IVF FAQs with Dr. Malpani: Clearing Doubts Before You Start
Patient: Dr. Malpani, thank you for taking the time to speak with us today. As we prepare to begin our IVF journey, we have quite a few questions. We want to be sure we’re doing everything possible to improve our chances.
Dr Malpani: I’m so glad you’re asking these questions—it shows you’re taking a thoughtful and proactive approach, which is exactly what every patient should do. Let’s go through them one by one.
1. Pre-IVF Testing: Is there anything more we should check before starting?
Patient: We saw the list of tests you recommended in the consultation sheet, but are there any additional tests—especially for evaluating my uterus or general health—that we should consider?
Dr Malpani: Great question. The standard pre-IVF workup typically includes hormone blood tests (like AMH, FSH, LH, and TSH), an antral follicle scan, and a semen analysis. For the uterus, a baseline transvaginal ultrasound is essential to rule out fibroids, polyps, or an abnormal endometrial lining.
If there’s any suspicion about uterine abnormalities, I may also suggest a hysteroscopy or saline infusion sonogram (SIS). But if your cycles are regular and your ultrasound looks normal, further testing isn’t always necessary.
It’s important not to overtest—you want to focus on tests that will actually impact your treatment plan.
2. Can I continue working during IVF? Or do I need to take time off?
Patient: I have a full-time job, and I’m wondering whether I can continue working throughout the IVF cycle. Are there phases when rest is essential?
Dr Malpani: Most women can absolutely continue working during IVF. In fact, staying engaged with work can help reduce stress and anxiety. The hormone injections and monitoring can be scheduled early in the day so they don't interfere with your job.
The only time I might recommend slowing down or taking a day off is on egg retrieval day, which is done under sedation. And after embryo transfer, you can resume normal activities—even walking or driving home is fine.
The key is balance. Listen to your body, avoid heavy lifting, and get adequate sleep. But there’s no need for total rest unless there's a medical reason.
3. Are there any specific dietary or lifestyle changes we should follow?
Patient: We’ve heard so much conflicting advice about diet and IVF. Some say no caffeine, others suggest strict fertility diets. What’s really necessary?
Dr Malpani: I get this one a lot. There’s no one-size-fits-all “fertility diet,” but here are some sensible guidelines:
- Eat a balanced, nutrient-rich diet—think fruits, vegetables, whole grains, lean proteins, and healthy fats.
- Stay well-hydrated and avoid processed junk food.
- A moderate amount of caffeine is fine—1 cup of coffee a day won’t hurt.
- Avoid alcohol and smoking. These are proven to negatively impact fertility.
- Moderate exercise is good, but avoid intense workouts during ovarian stimulation and after transfer.
In short, live like you’re preparing for pregnancy—because you are!
4. What are the common side effects of IVF medications?
Patient: I'm a little nervous about the hormone injections. What kind of side effects should I expect?
Dr Malpani: That’s very understandable. The medications we use—like gonadotropins for ovarian stimulation—can cause temporary side effects like
- Bloating and abdominal discomfort
- Mood swings or emotional sensitivity
- Mild bruising or soreness at injection sites
- Occasionally headaches or breast tenderness
These are usually manageable and go away after the retrieval.
A rare complication is Ovarian Hyperstimulation Syndrome (OHSS), where the ovaries become overly enlarged and fluid shifts into the abdomen. We take care to minimize this risk by monitoring your hormone levels and follicle growth closely during stimulation.
5. Are IVF babies at higher risk for abnormalities?
Patient: We've heard that IVF babies might have a higher risk of genetic or health issues. Is that true?
Dr Malpani: This is a common concern, and I’m glad you asked. Most studies show that IVF babies are as healthy as naturally conceived babies. There’s a slightly increased risk of certain birth defects—about 1–2% higher—but it’s unclear if that’s due to IVF itself or the underlying infertility.
You can minimize risks by:
- Avoiding unnecessary embryo manipulation
- Transferring a single embryo to avoid complications from multiple pregnancie
- Ensuring that your IVF clinic uses the best lab practices
And remember, all pregnant women—regardless of how they conceived—should undergo routine antenatal screenings and ultrasounds to monitor the baby’s development.
6. Do you recommend PGT-A (genetic testing of embryos) in our case?
Patient: We’re curious about PGT-A—preimplantation genetic testing for aneuploidy. Would it benefit us?
Dr Malpani: PGT-A can be helpful, but it’s not right for everyone. It’s mainly recommended for:
- Women over 35 years, who are at higher risk for chromosomally abnormal embryos
- Couples with recurrent implantation failure or recurrent miscarriage
- Cases with many embryos, to help select the best one
However, PGT-A is not a guarantee of success. It involves biopsying the embryo, which adds cost and complexity. And false positives or mosaicism can lead to discarding embryos that might have implanted.
In your case, if you’re younger and producing few embryos, it may not add much value. I’d be happy to review your test results and suggest whether it’s a good option.
Patient: Thank you, Dr. Malpani. That clarified so many doubts. We feel much more informed and confident now.
Dr Malpani: I’m really glad to hear that. IVF can be complex, but when you understand what’s happening and why, it becomes much easier to navigate. And remember, this is a partnership—we’re in this together.
The more you understand, the more in control you’ll feel—and that’s the best mindset to begin IVF.