It is Best to Let IVF Patients Make Their Own Informed Decisions

A patient who had been advised IVF treatment found during her pre-IVF treatment workup that she had a five millimeter endometrial polyp in her uterus. Another IVF doctor she had gone to had advised her to get the polyp removed before getting her IVF treatment. This patient came to Malpani clinic for a second opinion from me.

In cases like this, it is hard to make definitive decisions. Each doctor has a subjective opinion of issues like this which fall in the grey areas of medical practice. Most doctors do believe in removing anything from the uterus before putting an embryo inside the endometrial cavity . Naturally, they suggested she get an operative hysteroscopy to get the polyp removed prior to the IVF cycle. This being a standard and logical approach , is usual medical advice.

On the other hand, many doctors consider this move unnecessary as there is no evidence that a small polyp affects embryo implantation. Since, there is insufficient clinical evidence for a concrete conclusion to be made, this issue remains controversial. IVF specialists tend to see only infertile women and they are quite likely to assume that if a woman has uterine polyps, that these are the cause of her infertility and will therefore, suggest their removal.  However, contrary to this belief, it is a fact that even fertile women can have endometrial polyps and can get pregnant even if these are left alone. Since, they don’t have a fertility problem in the first place , neither they nor the doctor ever discover it.

This leaves both the doctor and the patient in a state of confusion. The patient gets contradictory advice from different experts. One advocates surgery, the other advises her to leave the polyps alone. What is she to do?

Are you confused as well ?  Do you need an objective high quality second opinion from an IVF expert ? Please send me your medical details by filling in the form at www.drmalpani.com/malpaniform.htm so that I can guide you better !

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 !