your organs a good amount of blood. A good blood supply for the uterus is also important for embryo implantation. It is very important to be physically active after an IVF cycle. The truth is that after a cycle, complete bed rest is not required.

-  Choose a doctor and clinic carefully: If your IVF cycle doesn't work out, you might question the credentials of your doctor and clinic and want to change them. This is fine, but you should pick someone who has the right skills. Choose a doctor who has the right qualifications and experience with infertility. Choose an IVF Clinic, which gives photos of the Embryos to their patients regularly and do only Day 5 (Blastocyst) Transfer.  https://www.drmalpani.com/free-second-opinion

In the four decades that IVF has been around, science has made huge leaps and bounds in the field. That means that there is nothing that you need to keep an eye on at all. All of IVF is safe, and there is no reason to be afraid. There have been a lot of babies born through IVF all over the world, and they're just like babies born naturally. As long as you don't expect too much and talk with your doctor about what to do after that, you'll be fine!

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 !

How to bounce back after a failed IVF cycle

IVF can be a ray of hope when you've been trying for a child for a long time. So you go in with your eyes wide open and your hopes high, and you follow your doctor's advise in the hopes of becoming pregnant. Then something unexpected occurs: your IVF cycle fails. You're heartbroken, your hopes dashed, and you're confused what to do next.

If this has been your experience, you should know that it is not the end of the world. A failed IVF cycle does not rule out the possibility of a second attempt; there is still hope for you.

It's critical to comprehend the causes for your IVF cycle's failure.

"First and foremost, you must recognise that the chances of getting pregnant after one embryo transfer are only about 40 to 50 percent," Dr. Malpani adds. "As a result, we need to look at the cumulative pregnancy rate, which is about 87.5 percent after three transfers," he continues.

But what happens if all three attempts are unsuccessful? Poor embryo quality or chromosomal incompetency of the embryos, according to Dr. Malpani, could be the culprits. Other variables could be at play as well, such as weight gain, an unhealthy lifestyle, a damaged uterus lining, and/or anomalies in the endometrium-embryo interaction.

This is what you should do as soon as a cycle fails.

Dr. Malpani advises that before attempting another IVF round, you have a thorough chat with your fertility specialist to figure out why your first cycle failed in the first place. "It's critical to understand whether the causes are recurrent—and if they can be corrected—as well as what changes need to be made before and during the second IVF cycle," he says.

Aside from understanding the causes and learning how to make your second attempt more successful, it's also crucial to talk to your doctor about realistic expectations and know how likely you are to get pregnant after your next cycle.

While it may appear that a second IVF try is a no-brainer, Dr. Malpani advises that you bear the following three points in mind:

1. Whether or if another IVF cycle is clinically indicated.

2. Your psychological and emotional readiness

3. The financial consequences of another IVF treatment

"We have to recognise that repetition is the key to success when it comes to IVF," Dr. Malpani explains, "so we really have to look at that cumulative number of 87.5 percent at the end of three embryo transfers."

However, there are a number of criteria that influence how many IVF rounds you and your partner are qualified for. "We need a good number of embryos from a good number of eggs obtained from a single IVF cycle for repeated embryo transfers," he adds, adding that "if we have a good number of embryos from a good number of eggs received from a single IVF cycle, then even one cycle can be enough."

So, from a medical standpoint, you can have as many IVF cycles as there are healthy embryos. There is no maximum limit to this amount, according to Dr. Malpani, who emphasises that the couple's patience, mental fortitude, and financial situation are the driving forces for future cycles.

Try not to make these mistakes before starting the following cycle.

There's no doubt that IVF failure can be heartbreaking. However, if you've taken the bold step of starting a new cycle, it's critical to get things right and avoid certain typical blunders, such as:

1. Don't do too much research on IVF: It's understandable to delve deep into the world of the internet to learn more about IVF. However, obsessing about what Google says about success rates, pregnancy techniques, and so on isn't going to help. "Google cannot substitute a doctor," says Dr. Malpani. However, it may provide you with undesired information about your medical state, causing concern. And anxiousness isn't conducive to IVF success." Rather than spending time on Dr. Google, go to www.drmalpani.com for genuine, trustworthy advice from an IVF expert!

2. Don't go to bed after an IVF cycle: According to Dr. Malpani, "taking bed rest after an IVF operation is completely unjustified." You see, when you walk around, you provide a good blood supply to all of your organs. This blood flow is also critical for the uterus, particularly during embryo implantation. "It's critical to stay physically active following an IVF round. Contrary to popular assumption, total bed rest during a cycle might result in life-threatening problems such as blood clots and embolism," he says.

3. Choose your doctor and clinic wisely: A failed IVF cycle may cause you to question your doctor's and clinic's qualifications, prompting you to seek a new doctor and clinic. And there's nothing wrong with it if you choose someone with the necessary experience. "Find a doctor with the necessary qualifications and experience with infertility who is affiliated with a reputable IVF clinic with a high success rate," advises Dr. Malpani. If you decide to change clinics and doctors, keep all of your reports because they will include a wealth of information for your second IVF cycle.

Finally, keep in mind...

Science has advanced by leaps and bounds in the four decades since IVF was introduced. As a result, you have nothing to be concerned about. "IVF is very safe, and there is no need to be concerned." IVF has resulted in the birth of millions of infants around the world, all of whom are as healthy as those born spontaneously. Dr. Malpani says, "You only need to have reasonable expectations and see your doctor about the next steps for you."

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 !

