What is the most common cause of not getting pregnant? | FAQ's | IVF Treatment

Every patient asks a doctor when they have a fertility problem: "Doctor, why am I not getting pregnant?" When they've done an IVF cycle and the IVF cycle fails, then the next logical question is "why did the cycle fail?" or "why did the embryo not implant?" Now, these are great questions, and no one's disputing that the problem is that we don't have the technology to be able to answer these questions.

And the reason for that is that while we have the technology to check if the tubes are open, we can't check if the tubes are functioning or not, so we know a tube that is blocked is not going to work, which is because it's open doesn't mean it's working. It's not a plumber's type. Similarly, we can do a semen analysis and check if there are sperm, we can count them, but it's not like a bank account; it doesn't necessarily tell you whether the sperm are functionally competent or not.

And that's exactly the problem with IVF failure We can make an embryo, but once you make an embryo and put it back in the uterus, we don't know whether that embryo is going to implant and what causes it to implant and what causes it to not implant.

Now the honest thing to do is to tell patients the truth and say, "Look, we don't have an answer." Patients get very upset when they hear this because, they want a doctor who will give them answers because, of course, once the doctor knows what the problem is, he's going to be able to solve it. Interestingly, in the field of infertility, the technology for diagnosing problems and making diagnoses is actually not very good.

But our technology for providing solutions is excellent. What could be possible if you don't know what the problem is? How can you identify the solution? The answer is that we can bypass the problem. For example, if the couple has unexplained infertility, which means the sperm are not fertilizing the eggs in the bedroom for whatever reason, we can fertilize them in the lab, create an embryo, and then place it back in the uterus so that, in this case, the test tube acts as a substitute or replacement for the fallopian tube, effectively bypassing the problem even if you don't know where the problem was.

To be honest, I believe this is for the best because we don't care about problems. This is not a research clinic where we're trying to find out why couples aren't getting pregnant. An infertility clinic wants to give infertile couples a baby, and the good news is that our technology for doing that has become extremely good.

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!

What is the most effective treatment option for women who have recurrent miscarriages?

 Many patients come to us who've had recurrent, unexplained first-trimester miscarriages, and they want us to do surrogacy for them. Which makes a lot of sense, doesn't it? After all, she is getting pregnant, which means she doesn't have any fertility problems, but she is not capable of carrying the pregnancy, which means for some reason she is miscarrying. And if she is miscarrying, then doesn't that mean that there's a problem with the uterus, and isn't it also very logical that if you switch the uterus and use the surrogate, the surrogate would go on to have a healthy baby?  but actually, it's not true at all, and let me explain why. Most recurrent first-trimester miscarriage patients miscarry because there's a genetic problem in the embryo.

We all know that the commonest reason for a first-trimester miscarriage is a genetic problem, and this is nature's defense mechanism. Rather than give birth to an abnormal baby, you stop the pregnancy there. Now if that's the issue, then obviously changing the uterus is not going to help, which is why surrogacy is a complete waste for these women.

The problem is that the embryos that they're creating are genetically abnormal. Now part of the problem is that these genetic errors are random. We have no control over them. We can't predict them, we can't treat them, we can't prevent them, and that can be very frustrating. But one thing we do know is that these genetic problems in embryos are usually because of genetic problems in the egg, and these problems are much more common in older women because as their eggs become older, they accumulate a lot of genetic defects.

So, statistically, the chance of having a genetically abnormal embryo is much higher in an older woman. This is why the eggs in these women are okay enough for them to ovulate and even to get pregnant with or without IVF, which means they can continue forming an embryo up to maybe six weeks or eight weeks, but then after that, because of that genetic abnormality, the cells stop dividing and this embryo cannot grow.

As a result, they miscarry, which could either be because the ultrasound shows no beating heartbeat or because they start bleeding. Now the reason for the miscarriage, the underlying reason, the root cause is because of an abnormal embryo, because of an abnormal egg. Doing surrogacy is not going to help. What these women actually require is donor eggs I know this sounds completely counter-intuitive but that's the truth and the reason for that is because embryos are active. The uterus, which is the soil, is very passive. It's the embryo, which is the seed, and if you have a good quality embryo, it's going to implant and continue to a healthy pregnancy.

But if you have a poor-quality embryo that is good enough to implant but not good enough to give rise to a healthy pregnancy, these are the women who miscarry. And I know using donor eggs may seem very counter-intuitive for these women, but especially if they're older, this is actually the best treatment option because that way they can carry their pregnancy and go on to have a healthy 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!

Demand embryo photos from your IVF doctor | Embryo Photos

 Demanding something from a doctor is unusual because patients are meant to be docile and compliant. But the reality is that most IVF patients are completely clueless about IVF treatment, and, sadly, bad doctors exploit their ignorance. They contribute to it by refusing to share information with patients and keeping them in the dark. Most doctors will take a very patronizing attitude towards patients. They tell them that IVF is so complex that they won't be able to understand it, so there's no point in wasting the doctor's precious time by asking him questions or even doing an internet search.

Rather, a good patient should trust the doctor blindly and leave everything in their capable hands. This is fine if you happen to end up in a good IVF clinic, but the bitter truth is that the number of bad IVF clinics far outweighs the number of good IVF clinics.

