How many IVF cycles should I do ?

This is one of the commonest questions patients who have failed an IVF cycle ask when they come to me for a second opinion.

Is it worth doing anotherIVF cycle ?What should I change ? Do I need to do anymore tests ? Should I expect to do three ? or four? How much stamina do I need? How much will this deplete my bank balance? Will multiple IVF cycles damage my health ?

Sometimes, with a lot of patients, you know that repeating the IVF treatment is futile, but many patients continue clutching at straws , because they're not willing to accept the truth.

Often they read about some fancy new research ( either in the newspaper or on a website )which claims to dramatically improve IVF pregnancy rates . They some with this newspaper report or website printout, saying, "Can't you do this for me?" You then have to do through the details , and often you end up explaining to them that the research was done in a mouse laboratory, and has not been proven to be safe to use in humans,

Then they come after a few weeks , with a full page colour ad from a spanking new clinic that offers the "latest advanced technology" - and ask - Should I go to them, since they seem to offer much more than you can !

False hope can be cruel, but hope springs eternal in the breast , and ifit wasn't for hope, none of us would survive for too long. This is what makes things so difficult for both patient and doctor - it's no fund having to explain the limitations of modern technology to a patient who feels you have all the answers, and wants you to deliver a miracle.

A good doctor would tell the patient the truth that, "Look, a lot of these things which sound good on paper don't stand the test of time . New is not always better, and it's not a good idea to use yourself as a guinea pig."

However, patients need to make their decisions for themselves, and if they want to try something new, unproven and experimental, it's hard to stop them. After all, there is no medical risk when doing IVF - the risk is predominantly financial and emotional. If patients understand that and are still willing to go ahead, then perhaps a doctor should not stop them from doing what gives them peace of mind, even if this is illusory.

However, one thing which patients forget to factor in is the opportunity cost of doing repeated IVF cycles. After all, if you repeat the same thing, you're mostly going to end up with the same outcome - there's no logical reason for it to be different after you have done 4 IVF cycles .

The problem is that because you have locked yourself into repeated IVF cycles, you end up stopping yourself from enjoying all the other pleasures which life has to offer you. Also, this pig-headedness can stop you from exploring alternative options , such as adoption or third party reproduction - a decision which you may come to regret as you grow older.

Need help in getting pregnant ? Please send me your medical details by filling in the form that I can guide you !

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