These terms
sound very similar , but actually they are very different . Let me explain why
One of the
reasons for repeated IVF failure is a bad IVF clinic that creates poor quality
embryos , because they don’t superovulate their
patients well, or because their lab can’t grow blastocysts properly in the
incubator . In fact, this is the most common reason why most IVF cycles fail in
India , because most IVF clinics don't have the required expertise or
experience to be able to create top quality blastocysts. They hide this fact by
refusing to share embryo photos with all their patients routinely and
proactively .
Treating these
patients who have experienced repeated IVF failure in other clinics is actually
fairly straightforward , because we just need to superovulate them properly and
transfer a single top quality blastocyst to maximize their chances of getting
pregnant .
Treating
recurrent implantation failure , on the other hand , is much more frustrating .
These are patients for whom the doctor has
transferred a top quality blastocyst inside a receptive uterine lining, but 3 cycles have failed inspite of doing so.
This is
frustrating for both patients and doctors !
The patient
wants to know how many more cycles they should be doing,
and when they should stop and consider alternative options . When does
repeating the next treatment cycle become futile ?
There really is
no easy way to answer this question. Statistically , the pregnancy rates
increase with the number of cycles patients do , and the cumulative conception
rate after three cycles when you transfer top quality blastocysts is about 80% .
Now that
doesn't mean that the chances of getting pregnant in the fourth IVF cycle
become zero , which is why the patient finds themselves at a crossroads , and needs to make some hard decisions !
Should I change the doctor ? Or should I change the treatment ? This may
involve exploring alternatives such as using donor eggs,
donor sperm , donor embryos, or surrogacy.
However, there
is often no logical medical basis for doing this, especially when the cycles
have been documented to be medically perfect.
The decision is
often based on emotions, and we may need to explore alternatives on an
empirical basis, to find the one that finally works.
That's why it's
important that patients make these decisions for themselves, and a good doctor
will emphasize how little we understand in this area . They are honest with the
patient , and will let them know that the answers are not clear , because the
future is uncertain and unpredictable , and our technology is not accurate
enough to be able to identify why top quality blastocysts fail to implant.
The good news is that options exist , and in fact, we encourage patients to also start exploring non-medical options such as child-free living and adoption.
This way,
patients have peace of mind that they have made the right decisions for
themselves , because while the outcome is always uncertain, the process itself
should be a happy and positive one .
The only way of ensuring this is by making sure that you explore all the options for yourself , and make your own decisions for yourself . These are life changing decisions and you need to own them , rather than outsource them to someone else , no matter how much expertise he may have.
Remember that
doctors are not mind readers , and while they may offer you options, these may
not always be in your best interests !
Yes, these are difficult decisions , and you should remember that you will learn from these difficult times , and grow as a person . Yes, this is a deep philosophical truth, and while what patients are really looking for is clear , simple, and easy answers , and a doctor who can be trusted to provide them, it’s equally true that often there are no clear answers in life , and you need to find your own path for yourself.
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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