And if you can't differentiate between a good clinic and a bad clinic, you could end up in serious trouble. The simple solution to this problem is to demand photos of your embryos and good IVF doctors are happy when you ask for them. because they are open and transparent and take pride in the quality of medical care that they provide.

They are happy to document this because, if they have made good quality embryos for you in their IVF lab, your confidence in them is going to increase. Also, this improves their professional reputation because, when you ask other doctors for a second opinion, they can confirm that the quality of medical care you received is good based on the photos of your embryos.

 Bad doctors, on the other hand, are in the business of hiding information because they don't have confidence in the competence of their IVF lab. They will often lie to patients and tell them that their embryos are A-grade or top quality, but without providing photographs to prove it.

This statement doesn't actually mean anything at all. This is why intelligent, well-informed patients always demand embryo photos, and the right time to demand photos is before you start your treatment by ensuring that the IVF clinic routinely provides photos to all their patients. This simple step will ensure that you don't get stuck in a bad IVF clinic and then regret your decision later on because you ended up wasting your time, money, and energy in a poor-quality clinic.

Need help in getting pregnant? We provide a second opinion on all infertility issues. Please send me your medical details by filling in the form at https://www.drmalpani.com/free-second-opinion so that we can guide you better.

Don't choose your IVF doctor without reading this blog | IVF treatment

The two most common cruel tricks IVF patients are subjected to by their IVF doctors. An IVF cycle is full of ups and downs and uncertainty and you never know what's going to happen next. You're happy that you're growing follicles well, but the eggs may not be enough, the eggs may not be mature, or they may not fertilize. And you're never really sure what's going to happen next, and all this uncertainty takes a toll, which is why there is a lot of emotional stress.

But there are two cruel things that bad IVF doctors do that actually make it much worse. The first is that they transfer dead embryos back into the uterus. You might wonder why they do that. I mean, the dead evil is obviously not going to plant and become a baby, so shouldn't they just be honest and tell the patient, "I'm sorry your embryos are dead or they didn't fertilize or they didn't leave, or whatever the truth is. But they don't.

They hide the truth from patients because they're scared that if they tell the patient the truth the patient will get angry and upset or will demand the money back, so they don't want to take any responsibility. For example, the fact that there was an infection in the IVF lab that killed all the embryos and they take advantage of the patient's ignorance and gullibility, because they don't provide any documentation or photos.

They call all the embryos grade a embryos, whatever that means. And because there are no photos, patients don't know whether those embryos were dead or not. And to add insult to injury, these same cruel doctors will then give an HCG injection after the transfer. As you know, a urine pregnancy test measures the presence of HCG in the urine and if it's positive, that means the patient is pregnant. Now, if the doctor gives you an HCG injection after the transfer, this HCG injection is going to go into the bloodstream, which means a beta-HCG blood test is going to be positive. I'm going to go in the urine, which means your urine pregnancy test is going to be positive and then you're on top of the world. You're so excited. What a great doctor on my IVF cycle.

 I'm finally pregnant. This was such great treatment. it's only when you repeat the blood test that you realize that it's not doubling, and that's when you finally realize, hopefully when you've done your own homework or got a second opinion, that you realize you were taken for a ride and the doctor was just cheating you.

The trouble is that once you've had one bad doctor who's cheated you, you're not going to trust any IVF doctor in the future, and this is such a shame, and that's why it's so important that patients demand some information even before starting the IVF cycle. This is a routine practice in good clinics and a global best practice. Make sure your doctor follows it too.

Need help? We provide a second opinion on all infertility issues. Please send me your medical details by filling in the form at https://www.drmalpani.com/free-second-opinion so we can better guide you.

Is multiple embryo transfer better or does it reduce pregnancy chances ?

Many IVF clinics routinely transfer two, three, or four embryos at a time to inflate their success rates. Often, patients push their doctor to transfer more embryos because they think that transferring more embryos will increase their chances of having a baby. Let me explain why.

While it's true that transferring two embryos in one cycle has a higher pregnancy rate than transferring a single embryo in that cycle, this is actually comparing apples and oranges. Let's suppose you have two top-quality blastocysts, if you transfer both and don't get pregnant, you need to start a fresh cycle, which is expensive and stressful.

On the other hand, if you transfer one and freeze the other, you can use the frozen embryo for your next attempt in case the first one fails, which is much less expensive, and if you do not get pregnant with the transfer of a single embryo, you can use your frozen embryo for your second baby.

This is why we tell patients that it's much more sensible and cost-effective to transfer only one embryo at a time because we are not wasting the spare embryos; we are freezing and storing them for you, and the success rate of freezing and thawing embryos is nearly 100% in a good clinic thanks to the science of vitrification. In fact, the embryo implantation rate is higher with frozen embryos because we can prepare the endometrium better, so that its receptivity is optimal.

Now if you transfer two embryos and both implants, you might think that this is a great outcome because you have created an instant family and got a bonus in the bargain: two babies for the price of one. This is actually not true because the complication rate with multiple pregnancies is much higher than with a singleton pregnancy.

The risk of miscarriage and the chances of pre-term labor are increased considerably, which means these pregnancies will often end up in a NICU or neonatal intensive care unit; they will often have lifelong problems because they were so small when they were born; and the biggest tragedy is that this is a hydrogenic problem, one created as a result of medical care by transferring more than one embryo at a time when you need to decide whether you should transfer two embryos at a time. With transferring a single embryo, you should compare the live birth rate, with two embryos at one time with a single embryo at a time in two consecutive cycles. The cumulative overall conception rate with transferring one embryo and freezing the other one is actually better because freezing embryos has become a standardized process.