A failed IVF cycle is not the end of the road for your dreams of building a family

 A failed IVF procedure can be disastrous for both you and your partner. You may be disoriented, dissatisfied, and melancholy. But you aren't ready to give up your ambition of starting a family just yet. What are your plans for the future with your partner?

When it comes to infertility treatments, each couple or person takes a different road. Of course, the mainstream media, magazine covers, and entertainment shows portray IVF as a walk in the park. Actresses and entertainers over the age of 40 appear to experience success after success. But keep in mind that those magazines and TV tabloid shows are in it for the money, so you'll see very little, if any, of the genuine tale behind their infertility.

There are a variety of reasons why IVF fails. When it comes to characterising a therapy that doesn't result in a viable pregnancy, the term "IVF Failure" is a little hazy. There are various options for dealing with a failed IVF cycle, ranging from another IVF round to third-party fertility help to adoption, depending on the cause.

REASONS WHY IVF DOESN'T WORK

Despite its effectiveness, fertility treatment, particularly IVF, is a delicate and exact science. Both the eggs and the sperm must be viable and fertile. The embryo must be healthy as a result of the fertilisation. In the uterus, that embryo must implant properly. The embryo must continue to develop once it has been placed. There are numerous factors that contribute to IVF success, as well as numerous reasons for IVF failure. Here are a few of the most prevalent reasons for your IVF failure.

Your eggs were not viable for the following reasons: Fertility medications are used to cause the ovaries to become overstimulated. This causes a large number of oocytes, or eggs, to be released. When the eggs are collected, they are combined with the sperm to make fertilisation easier. In rare situations, most usually due to age, a woman's eggs are insufficient to fertilise effectively. Your eggs begin to drop in quantity and quality when you reach your mid- to late-thirties.

Fertilization failed: In some circumstances, fertilisation just does not take place. This could be due to the eggs' or sperm's quality.

Embryo didn't implant: There are two main reasons why an embryo doesn't implant. The first is that the embryo's environment in the uterus is insufficient to support it. Endometrium, scar tissue, or an undiscovered, pre-existing disease could all be at blame. The second reason embryos fail to implant is often due to a chromosomal defect in the embryo. Your embryos must undergo PGT (preimplantation genetic testing) to determine their genetic health, which is critical to the success of IVF. This examination greatly increases the likelihood of a successful implantation. Women over 35 are more likely to have chromosomal defective eggs, and the risk increases as they get older.

IVF cycles may be cancelled if there are insufficient follicles: The number of viable follicles may not be enough to produce an acceptable number of eggs if the patient (and hence her ovaries) is over 35. This may usually be avoided by using a "age appropriate" dose/type of ovarian stimulation medication.

Factors affecting your lifestyle: There's no doubt that you want to be the ideal candidate for IVF success. This could imply having a healthy lifestyle and adhering to a decent fertility diet. Smoking will have a direct impact on the success of your IVF procedure. Women who smoke require twice as many IVF attempts to conceive, and they have a far higher risk of miscarriage. You're more likely to have a failed IVF cycle whether you're underweight or overweight.

WHAT SHOULD YOU DO NEXT ?

After a failed IVF, it's vital to grieve. Even if the IVF didn't result in an embryo, the emotional impact is as devastating as the loss of a pregnancy. You'll feel gloomy and depressed for a long time. It's quite normal, but you should consult your doctor about it. Before proceeding with your treatment, you and your partner should get help.

Consider the following possibilities while deciding on your next steps:

Another IVF attempt: Consult with Dr. Malpani to see if any alterations to the IVF cycle are necessary. It's not unusual for successful IVF to take multiple attempts. PGT may be recommended depending on the reason for the previous failed IVF.

Third-party donor: Donor eggs may be an option for women who have insufficient or non-viable eggs. Donors are thoroughly screened and under the age of 30, ensuring that their eggs are in good health.

Surrogacy: Some women are unable to carry a fertilised egg to term for various reasons. Even after successful IVF, this can result in the embryo failing to implant or in recurring miscarriages. The embryo and the surrogate are not genetically linked.  She is nothing more than a gestational carrier. Many couples resort to someone they know and have a relationship with. Others choose among surrogates who have been contacted through advertisements. Once your surrogate has been chosen, she will be subjected to a psychological and medical evaluation.

YES, YOU DO HAVE CHOICES.

It's comforting to know that you have options if you aren't ready to give up on having a family through reproductive treatments. Speak with Dr. Malpani about your concerns following a failed IVF cycle. Under the care and compassionate supervision of our medical and support personnel, seek alternative treatment or testing and evaluation.

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 !

Top 6 Reasons for IVF Failure

A failed IVF cycle can result in an outpouring of emotions. Going into the cycle, you were filled with anticipation and growing enthusiasm, hoping that this would be the start of your family, but also with worry. Will it be successful? You and your partner may experience loss and even rage if a cycle fails. What went wrong, exactly? Is it anyone's fault because IVF failed? Should you give it another shot?

It's natural to be sad about this loss, but try not to put the blame on yourself or your partner. It's likely that the failure was caused by factors outside your control. What happened and what you may do next will be explained by your IVF doctor. The following are some of the most prevalent reasons why an IVF cycle fails.

1) Quality of Embryos

The quality of the embryo is the most common reason for an IVF cycle's failure. Because many embryos are defective in some way, they are unable to implant after being transferred to the uterus. Even embryos that appear to be healthy in the lab can have abnormalities that lead them to perish rather than grow. It is almost never because your uterus is damaged and you are unable to carry a child. Because the embryo is not healthy enough to grow, it does not implant.

