How to Improve your chances of IVF Success?

There are several factors that can affect the success in vitro fertilization IVF and specific steps you can take to improve your chances would depend on your individual situation.

Some general tips for increasing your chances of success with IVF include:

1. Optimizing your overall health, Maintaining a healthy weight,  Eating a balanced diet and Being well informed about the treatment will help you reduce your stress levels. These can all improve your chances of successful IVF

2. Choosing an experienced Fertility Clinic -

The success rates of different fertility clinics vary.f so it's important to choose one with a good track record. find the clinic which does only blastocyst transfer and provide photos of Embryos to all their patients 

3. Timing your treatment -

Your fertility specialist will be able to advise you on the best time to undergo IVF based on your individual situation. Don't wait until you're too old, because egg quality declines with age, and poor ovarian reserve is the most common reason for IVF failure today, even when done in a good clinic.

4. Sticking to the treatment plan -

It's important to follow your fertility Specialist's instructions and attend all schedule appointments to increase your chances of success.

It's also worth keeping in mind that it is not always successful, and you may need to try more than once to achieve a successful pregnancy. It can be helpful to discuss your options and expectations with your Fertility specialist.

Need help getting pregnant? We provide a free second opinion for all infertility issues.

Visit our website at www.drmalpani.com to know more.

Please make sure that your IVF clinic has a full time embryologist

Many IVF clinics continue taking patients for a ride by cutting corners . While the ambience of the clinic maybe 5 star and the clinic may look very posh, with lots of patients and plenty of staff members, the reality is that the heart of the IVF clinic is the IVF laboratory , and the most important person in the IVF treatment is the embryologist , who actually does all the hard work behind the scenes in the lab to transform your eggs and sperms into embryos which the doctor can then transfer into your uterus so that they can become a baby .

If the embryologist is not good enough , you are not going to be able to get good quality embryos , as a result of which the IVF cycle will fail . The problem is that most patients are very poorly informed about the intricacies of IVF treatment , and they never ask this basic question to the doctor – Do you have a full-time embryologist ?

Now, it’s not possible for an IVF clinic to deliver high pregnancy rates without a full-time qualified , experienced and expert embryologist , because it’s his job to make sure that your eggs and sperms and embryos are cultured properly , and this is a full-time job , which can't be outsourced or done on a part-time basis .

Unfortunately, because there aren’t that many good quality embryologists available in the country , many IVF clinics take a shortcut and will hire a travelling embryologist to do IVF cycles for them in batches . While this maybe great for the clinic , because it helps them to earn more money , because they can now offer IVF treatment without having to employ a full-time embryologist ( who is an expensive resource) , this also means that their patients suffer, because their pregnancy rates are much lower .

A travelling embryologist doesn't have any long-term interest in making sure that the quality of the IVF lab is good , because he is not responsible for maintenance of the equipment . He can’t do any quality control , or troubleshooting, and if things don’t go well, he can blame the IVF clinic for not maintaining their equipment properly, while the doctor blames the embryologist for doing a bad job – but it’s the poor patient who ends up paying the price !

The travelling embryologist just comes in for a few days, does the procedures he is paid to do, and leaves without ever meeting the patient, or caring about what the final outcome was. This is why clinics without a full-time embryologist are not able to do day 5 transfers; are not able to provide embryo photographs to their patients; and are not able to freeze embryos efficiently for their patients , because the embryologist has left and moved on to do the procedures at some other clinic to earn more money for himself.

Because patients are ignorant and gullible, these clinics continue taking advantage of them by taking them for a ride. In our clinic, our embryologist, Dr Sai, talks to all our patients, and knows each of them, and each of them knows him !

This is why, before you start an IVF cycle, you should make sure that the clinic does only blastocyst transfer; that it provides photographs of embryos to all patients ; and has a full-time embryologist. Please make it a point to speak to the embryologist before you pay your fees, so you can judge competent , caring and expert he is.

Just like you need to ensure that you are in good hands because your doctor is a trusted expert , your need to ensure your eggs, sperm and embryos are in good hands as well, because the embryologist is an expert , and knows what he is doing .

Why you should freeze all your embryos when doing IVF

 

The reason freeze-all IVF cycles have become so popular is because it increases pregnancy rates , by allowing patients to have their cake and eat it too.

In the past . we would do only fresh cycles and fresh transfers , which means the embryos were transferred back in the same cycle in which the egg collection was done.

The reason for this was that the technology for freezing embryos wasn't very good , and many embryos would die during the freezing and thawing process. Today, however, we are very confident about offering this option routinely to all our patients , thanks to the technology of vitrification or flash freezing , where the survival rate of frozen embryos after thawing is 100% in good labs .