 And the implantation rates are higher in a frozen cycle because it's possible for us to prepare the endometrium so it's optimally receptive. If your doctor insists on transferring more than one embryo, that is a red flag, because it suggests he doesn't have enough confidence in the quality of the embryos his IVF lab creates. The best way to check the quality of your embryo is to demand it by demanding photos of your embryos. This is standard clinical practice and something that all good clinics all over the world do routinely and proactively. Remember that more is not always better. Read our free IVF comic book at www.drmalpani.com.

Need help? We provide a second opinion on all infertility issues . Please send me your medical details by filling in the form at https://www.drmalpani.com/free-second-opinion so we can better guide you.

Is Surrogacy the right treatment option for recurrent pregnancy loss ?

Many women who've been unfortunate enough to have experienced recurrent pregnancy loss, recurrent miscarriages, or habitual abortion often believe that surrogacy is the right treatment for them. The logic is very clear and, in fact, a lot of doctors believe this too. The fact that they're getting pregnant means they don't have a fertility issue, which means the eggs are okay, the sperm is okay, and the tubes are okay. The embryo is implanted in the uterus, but the uterus is not able to hold on to that embryo.

It cannot sustain or support the pregnancy. This means if there's a problem with the uterus, it's just common sense to find another woman (it's called a surrogate) who's had a pregnancy in the past and whose uterus is normal. And if you then put that intended parent's embryo in this surrogate's uterus, that embryo will continue growing and they'll be able to have a healthy baby because she will have a healthy pregnancy. Actually, this reasoning is completely flawed, and let me explain why. It's like the soil. It's the seed or the embryo which is active.

It's the seed that actually does all the work. The uterus doesn't have to do anything at all. This is in fact, why older women who, let's say 60, even though she hadn't had a period for 20 years, were absolutely fine once you started treating her with hormones and she could carry a baby all the way to nine months. Now remember, if this woman can carry at the age of 72, she's not going to have a problem carrying at a younger age and that's exactly the point; the uterus does not have a biological clock.

The problem is that they are not able to carry the pregnancy because the embryo is genetically abnormal. It's difficult to diagnose a genetically abnormal embryo, but research has shown that the most common cause of a first-trimester miscarriage is a genetically abnormal embryo, and the most common reason for a genetically abnormal embryo is genetically abnormal eggs, which usually occur in older women because their eggs have aged and accumulated a lot of genetic defects that we can't diagnose, treat, prevent, or predict.

Now, Interestingly, because the uterus is passive, therefore, what they really need to do is not worry about changing the uterus. What they need to do is change the embryo. Again, this sounds very counter-intuitive, but it's the truth and the reason for this is that it's the embryo that determines the fate of the pregnancy at the end of the day. In fact, a woman who's had recurrent miscarriages most of the time has a completely healthy uterus. After all, if a uterus hadn't been healthy, the embryo wouldn't have been implanted in the first place.

The fact that the embryo is implanted means a uterus is working fine. This embryo can't continue to grow because it's genetically abnormal, which is why nature terminates that pregnancy at either eight weeks or ten weeks or what have you, and this is why these women do not need surrogacy. Because even if they did a surrogate with their own eggs and sperm, that surrogate would end up miscarrying again because the underlying problem is the genetically abnormal embryo. Because the genetically abnormal eggs are not going away, what these women require to have a healthy baby is donor eggs. which doesn't sound intuitive I get that, but that is the one treatment option that will maximize their chance of having a healthy baby because once they use a younger woman's eggs, those eggs are much more likely to be genetically normal as compared to using their own eggs, which have a much higher risk of being genetically abnormal because they are older.

Need help in getting pregnant? We provide a second opinion on all infertility issues. Please send us your medical details by filling in the form at https://www.drmalpani.com/free-second-opinion so that we can guide you better.

Learn how to become a Smart Patient ?

Many patients who have had unsuccessful IVF cycles are shocked and confused by how little knowledge they actually have of the IVF procedure. Despite being extremely bright and educated professionals, they don't appear to understand how many follicles they developed, how many eggs the doctor gathered, how many embryos were transferred, or the quality of the embryos, despite all of this information being available to them.

This is partially a result of IVF experts' refusal to disclose information to their clients. They encourage their patients to basically leave everything up to them because they want them to be viewed as the expert, which keeps them on their toes. Since they are IVF experts and will perform the necessary tasks. Because it is much more convenient for them when patients obediently follow the doctor's recommendations, they treat their patients like idiots. In fact, these IVF doctors advise patients against using Google or other independent research methods.

IVF is described to patients as being incredibly complex and requiring ten years of training for a doctor to grasp, which makes it impossible for a patient to understand such a complex medical procedure. Because there is so much inaccurate information out there, many patients feel lost while trying to conduct a Google search to learn more about IVF. Furthermore, determining which information is trustworthy and which is not becomes difficult.

