Thursday, May 19, 2022

What to do if you are stuck with a bad IVF doctor

 



Most patients are very naïve when selecting an IVF clinic, because they believe that all IVF clinics are equally good. They will sign up for IVF treatment at the nearest clinic , or at a clinic to which they have been referred by their family doctor , or perhaps to a clinic they have read about in an ad .

However, after they start their treatment , they realise that they are receiving very poor quality care . After they have paid their fees, they don’t get to see the brand-name doctor, and their treatment is handled by clueless juniors and disinterested assistants.

They have no idea as to how their cycle is progressing , and the clinic refuses to share basic medical information ( such as the number of follicles on the ultrasound scan, and their sizes). They refuse to provide photographs of the transferred embryos , so when the cycle fails, the poor patient has no idea what the real reason for the failure is .

The doctor then starts Operation Coverup ! He hides all the information, and then pushes the patient into doing even more tests, or suggesting more expensive treatment , by blaming the patient’s eggs, sperm, or uterus for the failure , when in fact the real reason for the failure was the fact that the doctor was incompetent , which is why the embryos were of poor quality.

Patients are smart , and they suspect the doctor is hiding information from them , and not being honest, but they don't know what to do when they are stuck with a bad doctor. This is partly because they have already spent so much money , that they are very reluctant to walk away – especially when the clinic has signed them up for a 3-cycle package by offering them a discount for this !

They are scared to take the time and trouble to find a new doctor , because they can't really be certain that the new doctor will be any better than the old one , and they are scared they will end up jumping from the frying pan into the fire. Another fear is that the new doctor will make them repeat all the tests all over again , meaning they will end up wasting even more time and money.

The one thing you should remember is that if you are stuck with a bad doctor , then continuing with him will only lead to more grief , and will just make a bad situation worse. There's no point in regretting what you have done in the past , because this is a sunk cost and you can't undo it, but you can definitely learn from your mistakes , so you can choose a better doctor the next time around !

Your first step is to get a copy of all your medical records , including photos of your embryos. If the clinic refuses to share this , please remember that your medical records are your property , and doctors cannot refuse to give them to you ! If they do, send them a legal notice please !

After you have obtained your records, the next step is to get a second opinion , so that you can determine the lacunae in your treatment ,  and can move on to a better clinic . The good news is that your ability to find a better clinic will now increase dramatically because of all the mistakes which you made in your first IVF cycle ! 

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 !





Wednesday, May 18, 2022

What to do when the doctor isn't able to collect any eggs

 


One of the reasons IVF cycles fail is because doctors tell patients that they weren’t able to collect any eggs during the egg retrieval . This can come as a rude shock, because patients expect doctors to be able to collect one egg from each follicle , and it’s very hard to understand why they weren’t able to retrieve any eggs at all .

When doctors don’t get any eggs, they commonly lie to the patient, and tell them they suffer from the rare condition called empty follicle syndrome ! This is not true, because empty follicle syndrome is a very specific condition which can be diagnosed only by doing special tests, but doctors don’t bother to do this , and will use this diagnostic label as a pretext to cover up their own incompetence, which is what really caused them to fail to collect any eggs.

Let’s look at the real reasons why some doctors aren’t able to find any eggs at the time of egg retrieval. One of the commonest reasons is that the follicles have already ruptured before the start of the egg collection . This is not uncommon, especially in large clinics that do many egg collections in a day , because they "batch" their patients together into one group. If the doctor waits for longer than 38 hours after the HCG trigger , the follicles will rupture, and the eggs will be lost in the peritoneal fluid. However, the doctor will refuse to take any responsibility for this negligence, and will hide the truth so that patients remain completely in the dark.

Another reason why the doctor may not be able to collect any eggs is that the doctor may not be technically competent . This is becoming increasingly common in IVF corporate clinics that run large chains , because they are happy to hire any doctor they can find , no matter how inexperienced or clumsy he may be. This is because their focus is not on providing a high quality clinic service , but on doing as many IVF cycles as possible , to maximise their profits. Many of these junior doctors don't have the experience or the expertise to collect eggs for challenging patients—especially when there are only a few follicles ( in patients with poor ovarian reserve), or when the ovary is hard to reach because of adhesions. The doctor blames the poor ovarian function, and then uses this as an excuse to tell the patient to use donor eggs for the next cycle.

Another problem could be a bad embryologist , so if he is not experienced enough , he may fail to identify the oocyte cumulus complexes in the follicular fluid that the doctor sends at the time of egg retrieval. He will claim that no eggs were found, and the hapless patient will never get to know the truth , because it's concealed , and no one is willing to take responsibility for the mess.

Finally , another reason could be equipment malfunction , so if the lab is not well equipped , or if there is a loss of electrical power, the suction pump used for the egg collection will not create the negative pressure needed, or the stereozoom microscope used in the IVF lab will stop working.

The result of this sad saga is that the poor patient will waste all their time , money, and energy - and to add insult to injury, the doctor will lie and tell the patient that there was a problem with her eggs, and she will need to use donor eggs in her next treatment cycle, which is a complete lie.

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 !





Monday, May 09, 2022

Embryo transfer versus embryo implantation

 


One of the problems that plagues IVF today is that most IVF patients are still very poorly informed about the medical details of an IVF treatment cycle . Patients justify their ignorance by saying that they don’t need to worry about the technical minutiae , because that is the job of the doctor ; they don’t understand the medical jargon, and that a little knowledge can be dangerous !

If you do go to a good doctor who takes the time and trouble to explain the details to you, and is transparent and accountable , you will be fine . But what happens if you don't go to a good doctor ? Or if your doctor is not willing to be open and transparent about your treatment, and who hides critical medical  information from you, because they know they are incompetent ? This is the kind of doctor who will take you for a ride , because you don't know enough to be able to protect yourself – and sadly, this is still the majority in India today.

This is why it’s so important that you invest in Information Therapy ! A good doctor appreciates patients who have taken the time and trouble to educate and inform themselves,  because they have realistic expectations of IVF treatment, and this makes life much easier for both the patient and the doctor , because they are on the same page .

The patient knows exactly what to expect, and can check if the doctor is doing this, because they understand what to expect. This also reduces their stress levels because they are less anxious, since they know what’s going to happen next.

On the other hand, bad doctors get very upset when a patient is well informed because they know they are not going to be able to cheat this patient . They often get angry with the patient who asks them questions, and will insult them by telling them that there is no point in their becoming a half-doctor !

You need to protect yourself , because you can't automatically assume that every doctor you go to is a good doctor . This is why you need to understand the difference between embryo transfer and embryo implantation . Embryo transfer is a simple clinical procedure that we do routinely. This is done under ultrasound guidance, and good clinics will always provide photographs of embryos , so that patients know that the treatment has been done well . Until the point of embryo transfer , the medical treatment is in our hands , but after we transfer the embryo into the uterus , whether that embryo will implant and become a baby is not something which anyone can control , because this is a biological process , and human reproduction is not very efficient . This is true , whether you are trying to make babies in your bedroom or whether you are doing IVF  - and this is why every fertile couple doesn’t get pregnant every month they have sex !

We have no control over the implantation process – it’s still a black box for us. This is why patients need to understand the difference between embryo transfer and embryo implantation, and this knowledge is extremely important , because you can then decide what to do next in case the first IVF cycle fails !

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 !





Get A Free IVF Second Opinion

Dr Malpani would be happy to provide a second opinion on your problem.

Consult Now!