Why do IVF doctors write such irrational prescriptions ?


This is a standard prescription from a leading IVF clinic in India.
There are 8 medicines described for luteal phase support after the frozen embryo transfer.
This is a textbook example of needless polypharmacy and irrational prescribing.

The only 2 medicines which are needed for luteal phase support are estrogen and progesterone - which are Susten and Progynova. This much is rational.

Duphaston contains progesterone, as does Gestone. Why prescribe 3 different medicines which serve exactly the same purpose and contain the same hormone ?

Pregynl contains HCG and has no role to play in a frozen ET because there is no corpus luteum in a frozen thaw cycle.

Cutenox is Enoxaparin - low molecular weight heparin, which is painful and unproven and expensive.

MCBM69 contains Folic Acid, Mecobalamin, and Pyridoxine . Isn't folic acid enough ?

M2 Tone is an ayurvedic medicine and I can't understand why a Western medicine doctor will prescribe this. Isn't this a kind of cross-pathy ?

Sadly, this kind of prescribing has become institutionalised, and other junior doctors copy and paste the prescription and start advising the same medications for their patients, which is how these stupid practices spread.

I wonder why doctors don't use their common sense when prescribing ? The poor patient spends her entire day taking medicine - and the risk is that if you write so many medicines, she may get overwhelmed and may forget to take the important ones.

Also, this just needlessly add to her bill, without improving her pregnancy rates.

Do clinics prescribe so many medicines to show patients how careful and thorough they are ?

Or is it that they need to keep lots of pharma companies happy ?
Authored by : Dr Aniruddha Malpani, MD and reviewed by Dr Anjali Malpani.