However, it is quite simple for dishonest doctors to take advantage of you if you don't know anything about IVF. IVF specialists know that infertile patients are hopeless and gullible, which makes it so simple to cheat them. But when it comes to IVF, you can't afford to be a dummy; you need to do your research. Both before beginning the IVF cycle and throughout the IVF procedure, in order to ask the proper questions and gather the necessary information regarding medical care. It's far too crucial to leave everything up to the doctor, and a smart doctor will really advise you to learn as much as you can on your own.

They want you to have realistic expectations of what you can accomplish for them because they are aware that you will be better knowledgeable about IVF.  The lesser will be your stress levels and the happier you will be with the quality of care they give you.,  On the other hand, if you are completely clueless about IVF you will not know whether the care has been good or bad. and if the IVF cycle fails because the doctor was bad you will deprive yourself of your best chance of having a baby. Knowledge is power and ignorance is not bliss, so please arm yourself with information therapy before starting an IVF cycle. You can do this for free at www.drmalpani.com

Need help in getting pregnant? We provide a second opinion on all infertility issues. Please send us your medical details by filling in the form at https://www.drmalpani.com/free-second-opinion so that we can guide you better.

Best treatment for Recurrent Miscarriages | Pregnancy Loss

 It can be both extremely frustrating and quite satisfying to treat patients who have recurrent miscarriages. Recurrent pregnancy loss, recurrent miscarriages, or chronic abortion are terms used to describe people who have experienced two or more losses. It's disappointing because, despite conducting a full panel of tests on these individuals, we frequently come up with no results at all. The uterine cavity is normal, the chromosome studies are normal, and there are no signs of hormone imbalance.

The majority of these patients suffer from repeated first-semester miscarriages, which means that the miscarriage occurs at around eight to ten weeks and we are unable to identify the cause. It goes without saying that these patients are quite frustrated. Patients are now quite concerned about how the doctor will be able to treat them if he can't identify the underlying cause of the diagnosis, which is curiously why the entire course of treatment is not predicated on identifying a problem. Empirical therapy, which is founded on experience, is the foundation of the treatment.

 The good news is that studies have shown that even women who experienced three, four, or five recurrent miscarriages could eventually conceive successfully. If they don't give up and keep trying, more than 50% of them will eventually succeed in having a healthy kid with just one straightforward intervention. that's what tender loving care, or TLC, is all about. Now, this might seem incredible. After all, how could delicate loving care, especially for a woman who has lost, affect the result of pregnancy?


You could reasonably assume that because she's miscarried three times, the likelihood of her miscarrying a fourth time will be substantially higher, but this is untrue. and in fact, this is one of the main justifications for any treatment given to these individuals, be it immunotherapy, intravenous immunoglobulins, paternal lymphocyte vaccination, or anything else.

 




The reason why any therapy works so well, in my opinion, is that most of these patients don't need it. As a result, the baseline success rate for these women would remain at 50%, even if they undertook no additional interventions. which is fantastic because it means that half of them would go on to have a healthy baby and, guess what, they would attribute it entirely to the medical care, and the doctor would be more than happy to accept this credit as well.

Therefore, even though we frequently cannot identify the cause of miscarriages, there's no need to become discouraged. Despite the fact that you might feel like the odds are stacked against you, if you continue to be patient, your chances of having a healthy kid are very strong. Therefore, please hold onto hope.

Need help? We provide a second opinion on all infertility issues. Please send me your medical details by filling in the form at https://www.drmalpani.com/free-second-opinion so we can better guide you.

How can older women get pregnant ?

The majority of older women are aware that their chances of becoming pregnant are reduced and that menopause is a natural part of aging.

They also recognize that there is a biological clock at work. Due to their ignorance of the rate-limiting factor and the location of the biological clock, their likelihood of becoming pregnant decreases. Fascinatingly, the uterus lacks a biological clock.

That much is relatively passive for the uterus. The uterus doesn't require much work; it functions somewhat like the soil; the seed does all the work of growing, just as the embryo does all the work of implanting; the uterus simply permits the implantation process to take place.

As a result, even as women age and even after 25 years of menopause, we can still successfully conceive them because their uteruses will function normally once they are given estrogen and progesterone, which is just a straightforward hormone replacement therapy.

So the good news is that even as you age, even after menopause, if you're willing to use donor eggs or donor embryos, or you're lucky and you've frozen your younger eggs earlier, you can get pregnant and carry that pregnancy, there's no need for you to think about using surrogacy older women do not need surrogacy.

If they are unable to conceive naturally, they should think about IVF; if they are unable to conceive through IVF due to a poor ovarian response, they should think about donor eggs. This is because it is the ovaries, not the uterus, that begin to lose function as women age; the uterus, which is a remarkable organ that never ages, regenerates itself every menstrual cycle. It can be psychologically very difficult to accept the truth that using donor eggs would be much preferable to using a surrogate if you are older, but we can measure your blood test called an amh level or perform an anterior follicle count to determine your ovarian age.

No matter what you decide, you should be aware of the facts so that you can make an informed choice. so that you won't look back and feel guilty about spending a lot of money on the wrong 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!

Mistakes IVF patients make when choosing an IVF clinic | Tips to avoid these mistakes

 The most common error is to blindly rely on their family doctor, general practitioner, or gynecologist to refer them to a clinic because they believe and hope that their doctor is a trustworthy source of medical information and will act as a trusted gatekeeper and send them to the in vitro fertilization clinic with the highest success rate.

