As an IVF doctor, I'm very respectful of patients' preferences. After all, infertility is not a medical problem, it's a social construct. Lots of people are quite happy not having a baby, so if they choose not to have one, that's their choice too ! We treat them as intelligent adults and explain all their options to them, including adoption or third-party reproduction, so they can make a well-informed choice.

I try not to be dictatorial, which means if they have personal, we encourage patients to express them, and try to work with them.
On the other hand, I'm still the doctor in the room , and as a medical professional, I will not perform medical interventions which will reduce their chance of getting pregnant, even though it is profitable for me to do them.

Thus, doing lots of tests can help me generate a lot of money , but this is not in their best interests, as it does improve pregnancy rates. There is a whole list of procedures which many other IVF clinics do to maximise their profits, but we will refuse to do these. These include: ERA testing; PGT; immune therapy; NK cell testing; TB PCR testing; empiric therapy with LMWH ! In fact, the fact that there are so many "empiric" treatment options clearly means that nothing works !

Some patients appreciate the fact that we are being conservative because we are good doctors, and put their interests first. They are happy to work with us, because we explain to them why we are not doing these unnecessary tests and treatments. However, others are extremely unhappy , because they think this means we are technologically backward, and they go on to find a doctor who's more willing to do what they demand !

What to find an IVF clinic which respects your time and intelligence ?

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

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