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

IVF doctors are not mind readers

Unanswered questions and an inadequate knowledge base on the part of the infertile patient can diminish understanding and produce a large amount of anxiety Frequently , patients have complaints and preconceived notions about medical issues that are way off base. This especially true for infertility, because there are so many old wife's tales about this emotionally charged subject.  There are lots of myths about IVF, and these erroneous ideas come from listening to other people talk, a previous unhappy medical encounter , trying to reason an answer out in your own head or just not being sure of the procedure or process.  Your IVF doctor cannot help you to understand the process or clear your doubts if you don’t ask questions.  

Don’t be intimidated by your IVF physician and don’t be embarrassed about your lack of knowledge and understanding.  The only way you’ll learn is to ask questions.  All concerns and misconceptions need to be addressed and clarified before you, as a patient, can emotionally proceed with medical treatment.  IVF doctors understand this and want you to ask questions.  That tells us that you are emotionally involved in your care.  Knowledge is power and a great way to reduce stress and anxiety when dealing with the unknown. 

 Each patient is an individual with their own ideas, so don’t expect your physician to be a mind reader.  Ask your questions, state your concerns and request clarification if you still do not understand.  Be an active participant in your good health.

For more information see http://blog.drmalpani.com/2005/02/doctor-cant-read-your-mind.html

Motivation and IVF outcome

Reviews are everywhere about research conducted regarding physician expertise and experience and how this impacts the outcome of medical treatment.  After all, practice makes perfect and experience produces expertise.  A physician who enjoys his profession and who consistently does the same job repeatedly is much better prepared to care for his patient population.  

The same can be applied to the patient side of a medical relationship ! At Malpani Infertility Clinic we have found a higher rate of conception using IVF with patients who are motivated and involved in their medical care.  Active participation has been noted to significantly improve the results of treatment and the patients have less stress throughout the process.  Becoming psychologically involved with their treatment plans help to keep motivation levels high.

Motivated patients are typically well informed, more compliant and open to treatment options.  This creates a healthier environment and improves success of their treatment goals.  It keeps the stress of the situation in the control of the patient.  Highly motivated patients are usually more involved with understanding the dynamics of disease process and treatment options.  Motivated patients typically do much better than those who are not engaged in all aspects of their healthcare.  

Enquiring and curious IVF patients are much more likely to become happy parents with healthy babies ! 

For more information see http://blog.drmalpani.com/2005/02/impact-of-highly-motivated-patient-on.html

Can an IVF doctor cure my infertility?

Most diseases are addressed by diagnosing the cause of the disease and then treating the underlying health issue . That is the standard practice for most medical physicians.  Determining the diagnosis is the beginning of finding a cure or correcting the underlying problem.  In the field of infertility, this can lead to frustration and complaints by the infertile couple because the treatment modality is a little different.  Unlike other health issues, infertility frequently cannot be cured.  That’s why at Malpani Infertility Clinic, we frequently suggest IVF as an alternative to infertility. 

Here’s an example.  If a man has a low sperm count, the expectation would be that the physician will do a diagnostic work up to determine the cause.  The physician then reviews all of the test results.  Once a definitive diagnosis is made, the physician would then initiate treatment to correct the underlying problem that causes the low sperm count.  Treatment could be surgical intervention or medication depending on the diagnosis. While this is a logical approach, the tragedy is that it does not work well in real life, because we do not know the cause of a low sperm count in most men, which means we cannot treat the problem effectively ! This frustrates patients, who complain that doctors are useless. Many infertile men feel cheated because they have wasted so much time and money on ineffective treatments.

The good news is that treatment for infertility is success driven rather than problem or diagnosis driven.  At Malpani Infertility Clinic the goal is success in giving you a baby ! Instead of focusing on the cause, we often can provide a solution through bypassing the problem. IVF is recommended because IVF technology has provided us with the capabilities of achieving a pregnancy , even when we do not know the cause !

For additional information see http://blog.drmalpani.com/2012/03/we-want-doctor-who-will-treat-cause-of.html

Why follicular studies can be a waste of time

Follicular study ( also known as ovulation tracking ) is frequently the first test which many gynecologists advise for their infertile patients.  At first glance, this would make sense.  The process involves a series of vaginal ultrasound scans which will determine your precise ovulation time.  You then must engage in sexual intercourse at just the right time, the objective being to match the sperm with a ripe egg that will be fertilized.  Pregnancy occurs and the baby arrives several months later!  This seems like a failsafe solution if you are young and all your test results are normal.

Unfortunately, this is not the case and many patients have unrealistic expectations of follicular tracking.  The success rate of this practice is only about 10% in healthy women with perfect cycles.  Human reproduction is not very efficient and timing intercourse is probably not the solution if fertility is questionable.  Couples struggling with fertility are already stressed.

Gynecologists frequently forget the downside of follicular studies.  Taking the time from a work schedule or home life to have the ultrasounds done can create stress for the prospective parents.  What’s even worse is the emotional stress and loss of spontaneity during sex.  This can be deterring to even the most healthy sex life.  While women become focused on the exact time of ovulation and the need for perfectly timed  intercourse, men feel like all the fun has been taken out of one of their favorite pastimes.  This “baby lust” can negatively impact the emotional and sexual relationship between the couple and cause marital discord. Men begin to feel they are taking a backseat to the process of conception.  Male complaints include feelings of being sexually diminished and feeling like they are only being used as a sperm donor.  

Dr. Malpani does not want any of his infertile patients to feel this way.  Do not cheat yourself out of happiness just to have a baby ! 

Please read Why follicular studies ( ovulation tracking ) can be a waste of time