This used to be true, but due to the widespread corruption that now permeates the healthcare industry, your family doctor will frequently refer you to the clinic with the greatest kickback instead of the clinic with the highest success rate. This lessens your likelihood of becoming pregnant while also helping him to make more money.

The second issue is that they don't research potential IVF doctors before choosing one. Instead, they assume that an institution is reputable simply because a friend of theirs became pregnant there, or because it paid for a full-page newspaper advertisement, purchased a press release, or won an award.

 The truth is that not all in vitro fertilization clinics are created equal. Competence levels and success rates range greatly between good and bad facilities. Before choosing the clinic that is best for you, you should conduct your research.

One easy method to do this is to interview at least two clinics, make a short list, and then choose the clinic that you like the most. The third and most significant error patients make is expecting the doctor to tell them how their cycle is progressing while they are actually receiving ivf treatment. The problem is that the main doctor is never available, so they must rely on either the assistant or the nurse, leaving them completely in the dark.

The key message is that you shouldn't base your decision on an IVF clinic's brand name, reputation, or doctor's recommendation. By investing in information treatment, you must actively participate in making this important choice.

The good news is that doing this is simple. Before beginning your cycle, simply confirm that the clinic only performs day 5 blastocyst transfers and routinely gives all of its patients photographs of their embryos.

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!

Can sexual dysfunction affect fertility?

You'd think in this day and age of widespread internet access that most adults would be well-versed in matters of sexual health and fertility. While some teens may get their sex education from watching porn online, this can give them a skewed view of reality, and the fact that many of them don't realize how little they know only serves to perpetuate the problem.

 Other teens may get bits of information from friends or advice from aunties who don't know too much themselves but think of themselves as experts. Partially because patients don't know how to describe them, partially because they don't volunteer this information because they are ashamed, and partially because doctors don't have enough time or empathy to be able to ask questions about these sensitive issues in order to get at the truth, the problem festers and becomes worse over time because it is caused by psychological issues, and these become self-fulfilling prophecies.

The poor couple has no idea how to get out of this chakra view, and because it's such a sensitive subject, they lack the courage to resolve it. Unfortunately, there are many charlatans in the world, both online and off, who prey on naive, ignorant, and vulnerable couples by promising them quick and easy solutions to their problems.

Prioritizing one over the other will save you time and heartache in the long run; if having a baby is your number one priority, try mutual masturbation to enhance your sexual satisfaction and self-insemination to conceive rapidly.

Having babies is a straightforward biological process, and you shouldn't conflate orgasmic sex with a woman's ability to conceive.

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 do doctors predict the success of IVF?

 Why are IVF doctors so bad at predicting the outcome of an IVF cycle, we all know that IVF doctors are experts we've been doing IVF for many years we do thousands of cycles and therefore one would expect that doctors would be pretty good at telling patients in advance what their chances of having a baby are. after all, that is what they do day in and day out and how hard can that be that's the most important question. to the question, "What are my chances of success?" that a patient needs to be answered.

However, the dirty little secret of IVF is that doctors are terrible at answering this question for individual patients, so we just can't tell you what your chances of success are going to be in one cycle. I'll try to explain how close we can get to tell you whether your prognosis is good or bad.

We can tell you our success rate for women less than 35 who are good ovarian responders where we transfer one top quality blastocyst is 40 but those are generic figures which apply to groups of women to the population so to say that's what statistics is all about after all but you don't care what happens to the other 99 patients in my clinic you only care about what's going to happen to you.

 The problem is that doctors aren't fortune tellers; they have no way of knowing what will happen to any given patient. This means that they still can't provide an answer to the most pressing concern of their patients. Knowing this helps us maintain a healthy sense of perspective and humility, but it's far more crucial that patients have reasonable expectations and know what to expect from their doctor. A silver lining is that we can accurately predict your chances of success over a period of three to four cycles, even though none of this will ever hold true in the real world.

We learn from each cycle what worked, what didn't, how good your embryos are, how well the cycle is progressing, and if it fails, we have valuable information as to perhaps. This is why we calculate a cumulative conception rate. We are not very good at telling one individual patient what her chances are in a single cycle, but we are much better at telling one individual patient what her overall chance of success is going to be in four cycles, and so the better the quality of question you ask your doctor, the better the quality of answer you will get.

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 is putting patients first important?

As an IVF doctor, I believe in putting patients first and this is one of the reasons why I share so much information on our website and our youtube videos. And I'm pretty frank and forthright and quite willing to criticize bad IVF doctors because of the wrong things which they do lots of doctors don't like this, lots of doctors believe that patients are stupid they shouldn't ask any questions. They should just do what the doctor tells them. Now good IVF doctors appreciate the fact that I'm trying to educate patients by providing information therapy, bad doctors, on the other hand, feel threatened they get worried they don't want to have to answer questions to their patients because they'd rather deal with ignorant clueless patients. And this is part of the problem that we allow these bad doctors to get away with providing extremely poor quality medical care.

They lie to patients they don't document the treatment, they don't do blossoms transfers, they don't provide photographs of embryos, and they make all kinds of tall claims one of the cruelest things they do is they give an HCG injection, after the transfer so the urine pregnancy test comes back as positive and the patient feels oh great I'm pregnant such a good doctor whereas actually the patient is not pregnant it's the HCG which the doctor gave in the form of an injection which gets excreted in the urine and gives rise to a false positive urine pregnancy test or gives rise to a positive HCG blood test.