2) The Eggs' Age

The age of the eggs is more essential than the age of the lady undergoing IVF therapy when it comes to IVF. As a woman gets older, her ovarian reserve (the quality and quantity of her eggs) begins to deteriorate. This has an impact on her odds of IVF success as well. On average, only approximately 25% of transferred embryos result in live births of children. This, however, is highly dependent on the age of the woman's eggs. The implantation rate for women under 35 who use their own eggs for IVF is around 45 percent. Women between the ages of 40 and 42 who use their own eggs have a 15% chance of implantation.

IVF success rates for older women who use donor eggs provided by younger women are essentially identical to those of younger women. When it comes to creating healthy embryos, egg quality is crucial, and younger eggs are usually better.

3) Ovarian Response

The ovaries of some women do not respond well enough to fertility medicines to produce numerous eggs. If a woman is over 37 , has low AMH levels or has high FSH levels, she may not be able to create enough eggs to produce a large number of embryos for Transfer and possible implantation. When this happens, the chances of IVF failure are increased. Your reproductive endocrinologist will assess the situation and may alter your fertility drugs for the next IVF cycle.

4) Problems with Chromosomal DNA

Chromosomal abnormalities in the embryo are one of the most common causes of IVF failure. This holds true for all human embryos, whether they were created naturally or in an embryology lab. Most losses and failures to implant in an IVF cycle are caused by these disorders. According to studies, the incidence of choromosomal abnormalities in women's eggs begins to rise in their 30s as they get older. Up to 75% of a woman's eggs have chromosomal abnormalities by her mid-40s. As a guy gets older, his sperm accumulates more chromosomal defects, but at a much slower rate than a woman's eggs. Ladies, it's unjust, but it's true.

Your fertility expert may offer PGS, or preimplantation genetic screening, for your future IVF cycle if you've had a failed IVF cycle. PGS examines a few cells from an embryo to see if it has the correct amount of chromosomes. 

5) IVF Lab Quality and Fertility Clinic Skills

IVF is both a science and an art. Is it better to go with a seasoned reproductive endocrinologist with a proven track record or a fresh-faced young doctor just out of fellowship who may be on the cutting edge of practise? What are the success percentages of the practise with ladies your age? Is the lab well-known and employs knowledgeable personnel? Do you have confidence in your doctor's ability to listen to you and resolve your concerns? Consider how you and your partner feel before committing to a second IVF cycle.

 6) Factors related to your Lifestyle

Many fertility clinics demand that women quit smoking for at least three months before beginning IVF therapy. Smoking women require more IVF cycles to conceive and are far more likely to miscarry than non-smoking women. Overweight or underweight women have a lower chance of having a successful IVF procedure. Maintaining a healthy weight is the bottom line. If you're overweight, decreasing just 10% of your body weight can improve your chances of getting pregnant

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 !

The reasons for IVF Failure - and what you can do about them

IVF fails for a variety of reasons.

It's often difficult for patients to comprehend how IVF could fail when we collect eggs and sperm, combine them in a successful laboratory to generate embryos, then place what appear to be healthy dividing embryos into the uterus. Pregnancy is a complex process, as are most biological occurrences. What we don't know about pregnancy still outnumbers what we do.

Nonetheless, we have identified a number of specific characteristics that can lead to IVF failure on rare occasions.

IVF Failure: What Causes It?

A healthy egg, normal, functional sperm, and a uterus capable of supporting the growth of a baby are the most crucial variables involved in a successful IVF cycle. Aside from these concerns, there are a slew of other factors that can influence one's chances of conceiving through IVF. The laboratory atmosphere, techniques employed in the lab, and the expertise of the professionals performing egg retrieval and embryo transfer are all factors to consider.

Anomalies of eggs

The human egg is an extremely intricate structure. As a result, it is vulnerable to damage, which could render it useless. Chromosomes (DNA packets containing your genes and those of your partner) double and line up in the middle of the cell when cells split, as you may recall from high school biology. Half of the chromosomes migrate in one direction when the cell divides, while the other half moves in the opposite direction, resulting in two identical cells. These chromosomes move because they are connected to the spindle apparatus, which is in charge of chromosome separation, which is required for cell division. The spindle machinery of the oocyte becomes more susceptible to breaking as it ages; this breakage can result in an aberrant chromosome distribution, resulting in a chromosomally disordered and thus nonviable embryo. The existence of free radicals, reactive oxygen species, and other metabolic products in the ovary as a woman ages can also cause damage to the oocyte. According to numerous recent research, between 25% and 40% of all oocytes have chromosomal abnormalities. As a lady gets older, this figure certainly rises.

 

Sperm with a defect

Although defective sperm tend to be a less common issue affecting IVF cycle success, they nonetheless serve an important supportive role. Fertilization does not occur simply because sperm collide with an egg. Instead, fertilisation is a complicated process in and of itself. Sperm must be motile in order to migrate to the egg; that is, the sperm's tail must be capable of propelling the sperm through the female reproductive canal to the egg. Sperm/egg interaction is enabled by specialised receptors on the surface of sperm heads that bind to specific receptors on the outer membrane of an egg. Once this occurs, the sperm head releases enzymes that allow the egg's outer membranes to be digested. After penetrating the egg, the sperm's nucleus opens, releasing the sperm DNA. The sperm and egg chromosomes unite at this point, resulting in a fertilised egg (which is actually a very early embryo). According to studies, chromosomal abnormalities in sperm are much more common than in eggs. Unlike chromosomally abnormal oocytes, which can result in chromosomally abnormal pregnancy, chromosomally aberrant sperm do not appear to be capable of fertilising an egg.

