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Patient Beware: Multiple-Cycle IVF Packages and Their Hidden Agendas
August 24, 2023

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Most commercial IVF clinics are designed in order to maximize their revenue and not to optimize patient care. When they sign up for a new patient, they usually convince them to sign up for a three-cycle package. And it's quite easy for them to do this, because they're in sell mode, and the staff is very charming and helpful. They offer easy payment terms (interest-free EMI options), as well as a special “one-time only” discount for the second and third cycles if they sign up before the first cycle starts. Because patients know that the success rate in one IVF cycle is not 100%, they are quite willing to sign up for a multiple-cycle package, because this allows them to create a safety net for themselves, so that even if their first IVF cycle fails, they still will be able to do a second or third, in case this is required, at no extra cost.

Unfortunately, they don't realize that this is a trap because when the first cycle fails, the sunk cost fallacy comes into play. Instead of them looking for a second opinion or trying to find another clinic, especially if they weren't happy with the quality of care they received in the first cycle, they're forced to do a second and a third cycle in the same clinic, even though the medical care was terrible because they've already paid the money in advance. And these patients become extremely unhappy and dissatisfied and feel they were cheated. But because they've already spent the money, they don't have a choice and feel trapped.

Many of these clinics will take undue advantage of the fact that patients have signed up for the three cycle package by upselling in the second cycle! They start offering additional expensive add-ons such as ERA or PGD or costlier recombinant FSH injections, by saying – your first IVF cycle failed because your embryo quality was poor, but we can improve the chances of embryo implantation in the second cycle by using more expensive injections, or doing PGD, or some other equally false reason. And because patients are ignorant and gullible and don't know any better, they're happy to pay an additional Rs 20,000 or 50000 ( or whatever the doctor charges), because they hope this will improve their chances of success. Actually, this strategy is used only to help the clinic make more money because, in a bad clinic, the outcome for the second cycle is also going to be a failure. And then when it's time for the third and the final cycle, the doctor starts pushing them to consider either using donor eggs or donor sperm or donor embryos or surrogacy, for which they're happy to charge even more money!

The poor patient feels trapped. They have lost all hope, because 2 IVF cycles have already failed, and are willing to try something different because they are so desperate to have a baby. And these clinics are very good at hiding information and telling patients a lot of lies, as a result of which patients will often be completely confused. Because they are at their wit’s end, and very gullible because of their ignorance, it's very easy to take them for a ride. And this is exactly what a lot of these clinics are doing, which is why IVF is getting such a bad reputation in this country. These clinics don't bother to provide any documentation to the patients and don't provide them with any photographs of their embryos, which means it’s impossible for an independent IVF expert to judge the quality of care they have received. And when they try to get a second opinion, the old clinic refuses to share information, so the new doctor is also completely in the dark, and needs to start from scratch!

The truth is it’s very difficult for an IVF doctor to make any comment about the quality of IVF care if there are no embryo photos. So please beware, and don't allow these clinics to cheat you, because not only you will end up losing a lot of money, but you will also fail to have a baby, because of the poor quality care they provide.

Authored by : Dr Aniruddha Malpani, MD and reviewed by Dr Anjali Malpani.