And I'm fairly articulate about my criticism because I think patients are the ones who need to know and I'm perfectly okay if others don't agree with me but I think the important thing is they need to explain what they don't agree about and if they have an alternative point of view I'm quite happy to listen to their perspective. I'm not saying I have a monopoly of information I'm not saying I'm the only one who knows whatever there is to know I'm not saying that I have all the answers but what I am saying is I'm willing to share answers with patients in language and videos which they can understand and I think that's a big difference because the reason we put patients first is that patients should make well-informed decisions for themselves this is something which trusts me, good doctors. 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!

Fertility Doctor - How to Choose? How to find the right one for you?

It seems that everyone in India wants to be an IVF specialist these days, and every MD gynecologist refers to himself as an IVF doctor. You really don't need any credentials or qualifications other than the fact that you've earned an MD degree. Now, just because you earned an MD degree doesn't automatically make you a professional in vitro fertilization, as the majority of these doctors never even saw an IVF patient during their entire medical education.

However, I'm going to tell you the truth because everyone wants to do IVF because it seems to be a costly treatment, which many doctors believe to be a very profitable treatment. It also has the air of needing to be high-tech or highly sophisticated to be able to offer IVF, which is why they all do it.

 However, you need to go to an IVF doctor who specializes in IVF and makes it their full-time occupation. Call It Whatever You Like, which indicates that this is a full-time IVF doctor implanted in an IVF Clinic who doesn't travel between Clinics, do hysterectomies, or deliver babies because they are part-time jobs.

IVF doctors are simply too busy commuting from point A to point B and performing other tasks to be able to provide you with the level of depth of knowledge you need. Because they lack the breadth of experience that a full-time IVF specialist possesses, please ensure that the IVF doctor you choose is a full-time IVF specialist.

IVF doctors are only as excellent as their IVF lab, therefore unless it's a full-time IVF Clinic they won't be able to deliver good lab care or expertise, which is why don't choose a part-time IVF doctor. This is something that they do full-time in that IVF Clinic.

A doctor who must rely on an outside specialist to give you IVF care or who travels from one clinic to another from city to city should be avoided; this is a warning sign. therefore you don't want to put your priceless and expensive IVF treatment in the hands of a novice who is too busy to give you the attention, love, energy, and care you need to increase your chances of becoming 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!

What is the cumulative conception rate in IVF ?

Everyone is aware that the success rate rises. A portion of it is, of course, common sense; for example, your chances of winning a large sum will improve if you purchase four lottery tickets instead of one lottery ticket. I believe it goes a bit farther than that, so for instance, if you have your IVF cycles repeated at the same clinic, the clinic learns how your body is behaving and what works and what doesn't work for you.

Since they want to ensure that you become pregnant, they are vested in your success. Therefore, they can personalize and improve your treatment protocol to increase your probability of becoming pregnant. However, I don't think that's the only reason.

I believe that with each IVF cycle, patients get smarter, better question askers, more interested, and more involved. and I believe that after an unsuccessful IVF cycle, patients are far better able to assess if they are receiving high-quality medical treatment.

The good news is that anyone can become an expert IVF patient by asking this one straightforward question; you don't even need to wait for an IVF cycle to fail. before actually paying their IVF cycle fees Simple question: Part A: Do you only perform day five blastocyst transfers for all of your patients? Part B: Do you routinely and proactively provide all of your patient's images of these embryos? Global best standards are these.

This is something that every reputable clinic performs on a regular basis for all of its clients. And if your clinic is not asking this question before beginning an IVF cycle, it should raise red flags. Some patients are smart enough to invest in information therapy beforehand and know to do so. Others learn the hard way after making mistakes and after their cycle has failed.

But better late than never, so please make sure you do. If you do, I can guarantee that the second and third-cycle tests will show an increase in your likelihood of being 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!

Why IVF patients are overtreated, over tested and overcharged ?

 There are numerous reasons why IVF treatment is expensive, including the fact that it requires a lot of ability and knowledge, the consumables and disposables are imported, and they cannot be recycled. There is no doubt that IVF treatment is costly. But what worries me is that many of these costs are totally unnecessary and that they are being incurred not to raise the patient's probability of becoming pregnant but rather to increase the doctor's earnings.

The most frequent issue is excessive testing. Doctors routinely prescribe too many tests, the majority of which are performed mindlessly as a battery of tests. The unfortunate patient ends up in a tube ceiling going from one test to another test from consultant to another consultant because the more issues you discover, the more treatments you propose. One of which actually increases their chances of becoming pregnant and many of these tests are a complete waste of money.



However, all of these tests lead to excessive testing and treatment, which not only results in significant financial loss but also significant time loss because the doctor must wait until the abnormality has resolved before performing the test again. You end up wasting three months, six months, or even a year waiting for your in vitro fertilization (IVF) treatment to start, during which time you age, your ovarian reserve continues to decline, and you ultimately reduce your chance of becoming pregnant.

This is such a shame, and it's why you need to be informed. You can't afford to leave everything to a doctor and just because the only doctor who does lots of tests is typically the one who has no idea what they're doing so they're going off on shipping expeditions which means fishing expeditions which means they're looking for things which they don't even know are there and typically when you don't know what to look for you end up finding stuff which is irrelevant you go down multiple rabbit holes you look for multiple red herrings one of which is very profitable for the doctor but not good for you as a patient so patients need to be aware.