 

Intracytoplasmic sperm injection (ICSI) was created to help men with low sperm counts, low motility, or a small number of normal sperm fertilise and become pregnant. ICSI has progressed to the point where it is now commonly used in cases of severe male factor, with fertilisation rates comparable to those obtained with normal sperm. Furthermore, evidence from long-term research imply that the incidence of chromosomal abnormalities in the offspring of IVF cycles that included ICSI is not higher than in nature.

Deciding which embryos to Transfer

The embryologist chooses the embryos that will be Transferred into the uterus of the woman. Unfortunately, our ability to tell the difference between chromosomally normal and chromosomally defective embryos is still severely limited. Our embryologist choose which embryos to transplant based on three factors: cell stage, embryo grade, and cell division rate for Day 3 Embryos and Expansion, Inner Cell Mass and Trophoblast cells for Day 5 / Blastocysts . 

 

Similarly, we believe that higher-grade embryos (grade 1, 2, or even 2.5) are far more likely to implant than lower-quality embryos (3 or 4). Furthermore, our embryologists Dr. Sai can determine the pace of cell division because they see the embryos on a regular basis. An embryo that progressively reaches the 8 cell stage by day three, for example, has a significantly better chance of surviving than one that has delayed fertilisation 

and experienced fast growth near the end of the time period.

Following failed treatment elsewhere. Following a review of their medical records, we may recommend a new stimulation regimen, a different IVF technique, the use of ICSI, or even pre-implantation genetic screening, or a donor gamete procedure. It's crucial to remember that different IVF clinics may approach the same patient in different ways, so failure at one facility doesn't have to imply you can't have a baby.

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 !

Why does IVF fail?

Friends, family, and the internet have all told us about the effectiveness of in-vitro fertilisation (IVF) procedures. However, we don't often hear about unsuccessful IVF, owing to the fact that it's a very emotive subject for those who want to be parents. This blog post aims to dispel the taboo and discuss some of the reasons why IVF may fail.

When it comes to patients who do not have a clinical pregnancy or live delivery, there are a variety of causes for their IVF failure.

Age of the Female

The quality and quantity of a woman's eggs decreases as she gets older. It's common knowledge that as women age, they have a lower likelihood of becoming pregnant; nevertheless, a decrease in egg number and, more importantly, quality, also decreases the chances of a clinical pregnancy or live birth following IVF treatment.

Quality of Embryos

The female's eggs and the male's sperm are combined together in the laboratory portion of IVF treatment with the goal of generating an embryo. Embryos may appear healthy in the laboratory, but when implanted into the uterus, they may fail to implant due to an undetectable abnormality. Our IVF lab grades the quality of the embryos and selects the best to return to the uterus using a scoring system.

Ovarian Response

The female is required to inject a fertility hormone called follicle stimulating hormone (FSH) daily at the start of IVF treatment in order to boost egg production. Some women's ovaries do not respond to this medicine properly, and as a result, they do not generate enough eggs for harvest. Due to the already limited quantity of eggs in older women, this is especially true (low ovarian reserve).

"If you have a poor ovarian response, it doesn't imply the IVF treatment is over," Dr. Malpani adds. Investigations and medication changes may be able to help improve the issue. A blood test for Anti-Mullerian Hormone (AMH) and an ultrasound scan of the antral follicle count are used to determine ovarian reserve. The optimal protocol and dose of hormone to stimulate your ovaries and produce a respectable number of eggs would be determined by your ovarian reserve."

Problems with Implantation

This indicates that the embryos did not successfully implant in the uterus. This could be due to the existence of uterine polyps, a premature spike in progesterone levels, a thin endometrial lining, or a uterine infection. "If an embryo fails to implant, it is not your fault," Dr. Malpani adds. "Most of the time, implantation complications are beyond anyone's control." We assemble a complete set of tests to rule out any potential causes of implantation failure."

Abnormalities of the Chromosome

IVF can fail due to chromosomal abnormalities in the embryos. This indicates that chromosomal DNA is missing, excess, or irregular in the embryo. The embryo is then rejected by the body, resulting in IVF failure.

Why Does IVF Fail? : How To Avoid Repeat IVF Failure

It may take two or more IVF treatments to obtain a successful pregnancy. While this can be physically, emotionally, and cognitively draining, knowing that you are not alone in your struggle, that support is available from fertility professionals with decades of experience, and that IVF failure is not your fault may be comforting.

Your doctor will advise you on what caused the failure after each round of IVF and how to use this information to improve your chances of success if you decide to try IVF again.

Priyanka Chopra and Nick Jonas welcome first baby via surrogate

Priyanka Chopra and Nick Jonas announced the birth of their child via surrogacy on Instagram.

Priyanka Chopra and Nick Jonas jointly shared a photo on Instagram that read: "We are happy to announce that we have welcomed a surrogate baby into our family. We sincerely request that you respect our privacy during this important time so that we can focus on our family."

Neither of them has revealed the gender of their baby, but according to TMZ, the surrogate gave birth to a girl last Saturday.

Chopra, 39, expressed her and Jonas' wish for children in an interview with "Vanity Fair" just a week before the pair made their joyous announcement.

"They're a significant part of our future aspirations," the "Quantico" star said. "By God's grace, things happen when they happen."

Chopra has been married to Jonas, 29, for three years. They married in a lavish three-day wedding in India in 2018.