This strategy has lots of advantages .

For one thing, we can transfer only one embryo at a time , because we can store the rest safely. This improves the cumulative conception rate without incurring the risk of a multiple pregnancy , which often ends up as a preterm birth because the uterus wasn’t designed to hold more than one baby at a time !

This means that patients can have as many babies as they want - but one at a time , which is the right way to have babies , because twin pregnancies have a much higher risk of preterm births, and these premature babies often end up with multiple complications ( and also run up a huge bill during their NICU stay).

We can also optimise our superovulation strategy during the fresh cycle, and help the patient to grow many eggs, so we get lots of embryos. Because we are not doing a fresh transfer, the risk of OHSS( ovarian hyperstimulation syndrome, which can be a life-threatening complication) ) is nearly zero, and we can go ahead and freeze all the embryos. This is why, when we do a fresh cycle, our focus is on helping you to grow many eggs. However, the price we pay for this is that endometrial receptivity is compromised,  which is why the pregnancy rate in a fresh cycle is not very good , and this is the reason we prefer not transferring fresh embryos.

On the other hand , when we freeze all the embryos and then transfer them in the next cycle after thawing them one as a time, we can focus only on growing the endometrium in the thaw cycle, so that it’s receptivity is optimal. During this cycle, we don’t need to grow eggs, which is why this thaw cycle is much easier and less expensive, because no injections are needed.

This combined option ( freeze all embryos at the blastocyst stage in the fresh cycle and then thaw them and transfer them one at a time) increases pregnancy rates,  because it allows us to grow lots of embryos, and transferring them one at a time reduces the risk of multiple pregnancies and increases live birth rates. You should ensure that all your embryos are frozen only on Day 5; and that the clinic has a full-time embryologist, who will provide you with photos of your embryos, both before freezing them, and after thawing them

How to improve your chances of IVF success

There are several factors that can affect the success of in vitro fertilization (IVF), and the specific steps you can take to improve your chances will depend on your individual situation.

Some general tips for increasing your chances of success with IVF include:

Optimizing your overall health: Maintaining a healthy weight, eating a balanced diet, and being well-informed about the treatment will help you reduce your stress levels. These can all improve your chances of successful IVF.

Choosing an experienced fertility clinic: The success rates of different fertility clinics can vary, so it's important to choose one with a good track record. Find a clinic which 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

Timing your treatment: Your fertility specialist will be able to advise you on the best time to undergo IVF based on your individual situation. Don't wait until you are too old, because your egg quality declines with age, and poor ovarian reserve is the commonest reason for IVF failure today, when the IVF is done in a good clinic.

Sticking to the treatment plan: It's important to follow your fertility specialist's instructions and attend all scheduled appointments to increase your chances of success.

It's also worth keeping in mind that IVF is not always successful, and you may need to try more than once to achieve a successful pregnancy. It can be helpful to discuss your options and expectations with your fertility specialist.

You can download the IVF Comic Book free at www.drmalpani.com/IVFComicBook 

How can you know if your frozen embryos are alive after thawing and are ready to be transferred?

Saiprasad Gundeti, Chief Embryologist, Malpani Infertility Clinic

In IVF treatment, we freeze/ cryopreserve your spare Embryos after your Embryo Transfer to store them as a backup in case your first cycle is unsuccessful, or we freeze all of your Embryos owing to the risk of ovarian Hyperstimulation Syndrome (OHSS) or if the lining is not optimal .

For subsequent frozen embryo transfer cycles, your frozen embryos must be thawed prior to transfer.

Patients typically have lots of questions and are concerned about the viability of their embryos upon thawing.

How can one know if the embryos have survived post thawing and are ready to be transferred?

At Malpani Infertility Clinic, we culture fresh embryos till day 5 and transfer or freeze embryos at the blastocyst stage for all of our patients.

You can see what embryos should look like at www.drmalpani.com/knowledge-center/ivf/embryos

This allows us to select the best embryos for transfer and freezing, increasing your chances of becoming pregnant.

When we freeze Blastocysts on Day 5/Day 6, we put Laser Pulse between the Trophectoderm Cells to artificially collapse them. This reduces the amount of water that must be replaced during vitrification, as well as the duration that embryos are exposed to Vitrification solutions (cryoprotectants), hence decreasing the toxicity of cryoprotectants.

Therefore, when we vitrify (freeze) your Blastocyst, it will be in a collapsed (reduced) state.

For Frozen Embryo Transfer (FET), when we thaw your frozen blastocyst prior to the transfer, it will be in a collapsed state; however, after a few hours of incubation, the thawed blastocyst re-expands.