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 find the right IVF clinic ? | IVF Tips

Finding the right doctor who you are confident will be knowledgeable and capable of helping you conceive is one of the most challenging tasks any IVF patient must undertake. This is because there are significant differences between the success rates of a good IVF clinic and a bad IVF clinic.

The truth is that it's frequently difficult to choose the right doctor because, for starters, all of their websites look the same and, when you go in for the first consultation, they're all very charming and persuasive.

However, it's only after you've paid your money that you realize that it's difficult to speak with the senior doctor or that your entire care is being handled by juniors or nurses. and many patients feel extremely duped.

So here's a fairly straightforward fix. Making a short list of the top IVF clinics you're interested in is the first step. This list can be based on clinics you've heard about, clinics your friends have suggested, clinics that are promoted, and clinics whose websites have impressed you.

The next step is to visit these clinics. Now the beauty is that you don't actually have to go to the clinic to find out if it's right for you or not; all you have to do is send them an email or give them a call and ask them the straightforward question of whether all of your patients only receive blastocyst transfers and whether you give them pictures of these blastocysts.



There is no reason why you can't get a response to a straightforward issue by phone or email. Now, if the receptionist, nurse, or whoever responds to your email is evasive or unwilling to tell you, it is clear that they have something to hide, and you should be concerned.

It's a clear red flag if they don't know what a blastocyst is or if they question why you need pictures of your embryos, in particular. Because an embryo is the only tangible thing an IVF facility can actually offer to a patient.

This is such an easy approach you can use to phone them up or email them because all good clinics will proactively and routinely send embryo photographs to all patients without the patient having to ask for them.

Find out if they provide you with images of your embryos and confirm that they only perform blastocyst transfers. By taking this simple step, you can be sure that the clinic you select is competent and will be able to help you become pregnant. Please don't let unreliable clinics take advantage of you—there is simply too much at stake.

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 reduce your stress levels during IVF treatment ?

Everyone is aware that stress is bad for you, and when IVF cycles don't work, doctors often blame the patient. Patients frequently place the blame for the embryo not implanting on themselves, claiming that they were too stressed out.

Although stress doesn't actually affect IVF success rates, it is still bad for you, and if you enjoy your ivf treatment, it will make things much easier for both you and your doctor. Now, I'm not saying that receiving IVF therapy is fun.

There is one easy thing you can do to lower your stress levels despite the fact that no one like visiting the doctor, receiving vaccinations, or having pelvic scans. Of course, in an ideal world with sympathetic, caring doctors, you would be the only patient in the clinic, there would be no wait times, and the nurses would tend to your every need.

The life would be comfortable because the embryologist would explain everything that was happening. But because we all know that's not going to be the case, the only thing you can do to lower your stress levels that you have control over and can be guaranteed to implement is to invest in information therapy.

What does that suggest? It implies that if you are fully informed and aware of everything that will occur during the IVF cycle, your anxiety levels will drop significantly. You will feel in control of the situation and won't be afraid of the unknown. Because you already know what will happen and because you have control over what happens, you won't be afraid of what will occur next.

You'll gain the respect of the doctor and nurse, who will be much more eager to share information with you. Therefore, there is one easy thing you can do that is within your power to ensure that, while your ivf experience might not be cheerful or enjoyable, it won't be stressful either.

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!

Patients must take their own decision | IVF Tips

 The one piece of advice I give all my IVF patients is that they should learn to make their own decisions for themselves. It can be very tempting to have a doctor make the decision for you because, for one thing, doctors in India tend to have a very paternalistic attitude, and patients are quite happy to put the doctor on a pedestal, which means they expect the doctor to tell them what to do.

 After all, that's why they are paying the consultation fees, isn't the doctor supposed to be all of the options are appropriate for the patient who decides to make that decision for themselves, which is why it's crucial to invest in information therapy.

I always tell patients that when you're making their decisions, it's important to consider information therapy. You could choose not to have a baby, you could choose to adopt a baby, you could choose to do IVF as many times as you like, you could choose to do third-party reproduction with donor eggs, and so on. make sure you start by using your brain.

 You've done your research and are aware of all your possibilities. Please don't underestimate your intelligence or assume that you won't be able to understand because it annoys me. You're brilliant. Pretend that you're completing this homework for your younger sister, for example, and not for yourself so that you do it a little objectively.

Since it is your life, it's very easy for me to tell you what to do, but I'm not going to live with the consequences of that decision, and tomorrow if you're not happy with that decision, I don't want you to come back.

Doctors are specialists in what we do, but ultimately you're the one who makes that decision for yourself because it is your life. Pay attention to your intuition and give yourself ample time to decide. Except that it has emotional repercussions, this is not a simple choice.

It's very difficult, so it's very helpful to have a sounding board you can talk your decision through with. Ideally, this will be your husband, but it could also be your mother, any family member, or any mentor. This person should be someone you feel comfortable talking to in private and who will tell you what to do for your own best interests. I believe that once you go through this process, you should give yourself enough time so that your heart will finally tell you what's right 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!

What factors should be considered when selecting the best IVF clinic?