Although she has a "busy" schedule, the Bollywood diva said in March 2020 that having a family is "extremely essential" to her.

"It's something I certainly want to do, and I'm hopeful that it'll happen whenever God wills it, at the proper, opportune time," she told Tatler magazine at the time, echoing her Vanity Fair interview.

It is inspiring when our Indian celebrities battling infertility, openly talk about barrenness and how they overcome this obstacle. There are lots of stigma and myths related to IVF & Surrogacy that has to get answered and stories like these give hopes and positive message to people who wanted to embrace parenthood.

Need help in getting pregnant? Please whatsapp us by clicking here or send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you! 

Why we specialise in treating patients who have failed IVF cycles in other clinics.

Patients  who have failed an IVF cycle are very different from those who are doing their first IVF cycle .

When you start your first IVF cycle , you are full of hope and optimism . You know that IVF has a high success rate , and is the one medical treatment which maximizes your chances of having a baby.

Most women start IVF with the expectation that they will get pregnant in the first cycle itself.

After all, if you didn’t secretly believe this, you wouldn't have started in the first place.

 Also, IVF doctors add to this false hope. The doctor you do a consultation with in an IVF clinic is extremely optimistic , because they are in sell mode , and want you to sign up with them for your IVF treatment. That is why they promise you the earth and the moon, and praise themselves and their high success rates.

 This is why you are sure that your first IVF cycle will be your last as well, and you are extremely optimistic that it’s going to work – especially when the doctor tells you that your embryos are "top quality " and is very hopeful at the time of the transfer.

 This is why most first-time IVF patients are poorly informed . They don’t really know what an IVF cycle entails, and are pretty much willing to accept whatever the doctor tells them at face value,

 They fail to do their homework , and get carried away by the misleading claims of 70% success rates that many IVF clinics claim on their websites.

 This is why, when their IVF cycle fails, they go to pieces. They come to their senses because this is their first rude brush with reality . They are extremely angry and unhappy, and will blame the doctor for the failure.

 Also, since most IVF clinics are only interested in maximizing their profits, they would rather spend their time and energy on marketing and attracting patients for their first IVF cycle, rather than talking to those who have failed an IVF cycle.

 Patients who have failed an IVF cycle are very unhappy and angry , and they will vent their ire on the doctor, because they need someone to blame. It’s no fun talking to an angry patient, which is why most doctors will avoid them and refuse to take their calls.

 The patient feels cheated and abandoned , because this is adding insult to injury.

Ironically, high-end brand-name IVF clinics see failure as an opportunity to make even more money.They advise the patient to do a battery of expensive and complex tests - and the patient wonders if these are really necessary, because they have lost faith in the doctor.

After all, if the tests were useful, why didn’t the doctor do them before starting the cycle ? Why did he wait for the cycle to fail before advising them ?

They feel let down and confused.

These are the patients whom we enjoy treating, because it’s only after failure that patients understand the importance of Information Therapy !

They wake up, and start doing their homework – a little late, perhaps, but better late than never !

They then understand what global good practices are – and this allows them to appreciate the difference between an expert doctor , and someone who just makes a lot of tall promises on their website .

These are the patients we are very good at treating, because we're very open and transparent , and take pride in being answerable and accountable to patients, and educating them , so that they know exactly what to expect.

We highlight the importance of doing only blastocyst transfers,  and making sure they have photographs of their embryos, so they can have peace of mind that they've received high quality treatment , no matter what the outcome of the cycle may be. This is when they realise that the reason for their IVF failure was a bad IVF clinic !

 If you’ve been unfortunate and have failed an IVF cycle in another clinic and are not sure what to do next , please reach out to us, and we'll be more than happy to help , because we are a boutique, highly specialised IVF clinic that focuses on dealing with challenging patients who have been let down by other clinics because of poor quality treatment.

 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 !

 

Why are IVF clinics so scared of growing embryos to the blastocyst stage in the lab ?

Why are IVF clinics so scared of growing embryos to the blastocyst  stage ? Many IVF clinics come up with all kinds of flimsy excuses and pretexts for transferring embryos back into the uterus on Day 3, especially when the patient has only a few follicles and a few eggs .

This is to cover up their incompetence, because they are scared that the embryo will not develop  to the blastocyst stage in their IVF lab, because they don't have enough confidence in their embryologist. This is why they pressurize the patient to transfer the embryo back into the uterus as soon as possible . This way, if it fails to implant , they can blame the patient’s poor endometrial receptivity, rather than accept responsibility for the fact that their lab was not good enough to make a good quality blastocyst.

The reality is that it makes no sense to transfer Day 2 or Day 3 embryos into the uterus , because the day 3 embryo doesn't belong in the uterus - it belongs in the fallopian tube . An embryo reaches the uterus after spending about 5 days in the fallopian tube, which is why all embryos that are transferred into the uterus should only be Day 5 embryos.

Now I understand the patient’s concern. You are worried that if your embryo arrests in vitro in the lab and doesn't become a blastocyst, you will end up with no embryos to transfer , which means your chances of getting pregnant will be zero .

That is a perfectly valid worry , but also remember that if your day 3 embryo doesn't become a day 5 embryo in a good laboratory , then it’s not going to become a Day 5 embryo in your uterus either. This embryo would not have implanted, no matter what.

Now if your IVF lab is not good, then you should kick yourself for having paid good money to take treatment in a bad IVF clinic !

Good IVF clinics are very confident about their ability to grow embryos to blastocysts routinely , irrespective of how many embryos they have to start off with .