The re expansion of the blastocyst provides confidence that it has survived and is ready for transfer.

We at Malpani Infertility Clinic often thaw blastocysts three hours ahead of the transfer, which provides sufficient incubation time and re-expansion of the blastocyst prior to transfer. 

We routinely show our patients their embryos before transferring them and explain how their embryos recovered after freezing and thawing, which makes them happy and gives them confidence that their embryos have recovered well from the freezing process and are ready for transfer.         

Need help in making the right decision ?

Please send me your medical details by filling in the form at www.drmalpani.com/malpaniform.htm so that I can guide you better !

Why do bad IVF clinics refuse to give embryo photos routinely to all their patients ?

There are 3 important reasons you should demand photos of your embryos from your IVF clinic

1. This is a global best practice , which all leading IVF clinics all over the world follow , because this allows them to document that they generated top quality embryos. This is invaluable diagnostic and prognostic information as well ! If they did produce top quality blastocysts for you, then you know that your chances of getting pregnant over a period of time are excellent , and you just need to be patient ! However, if you don't have any photographs , this is valuable information that was wasted because of the lack of photos. If your clinic refuses to provide photographs , you have to ask yourself why they are hiding information from you ! All modern IVF labs have cameras attached to their microscopes,  and taking photographs does not harm the embryos at all , which is why we good clinics do this routinely for all their patients.

2. This practise is good for the patient because it proves to them that they received top quality medical care . The fact that the doctor made top quality blastocysts for them increases their trust and confidence in him. Much more importantly, they have peace of mind knowing that they have received the best possible medical care , and didn't leave any stone unturned in their quest for a baby. The outcome maybe uncertain, but embryo photos prove the process was carried out properly !

3. It's also good for the doctor to provide embryo photographs , because good doctors take pride in the high quality of care they provide . If they can provide photos of top quality blastocysts, this confirms that they are competent professionals who are doing a good job for their patients . This is great for the doctor’s reputation as well, because patients will often get a second opinion when their IVF cycle fails, and if the new specialist can see that the first doctor created top quality blastocysts, they can vouch for the fact that good quality medical care was provided , irrespective of the final outcome.

You can see what embryos should look like at www.drmalpani.com/knowledge-center/ivf/embryos

Why Batch IVF has a lower pregnancy rate

 

Now that every gynecologist wants to become an IVF specialist ( because this is considered to be high-profile and profitable) , many gynecologists have started doing IVF in their own clinics. However, because they don't have either the confidence , expertise, competence or experience of doing this, they need to hire an IVF specialist to do the actual medical treatment for their patients.

This is why they do batched IVF . They cycle a group of patients together - usually 5 to 25, depending on how greedy they are. The medical experts who do the IVF treatment then fly down for 1-2 days to actually do the procedures. The gynecologists claims that the success rate for batch IVF is as good as regular IVF, and that this option is much more convenient for patients . who don't need to travel and much less expensive as well. Most patients are also happy with this option , because they prefer taking treatment from a trusted local doctor .

However, the reality is that this is a bad idea because the success rate of batched IVF is terrible, and there are many reasons for this .

For one thing , these gynecologists are not IVF specialists, and are doing this just in order make more money . They often end up having to take shortcuts,  which compromise pregnancy rates.

For example , they are not able to do Day 5 transfers , because the embryologist has left , and they end up transferring many Day 2 and Day 3 embryos, to try to compensate for this. They aren’t able to freeze embryos, because the embryologist is too busy doing ICSI, and doesn't have the time to do this. They end up doing too many cases in one day , because the travelling embryologist and IVF specialist want to maximize their income , which means they have to complete one pick up and transfer in about 10 minutes. The scope for mix-ups and mistakes is much higher in this chaotic setting. All patients end up having their pickups and transfers done on the same day , even if they aren’t medically ready. The doctor is not able to customise the treatment protocol for each patient , because they have to use the same treatment plan for every patient, based on what the IVF specialist tells them . This expert is remote, and has never seen the patient , and really doesn't care about what happens to you.

This is also why the documentation in these clinics is so poor, because the staff doesn't have the time or the energy to take photos of the embryos.

The medical equipment is also not maintained properly, because it is used for only a few days in a month, as a result of which the lab often isn’t able to create good quality embryos, but it’s easy to pass the buck, and the IVF specialist blames the local gynecologist, who blames the specialist, but it’s the poor patient who ends up suffering.

Finally, many of the “extra” eggs and embryos created during these batches are “donated” to other patients, without their permission, knowledge or consent ! This has now become illegal under the new ART Act, but this practice continues merrily nevertheless !