 The issue with the majority of IVF patients is that they don't learn the details of an IVF treatment cycle until their cycle has failed. By then, the harm has already been done, and they wasted their time, money, and energy by visiting a poor-quality clinic. The medical professional hasn't bothered to do a blastocyst transfer, communicate information, or give them pictures of their embryos and it wasn't until later that they recognized the treatment had failed because they had received such poor quality care.

The problem is that after the damage has been done, it is much more difficult to heal it, and they have lost faith in the entire medical system because they believe that if one doctor is bad, why would another doctor be any better? This is why it's crucial for you to take charge of your medical care.



You don't have to train to be an IVF expert. You don't need to build an IVF lab, but you do need to do enough research to know that every good IVF facility only performs blastocyst transfers and only single transfers, and always gives all of their patients images of the embryos. and this straightforward test, which I would refer to as a quality control test. Before beginning IVF treatment, you should ask this straightforward question and ensure that you receive a satisfactory response. Doing so will ensure that you receive high-quality care and that a doctor doesn't take advantage of 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!

How to handle the emotional stress during the IVF process ?

One of the reasons IVF treatment is so stressful is that it's impossible to predict whether the cycle will work or not. This is why most women are anxious and worried before beginning an IVF cycle, and this is especially true if they failed one IVF cycle and are starting the second one; they're full of doubts and questions, will the cycle work, will we do something different this time, why did it fail the first time, and a lot of their stress and anxiety begins to affect their daily life.

It begins to affect how they interact with others, particularly their husbands, and their husbands become increasingly concerned because they believe their wife is completely obsessed; all they can think about is why did the cycle fail or what can I do to prevent failure, how can I reduce the chances of failure, and what can I do to increase the chances of success.




Most of these patients now spend their entire day on an IVF website, devouring any information they come across, whether it's on a WhatsApp group, a Facebook group, Instagram, or a website, and they're often confused because there's so much conflicting information that they're not really sure what applies to them.

Their husbands think they're crazy because that's all they think about all day, and they want them to keep their sanity, but what husbands really mean is that obsessing and worrying about it won't change the outcome.

“ Let us pause and just give it our all. “

“ Let's stop worrying “. That's very easy for the husband to say and very difficult for a woman to do and in fact, the woman frequently misinterprets this as thinking – “ Oh, my husband isn't being empathetic at all “. He doesn't understand what I'm going through “. That’s why both of you should read the book - Men are from Mars and Women are from Venus “.

The truth is both of you are on the same side – so please be patient and support and love each other during this difficult time, please

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!

Which tests are unnecessary during IVF treatment?

 Patients who have had consultations at other clinics frequently come to our office with a lengthy list of tests that their doctor has prescribed for them. and many of these tests—such as those that examine sperm DNA fragmentation, the immune system, or the torch—are absolutely useless. Sometimes we wonder why doctors order so many useless tests.

They are expensive, they make patients anxious when the results are abnormal, and they actually don't improve the patient's treatment at all. But I believe that one of the reasons doctors order so many tests— and I'm not just saying this they do it just to make money—is that patients expect them to do so.  After all, isn't that what doctors do? Without the test, how will he be able to make a diagnosis, and without a diagnosis, how will he be able to provide the proper treatment? And they have a hunch that the doctor will make the correct diagnosis and thus prescribe the proper course of action if he conducts a lot of tests, is thorough, and is meticulous.



 Patients sometimes think that the more expensive the tests, the better the doctor, which is sometimes the reason why there's a race, so doctors order all kinds of tests. However, in reality, the more tests the doctor orders, the more profitable it is for him, but also the more abnormalities you will find, and in reality, a lot of these abnormalities are not clinically important or relevant and they just distract you, which causes you to go off in a wild goose chase. Because of his insensitive nature, you wind up spending a lot of time, and your IVF treatment simply enters a death spiral when he performs a thyroid test and then refers you to a thyroid specialist or he performs some immunological testing and then they come back as abnormal.

When your doctor recommends a test, the easiest approach to protect yourself is to ask just one simple question: How will this test impact my treatment? Please don't take the test if it doesn't affect how you're being treated. You shouldn't be treated like a test subject; you should understand everything the doctor is doing and why. If you look out for your own interests, the doctor will do the same 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!

Do single embryo transfers lead to increased pregnancy rates?

 One of the most frequent questions I have from patients is: If we only have one embryo on day three, and it doesn't even appear to be an embryo of very high quality, should we just transfer it, or should we ask the doctor to grow it until day five and then perform a blastocyst transfer? After all, isn't a bird in the hand too in the bush because if we put it back in the uterus it may implant who knows? However, if it remains in the lab, no transfer will take place, and there won't be any chance for implantation so we're guaranteeing that our chances of success are zero. 

This is the excuse used by many IVF clinics to delay embryos after day three, although in truth if the lab is a good one, the embryo will rest there anyway. It will also rest in the uterus, so you have unnecessarily put yourself through a trying two-week waiting period filled with false hope. Why would you want to do that? Wouldn't it be better to know that the embryo rested instead of having to wait for those terrible two weeks when every little twinge could mean you're pregnant or not? In addition, you lose that crucial information because, if the cycle fails, you'll not even know why, whereas if you let the embryo arrest in vitro, you'll know the issue was with the embryo and can fix it in the next cycle. Please don't let your doctor do this; it might be in his best interests, not yours. The whole idea is that by returning embryos to day three, you're losing crucial information

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!