Let’s assume the worst, and suppose your embryo does arrest in the lab. You will be broken-hearted in the short term, but this way you have gained invaluable information as to what the problem is , so that you can come up with more intelligent solutions for your next cycle . This way, at least you know what to do differently in the next cycle. You will also end up saving yourself from a fruitless and pointless 2ww !

Keeping on transferring Day 3 embryos cycle after cycle means you will end up wasting a lot of time, money and energy , and the only person who will benefit from your repeated failures is the IVF Clinic.

This is why it's so important that you be well informed about IVF treatment. If your doctor refuses  to grow your embryos to the blastocyst phase, this in itself is a red flag , and you should worry a lot about why they are reluctant to do so. Often, the truth is that they know their lab is incompetent, and want to hide this fact from you.

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 !

Unexplained infertility is easy to treat !

 

One of the commonest diagnoses we make for infertile couples is called unexplained infertility. 

Patients get very upset with this diagnosis , because they believe that if the doctor cannot find out what the problem is , then either he is not a good doctor because he seems to be groping in the dark, or even worse , he will not be able to find a solution. After all, don’t you need a diagnosis so you can prescribe the right treatment ?

This is why, when a patient gets a diagnosis of unexplained infertility , their first step is to get a second opinion from a new doctor , and the new doctor orders an entire battery of tests . He repeats the old ones ( because he doesn’t trust the earlier labs), and adds many more, most of which are extremely expensive , because he wants to show off to the patient that he is very thorough and experienced, and knows a lot more than the earlier doctor.

The truth is that all these expensive tests don’t provide any useful information . In fact, they actually end up creating more confusion , because the doctor is going on a hunting expedition, and is looking for problems to find. However, most of these new tests haven't been clinically validated , and "abnormal " results mean nothing, because many fertile couples will also have abnormal results ( but because they have enough sense not to go to a doctor, doctors are blissfully unaware of this fact).

If your diagnosis is unexplained infertility , you should actually be happy – this means that your eggs, sperm, uterus, and tubes seem to be normal ! This is far better than having a zero sperm count (azoospermia), or blocked fallopian tubes !

The truth is that all tests have certain limitations , and our technology cannot answer all the questions that doctors and patients ask.

For example, while our tests ( HSG and laparoscopy) can tell us if your fallopian tubes are open , we can't tell you whether they are working properly or not . We can check anatomical patency, but not physiological function. 

Just because we can't answer that question doesn't mean that there is any point in running more tests ! No matter what the results of these additional tests may be , this doesn't change any of the treatment options we can offer you , which is why there’s no point in doing them at all.

The quality of an answer depends on the quality of the question , and the question really shouldn't be - Why am I not getting pregnant ? A far better question is - What should I do in order to get pregnant ?

Unexplained infertility simply means that your eggs and sperm are not meeting in the fallopian tube when you have sex in the bedroom , and we cannot determine the reason because of the limitations of our testing technology.

The good news is that we can increase the probability of the eggs and sperm meeting, either by doing IUI, or by doing IVF ( if IUI fails).

A basic rule in medicine is that before agreeing to do any test , you need to ask your doctor: how will the results of the test change my treatment options ? And if the test results aren’t going to lead to any actionable information, then don't let the doctor do the test just to satisfy his curiosity !

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 !

Why I get upset when my patients don't ask questions !

 

IVF patients often complain that doctors are not willing to answer their questions .

It’s true that many doctors get upset when patients ask too many questions . What’s even worse is that they get even more upset when patients are forced to go to Google to find answers to their questions because the doctor refuses to answer them !

This is why patients often bottle up their questions , or suppress their doubts . They hope that the doctor will do what is required, and treat them properly.

However, I get upset when patients don't ask me questions !

I remind them that I am not a mind reader , and that if you ask me questions , I can answer them . However, if you don't ask me questions , I don't know what you are worrying about , and I will not be able to help you reduce your anxiety levels .

In fact, I ask patients questions during their IVF  treatment all the time,  and I get upset with patients who can't answer them. This means they haven't done their homework , and will most probably have unrealistic expectations of what I can do for them – something that is not good for either me or them.

Asking questions during your IVF treatment - and getting answers from your doctor - reduces your anxiety levels .

The truth is that the outcome of any IVF cycle is going to be uncertain , no matter how well it goes. All we can do is ensure the process itself is a happy and positive one , so that patients have peace of mind that they received high quality medical treatment from a good doctor , who took good care of them.

However, the only way you will know this is if you ask questions , and get answers .

However, don’t expect your doctor to spoonfeed you. You should do your own homework for yourself , so you don’t pepper your doctor with questions that you can easily answer for yourself by doing a search online .

The only stupid question is the one you don't ask , so make a list; try figuring out the answers for yourself from reliable websites; and then ask the doctor the ones that stump you.

It’s important that you spend enough time doing some homework , so you can learn to differentiate between reliable websites and unreliable websites , so you don't get confused by Dr Google , and don't get taken for a ride by bad doctors .

This is why we provide so much information about IVFfor free on our website and our YouTube channel, so that patients can behave as well-informed, partners during their infertility journey and we can help them achieve their goal of completing their family.

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 !

Or you can WhatsApp us at https://api.whatsapp.com/send?phone=919867441589&text=Hey!%20DrMalpani

For how long can I safely postpone having a baby ?

 

This is a common question which plagues many 30 year old professional women.

