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 .

An embryo is not a baby

As an IVF  doctor , I treat women dream of becoming a mother. Many naively expect that once I have made the embryo in the IVF cycle and transferred this into her uterus, she will get pregnant. Lots of women called their embryos embies, because they start thinking of them as their babies. While it is true that embryos have the potential to become babies, there is a huge difference between a baby and an embryo which is simply a fertilized egg. 

You see the debate all the time on the news when it comes to abortion ! People who are pro-life will treat the fertilized egg as being a baby , because they feel it is uniquely human. However, pro-lifes fail to realize that a cluster of cells is nothing more than a cluster of cells, and it needs to undergo many weeks of development before it even starts resembling baby. 

Most women are on a high after their embryo transfer. Many start treating themselves as being pregnant - after all, isn't there an embryo inside the uterus ? However, the sad truth is that most

embryos fail to implant inside the uterus, and IVF cycles fail all the time. I have seen women who have been so devastated by a negative pregnancy test that they break down and cry in my clinic, because in their minds  they have just lost a baby.  They feel that they have miscarried - and have failed to be able to provide their precious embryos with a safe and secure home.

Because patients do not understand the difference between embryos and babies, Malpani Clinic has been the subject of complaints and negative reviews . Patients feel cheated when their IVF cycle fails, and are happy to badmouth their IVF doctor by writing unfair reviews.

If you are not sure why your embryos did not become babies, please send me your medical details by filling in the form at www.drmalpani.com/malpaniform.htm so that I can guide you better !

How to make sense of your IVF doctor’s advice

Infertility specialists are sought after by patients for their tremendous technical expertise. Infertility doctors master technical skills like egg collections and embryo transfers over several years in medical school. Our patients at Malpani Fertility Clinic have come to us not only for our technical prowess but also for our professional opinion. Rightly so, as medical professionals like infertility specialists can properly suggest possible treatment options and advise them on their best course of action.

Although a significant number do expect guidance from the doctor, this is not true of all infertile couples. These couples have a course of action in mind and simply want the doctor to implement their plan as a technician. They want the doctor to carry out assisted reproductive procedures for them in the laboratory as they cannot do it themselves in their own bedroom. For their purpose, a doctor is merely a trained technician than a professional.

Because they know their own minds, this makes them an easy group of patients to deal with , as they do not require much counseling. For them the IVF clinic simply has to carry out their treatment plan. Older women with poor ovarian reserve comprise many of these patients. They are unwilling to consider egg donation or adoption and therefore want the doctor to perform IVF for them, even while knowing fully well that with their depleted ovarian reserve, their chances for success are pretty low. http://blog.drmalpani.com/2012/12/should-patients-follow-their-doctors.html

The reasons behind IVF failures

Even the perfect IVF cycle does not guarantee a pregnancy despite the best efforts of the best IVF doctor. The failure of an IVF cycle can be highly depressing for both doctors and patients. IVF doctors get baffled at why the IVF cycle failed and their competence gets questioned. They try to figure out whether there were other factors involved. Patients with complaints of repeated IVF failures even consider switching clinics as they are emotionally susceptible and need solutions immediately. They woes at the inability to conceive even when seemingly perfect embryos were transferred translates into frustration and extreme distress.

A successful pregnancy by IVF is determined by just two factors: the quality of the embryo created by the doctor in the IVF laboratory and the uterus of the recipient. A top quality embryo is logically expected to develop into a baby in a receptive endometrium, putting the theoretical success rate of IVF at a hundred percent. But the most baffling fact is that even the best embryos in a receptive uterus sometimes, do not implant. This unknown realm depicts the presence of yet another factor. To learn more about this X-Factor in IVF treatment see http://blog.drmalpani.com/2012/09/the-x-factor-in-ivf.html

Is there hope after several failed IVF cycles?

It is a challenge for IVF specialists to deal with patients with recurrent implantation failures. These patients, also labeled as having repeated IVF failures, have undergone numerous IVF cycles without getting pregnant yet. The reasons for the staggering amount of IVF or implantations failures for these women are still unknown.

At Malpani Fertility Clinic, we theorize the reasons for such failures to either be the poor quality of embryos or problems with endometrial reception.

Since the exact reason for IVF failures cannot be pinned down for a particular patient, the treatment options for these patients are in a cloudy scenario. Run down by repeated failures, these patients are highly strung and desperate for a pregnancy. This results in them going to various doctors, with each new doctor offering a new solution of his own to the problem. The range of treatment options thus suggested include intravenous intralipids, PCG for comprehensive chromosomal screening, immunotherapy to treat natural killer (NK) cells and so on.  Find out more about the treatment options after multiple IVF failures at http://blog.drmalpani.com/2012/09/the-best-treatment-option-for-patients.html

Can PGD improve the chances of a successful IVF?

While making embryos in the IVF lab at Malpani Fertility Clinic, we aim at transferring a single embryo of a good quality to the recipient’s uterus which may then implant and develop into a healthy baby. However, our expertise at pinpointing which embryo will develop into a baby is limited. We evaluate embryo quality based on their microscopic appearance. Features such as any fragments of the embryo, the equality of the cells, the cell division rate etc. are examined.  Malpani Fertility Clinic then singles out the embryo that appears best and performs the transfer with this top quality embryo. But even this embryo is likely to be genetically abnormal as its appearance cannot guarantee a normal chromosomal make up.

To solve this problem, Malpani Fertilty Clinic carries out Preimplantation Genetic Diagnosis (PGD). The embryo is biopsied and a few cells removed. We check the chromosome copy number of these cells using Comprehensive Chromosome Screening (CCS) . This technique has great potential as it allows us to select genetically normal embryos. It can improve IVF success rates as they have better odds for implantation than genetically abnormal embryos. Learn more about PGD at http://blog.drmalpani.com/2012/09/should-we-be-doing-pgd-for-everyone.html