We deal with numerous infertile couples that have failed IVF cycles at other clinics. Most of these are poor ovarian responders and one of the most common questions they have is what the minimum of follicles required is, to move forth with an IVF cycle. They want to know whether there is a minimum number below which we will cancel the cycle.

These patients go through a significant amount of stress an apprehension while they are being superovulated, because they are aware that they won’t grow a sufficient number of eggs. A number of their cycles have been cancelled in the past and it’s really cruel that they have to deal with this kind of angst; after all their eggs have been created with a great deal of effort.  Their eggs are precious and it’s their best chance of actually having a baby that has their own genes.

Slim chances of success

And so, when they don’t produce a sufficient number of eggs and the doctor has to cancel the cycle, they are heartbroken. From the doctor’s viewpoint, cancelling the cycle becomes the most rational thing to do. They feel that when the chances of success are so dismal, why should the patient spend so much money on the treatment? The thing they are forgetting here is that their patients knew full well at the outset itself that their chances of success were slim.

And the fact that she has produced very few eggs doesn’t really change anything. If the patient is making a well-informed decision and wants to go ahead with the cycle, then depriving her of that chance can be a very cruel thing for a doctor to do. Many clinics do this because they don’t want to mar their clinic’s success statistics. The truth is that all that’s required is one follicle to go ahead with the cycle. We try very hard to give the patient the baby she wants, but sometimes we have to bear defeat at the hands of biology.

The right counseling

But we don’t stop trying unless the patient explicitly tells us she has had enough. It’s because we counsel our patients well and ensure they have realistic expectations of the treatment and they know what their odds are. This approach gives patients the peace of mind that they have tried their best. They can then decide whether they want to try some other treatment option like donor eggs or adoption.  

When it comes to IVF, the outcome is always uncertain, but we don’t want our patients to regret the fact that they didn’t try their best, regardless of whether this approach reduces our success rates.

Not happy with the attention you are getting from your IVF clinic? Need more information? Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you!

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

Open Video