They have a number of questions about their fertility. They want to know when they need to start worrying about their biological clock; whether they should accelerate their search for Mr Right; if they should prioritise becoming a mother over pursuing a career; or if they should explore the option of freezing their eggs.

These are complex questions . While we know that every woman has a biological clock , and that as you get older , your ovarian reserve gradually gets depleted because you start running out of eggs until you become menopausal , and that this decline is irreversible, the trouble is that it's hard to know for an individual patient what her personal ovarian reserve is – and women only care about their personal situation – they don’t care about statistics.

The truth is that there is a difference between your chronological age and your ovarian age, and while you could be the fittest 38 year old woman in the world who can run a marathon without breaking into a sweat, this doesn't mean that your egg quality is good enough to allow you to make a baby .

Many women get confused , because they feel that if they are physically fit , this means their ovaries will also be fit , and they will be able to have babies as long as they continue having regular cycles .

Sadly, that’s not true, and this can come as a rude shock, when you realize that your eggs are good enough to produce enough hormones to lull you into a sense of false security, but not good enough to make babies.

The good news is that it's now possible for an individual woman to accurately measure her personal biological reserve . You need to do a simple blood test called the AMH level ( Anti-Mullerian Hormone) , which you can order for yourself at the local pathology lab.

While this is a good test that is inexpensive and easy to do, interpreting it correctly can be quite tricky.

For women who are more than 30 and who want to postpone childbearing ( which seems to be the norm across the world for highly educated, ambitious women who want to have their cake and eat it too ) , the good news is that you don't have to sacrifice your career because you have taken time out to have a baby .

You need to make well-informed  decisions for yourself, and the best way of doing this is by measuring your AMH level every year on your birthday, once you turn 30.

This will provide you with a very useful trend as to what is happening with your ovarian reserve, because we don’t treat numbers – we treat people.  The trend will give far more reliable information about your fertility, and how it is declining as you grow older. If the drop is rapid, you may want to consider arresting your biological clock by freezing your eggs , so that you can later on have a baby using those frozen eggs.

These are complex decisions , and you need to make them for yourself ! If you make well-informed decisions , you will be able to follow the path of least regret , because you will have peace of mind that you used technology intelligently, and selected the path that was right for you.

This way, you can ensure that biology doesn't become destiny, as regards your choices about building your family !

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 !

Ovarian cysts and infertility - what every patient needs to know

 

Ovarian cysts are extremely common in women in the reproductive age group of between 20 to 40 . Because they are common in fertile women, they are obviously common in infertile women as well .

However , the problem is that whenever an infertility specialist sees an ovarian cyst in an infertile woman , patients tend to put two and two together , and blame the ovarian cyst for the infertility . They naively believe the cyst is responsible for the infertility, and if the doctor treats it properly , she will get pregnant.

 The problem is compounded by the fact that many doctors also believe this. Sadly, they don’t bother to explain to patients how common cysts are, and that most cysts are physiological or functional, and don’t need any treatment as all. They are usually incidental findings, and can be left alone.

 Technology has actually made this problem worse. Ultrasound has become cheap and ubiquitous , and every infertile woman is subjected to a routine ultrasound scan.

Because the machines are so good, we can easily pick up cysts which are as small as 10 mm/ 1 cm.

 This is the size of a small marble, and is of no clinical importance ! Remember that a mature ovarian follicle is also about 20 mm in size .

However, sonographers will document this, and underline this finding in red / bold.

This will cause the patient to panic ! The other problem is that sonographers report sizes in mm instead of cm, so that it appears more significant ! Instead of saying the patient has a 4 cm size cyst, they will say the patient has a 40 mm cyst .  Most patients are mathematically challenged, and start worrying if this is a tumour or a cancer.

Bad doctors compound this problem by telling the patient that if we don't do anything , this will become larger , or will become cancerous , or will burst and lead to complications. They scare the patient and cause them to panic.

Most cysts don’t need any treatment at all because they will resolve on their own . These are called functional or physiological ovarian cysts . For example, the follicle may not rupture at the time of ovulation, and may form a corpus luteum cyst.

The real danger of these cysts us that trigger-happy doctors end up over treating it . They often advice surgery to remove the cyst , but this can actually increase the chances of the patient becoming infertile, because whenever they remove the cyst, they also remove normal ovarian tissue , and this reduces the patient’s ovarian reserve .

Other doctors will try to “ suppress “ the cyst with medical therapy - for example , with birth control pills . This is completely pointless , because putting an infertile patient on birth control pills means she can't get pregnant while taking them !

This is why it’s so important that you be well-informed, and don’t let the doctor subject you to unnecessary treatment.

The other common kind of cyst is called a chocolate cyst or an endometrioma. This is a common finding in young women , and just because the doctor sees what he thinks is a chocolate cyst doesn't mean that you need to allow him to remove it .

To add to the confusion, many patients don't understand the difference between an ovarian cyst and PCOD ( polycystic ovarian disease). These are very different  conditions !

While it’s true that the definitive solution for treating a cyst is removing it via surgery, often the surgery is not a good idea . It subjects you to the risks of surgery and anesthesia, and reduces your fertility by reducing your ovarian reserve and causing scar tissue ( adhesions).

Also, the surgery cannot prevent a new cyst from forming, and many of these cysts will recur after the surgery, so the poor patient is back to square one, after wasting a lot of time, money and energy !

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 !

