Games the mind plays during an IVF pregnancy

This is a guest post from an expert patient, who is pregnant

Dear Dr Malpani,

Today was not a great day- Its 7w2d right now, and I oscillate so much between fantastic days and horrible ones that these remaining 7 months are going to be hard. I see it, I feel it. I place too much weight on my illogical symptoms and I need to let go of that. I have ‘zero’ nausea. I started with hunger pangs and some stretching and aching in the general uterus area and increased frequency of peeing and it’s all dying down. The only thing consistent are my heavy breasts- and I’m taking external progesterone, so I don’t know what to credit them to.

I wake up at night in a sweat, wondering of my baby is still fluttering… worry if it’s growing and as I lie awake at night for a bit- then I just drink water, urinate and try to fall back asleep. I panic in the day if I forget to think about my baby for over an hour. I dream about holding her, then feel guilty for dreaming. I look up baby names, then abruptly shut the browser window. I just wish I didn’t know that I was pregnant- because if I didn’t, all these symptoms that I feel or don’t feel would just be chalked up to nothing. I wish I could go back to the innocent days of not knowing what could go wrong. I wish I could get my faith back right now- because today it’s giving me a very tough time.

I am not complaining - I know that complaints don't help, and that I have a lot to be grateful for. Still, I wish there was a way I could fast forward time !

And if I get through my 8 week appointment with a beautiful ultrasound and a strong beating heart and perfect size baby and sac, I will remind myself with this post that my symptoms- actual or lack thereof mean nothing. I have to enjoy what there is to enjoy and suffer what there is to suffer. Treat both joy and suffering as part of life and keep praying every single day.

As an IVF doctor, all I can do empathise and pray ! I know the waiting is hard - and even after 25 years as an IVF specialist, there's still so much suspense and anticipation while we wait for our patient's HCG reports and pregnancy scan updates.

Why IVF patients need to complain if they are unhappy

IVF treatment does not always go well, and many IVF patients may have complaints about the way they were treated.

However, if you have complaints about your treatment, or want to complain about a particular staff member of the IVF clinic, you are scared to do so, as you feel this confrontation will aggravate your stress. This is why a lot of complaints get bottled up, and patients are reluctant to provide feedback which can help the IVF clinic to improve.

The best way to solve a problem is to do it face to face, right when the problem is occurring, or soon after  State your concerns, needs, and expectations clearly.

• If you have a concern, you should immediately speak up. At a small clinic, you can talk to the doctor directly. A lot of patients are scared to do so, because they feel the doctor is "too busy". However, the job of a good doctor is to take care of patients, and no doctor is so busy that he can afford to neglect his patients. After all, patients come first, and you should focus on making sure you get good care. If you are taking treatment is in a large hospital, you may need to talk to the IVF Clinic Manager or the CEO.
• A lot of patients are scared that the staff will get irritated with them if they complain. However, don't think that the doctor will get angry if you complain. Complaining will not cause your care to be compromised. Good IVF clinics want to help you resolve your problem as quickly as possible. This is in your best interests, and theirs as well. After all, no good IVF clinics wants unhappy patients !
• You should be clear about your own expectations. What do you want? What do you expect the clinic to do? This allows the IVF clinic to know what will help. Please remember that your responsibility does not stop when you identify the problem - a constructive complaint also identifies a solution !
• If the doctor is not accessible, you can always send him your concerns in writing - perhaps by email or as a letter. Written complaints are always taken more seriously.
• It is usually best to resolve problems through face-to-face conversations. These can result in better and faster understanding.
• A good IVF clinic will use your experience to further improve their quality of care. 

At Malpani Infertility Clinic, we take patient complaints very seriously, as they are an opportunity for us to improve. Not only do we have a  have a Patient Complaints and Compliments book, we encourage patients to email me directly, so I can help to resolve their complaints .

Managing patient complaints - Dr Malpani's guide for IVF specialists

The best way to manage complaints is to prevent them. This is why patient education becomes so important.


The trouble is that IVF doctors are very busy, and don't have time to sit and talk to their patients.



Also, for the first consultation, the IVF specialist is usually in "sell mode" and is trying to do his best to convince the infertile couple is that he is the best IVF doctor in town and that they should come to him for their IVF treatment.

He is very likely to overpromise - and fill the patient with lots of false hope, based on sweet talking them, or quoting highly inflated success rates.


While it's easy to fool gullible patients, it's not possible to fool all the patients all the time, and this kind of behaviour is very short-sighted because it comes back to haunt the doctor when the IVF cycle fails.

Patients feel cheated , and feel the IVF failure was a result of the doctor's negligence or incompetence. Even worse, lots of doctors refuse to see patients when the cycle fails. Because the doctor is too busy doing consultations for new patients, the old patients are fobbed off and handed over to an assistant or a nurse. Patients feel abandoned and are angry and vengeful.


It's important that patients have realistic expectations of IVF treatment - they need to understand that the outcome of an IVF cycle is always uncertain and not in anyone's control. If this is explained before the cycle starts, patients are much better able to come to terms with IVF failure, and are much less likely to complain unnecessarily.



This is why doctors need to be proactive, and educate patients, either using books to do so; or with the help or nurses, assistants and counsellors.


We use our IVF Comic book ( which you can download free); and the free IVF e-learning course at www.ivfindia.com to ensure that patients have realistic expectations of our treatment. The fact that we are willing to discuss failure openly actually helps mature IVF patients to increase their trust in us.

Have complaints about your IVF doctor ? Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you better !