After an IVF cycle fails ,
the commonest question patients ask is – Why ?
This seems to
be a simple, straight-forward question , given the fact that IVF failure is so
common, but the answer can be surprisingly complex . This is because there are
so many possible factors which affect embryo implantation , and it can be very
hard for doctors to pin point what the exact causes are for an
individual couple.
Unfortunately ,
rather than admit the truth to patients – that medical
science doesn’t have all the answers - doctors often
subject them to a whole battery of additional tests . Then, to add insult to
injury, since some of these tests are bound to come back as abnormal ( even if
they aren’t of any clinical importance), they propose additional invasive and
expensive treatments , such as PGD, immune therapy, and ERA testing , and suggest
to patients that this additional information will improve the chance of success
in the next IVF cycle .
This is
completely false , because more information does not increase pregnancy rates ,
simply because so much of this information is irrelevant, and just causes
doctors to go down many rabbit holes, chasing expensive red herrings !
This is why
it’s helpful to use a simple framework , so that you know what to do for your
next cycle when the first one fails.
Start by
simplifying, and breaking down the causes of IVF failure
into two groups . One is stuff which you can do something about , and the other
is all the rest, which you can't do anything about . For example, you can’t
become younger, so if you are older , your ovarian reserve is likely to be poor
, and you are likely to be a poor ovarian responder, no matter what protocol
the doctor tries. It becomes very difficult for a doctor to fix this underlying
problem, because ovarian reserve is a
biological fact of life, and the drop is irreversible.
The good news
is that often the cause of IVF failure is something that can be fixed ! The
commonest cause of IVF failure in Indian IVF clinics is a poor IVF lab – one
that is poorly equipped, or that doesn’t
have a full-time experienced expert embryologist.
The good news
is that it’s easy to identify these bad IVF clinics – they
hide information from patients by refusing to share photos of their embryos
with them. If your clinic doesn’t do this, it’s
easy to identify that they are incompetent, and you need to find a better
clinic – one that is open and transparent , respects their patients, does only
blastocyst transfers, and provides embryo photos routinely to all their
patients.
You can see
what embryos should look like at www.drmalpani.com/knowledge-center/ivf/embryos
Read more at https://blog.drmalpani.com/2021/03/how-to-check-on-your-ivf-doctor-so-you.html
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