10 Bollywood Celebs Who Opted for Surrogacy or IVF for Childbirth

From Shah Rukh Khan to Karan Johar, many big names have taken the surrogacy or IVF route. Lets take a look at the list below

1. Preity Zinta

Preity Zinta has given birth to twins through surrogacy. Zinta, revealed that their newborn twins had been called Jai and Gia. She showered praise and wrote a heartfelt thank you note for the doctors, nurses and the surrogate mother who has been with them in the journey.

2. Shilpa Shetty

Shilpa Shetty's second child, a baby girl named Samisha, was born through surrogacy in 2020, according to the actress.

3. Aamir Khan

Aamir Khan and Kiran Rao have their son Azaad through IVF in 2011. Aamir has also advised couples to consider IVF and surrogacy without feeling judged for their inherent flaws.

4. Shah Rukh Khan

In 2013, Shah Rukh Khan and Gauri Khan welcomed their youngest son AbRam through surrogacy, which was recommended to them by Sohail and Seema Khan.

5. Sohail Khan

Ten years after the birth of their first child, Nirvaan, Seema and Sohail Khan decided to have another baby. When natural means failed, they had no choice but to seek medical treatment and opt for IVF surrogacy. Yohan, their second child, was born in June 2011, 13 years after they married. According to an article, they also recommended surrogacy to Shah Rukh Khan and Gauri Khan.

6. Farah Khan

Farah has talked about how surrogacy can be a lifesaver for couples who are seeking to start a family. Farah was 43 when she gave birth to her triplets in February 2008. "IVF is a blessing, and I am thankful for it since it has changed my life." Many circumstances make it difficult for some couples to conceive nowadays, but we have treatments to help," Farah said in a statement.

7. Karan Johar

Karan Johar became a joyful father to twins, Yash and Roohi, after deciding to use surrogacy. In February of 2017, the twins were born.

8. Tusshar Kapoor

Tusshar adopted his son Laksshya via surrogacy and became a single father. Laksshya Kapoor was born in June 2016 and is Jeetendra and Shobha Kapoor's first grandchild. Tushar is still unmarried and raises his son as a single father.

9. Ekta Kapoor

Ekta Kapoor became a single mother to her son Ravie via surrogacy in January 2019. She is also a wonderful aunt to Tusshar's son Lakshya. Tusshar chose surrogacy as well and is raising his baby as a single parent.

10. Sunny Leone

Sunny Leone and her husband Daniel Weber were recently blessed with twins after opting for surrogacy. In 2018, the twins were born. 

What does the law say?

The Surrogacy (Regulation) Bill, 2019 bans commercial surrogacy in India and it defines surrogacy as a practise where a woman gives birth to a child for an intending couple.

It is inspiring when our Indian celebrities battling infertility, openly talk about barrenness and how they overcome this obstacle. There are lots of stigma and myths related to IVF that has to get answered and stories like these give hopes and positive message to people who wanted to embrace parenthood.

Need help in getting pregnant? Please whatsapp us by clicking here or send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you! 

How ignorance causes infertility

 

One of the commonest causes of infertility is ignorance .

This might sound surprising , because you would expect that in this day and age of sexual enlightenment, where everyone has access to Google , everyone would know everything about how to have sex , and what their fertile time is .

You would be completely wrong !

Even people who think they are well educated actually have very little understanding of medical concepts  such as ovarian reserve , trying time, or how to track their ovulation.

In fact, some couples don't even know how to have sexual intercourse properly . Many Indian couples are virgins,  and no one has ever taught them how to have sex . As a result of this, a lot of the information they get is derived from watching porno films , which distort reality.

This is why many of them believe they aren't able to perform , and this sexual inadequacy is compounded by their ignorance.

This problem gets progressively worse over time, because neither the husband nor the wife knows what the problem is - or even if there is a problem ! They don't know how to find a solution, and keep on groping in the dark (pardon the pun, I couldn't resist !)

This starts to become a negative vicious cycle . Every time they try to have sex, they are burdened by their past failures. As a result, this becomes a self-fulfilling prophecy.

This causes anger, resentment, and guilt . Many of these couples have an inferiority complex , because they are ashamed that they can't even do something as simple as having sex properly .

Sadly, this is not one of the things that they can talk about openly to anyone , as a result of which they hide the fact , and suppress it. This becomes the elephant in the room, and because it's such a touchy and sensitive topic, and because neither husband nor wife is comfortable bringing it up, this makes a bad problem even worse .

While schools are supposed to provide sex education, they do a terrible job at this, and this is why many adults don't know what to do in order to have intercourse properly in order to get pregnant . This creates all kinds of problems , such as premature ejaculation , and vaginismus. The bigger tragedy is that doctors often make this even worse ! Rather than sitting with the patient , and patiently counselling them , by explaining to them the normal physiology of the sexual act , and what they can do in order to solve the problem for themselves in their bedroom , they medicalise the problem.

They know they will make money by treating the problem in the clinic, even though they know that the couple could solve this for themselves in their bedroom , with the right information .

Putting a medical label on the problem makes it even worse , and these couples become dependent on a doctor in order to get pregnant . This may be great for the doctor , because it helps them to make more money , but it is really not fair for the patient .

This is why, one of the first things I do when I talk to patients who have sexual dysfunction as the underlying reason of their infertility, is to advice them to invest in information therapy , and buy the right books , so they have a better understanding of how they can deal with this themselves.

This can be very reassuring for them , because they realise that they are not the only people in the world with this issue - and that other people have dealt with this problem successfully in the past.  Armed with this information , many of them are able to fix the problem for themselves in the privacy and comfort of their bedroom without having to waste any money, which is great for their self-esteem, and helps them to make their marriage even stronger.

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 !