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Not every IVF cycle is going to result in a baby ! How much does the outcome of the IVF cycle depend upon chance ? destiny ? or choice? IVF treatment has now been around for over 30 years. Over 2 million IVF babies have been born worldwide, and the treatment is considered to be safe and effective.

A well-defined process

However, while the IVF treatment process itself is well-defined, the outcome of an individual cycle is always uncertain - something which seems to be true for most complex biological systems. While we are very good at making embryos in the IVF lab, after we transfer them into the uterus, we have no control over whether or not they will implant.

So what affects the outcome of the IVF cycle ? Is it chance ? choice ? or destiny ?

The right mix

Even today, many patients in India will ask an astrologer for help in selecting the most auspicious time to do their IVF treatment. While many doctors will pooh-pooh this kind of irrational unscientific approach, I think this actually helps patients ! It helps them to be more confident because they feel they are now using the right combination of science and religion - and this belief has to be good for patients. It helps them to cover all their bases, so they have peace of mind they tried their best !

Doctors must keep an open mind 

I feel it's good for doctors to be open-minded and to accept our patient's personal deep seated beliefs, whether or not we believe in them ourselves. I am not asking doctors to suspend their scepticism or to start becoming irrational - it's just that as empathetic professionals, if they can comply with their patient's desires, this will help them to have happy patients !

Patients are much more please when they feel that their doctor has listened to their concerns and respected their desires, even if these are "unscientific". After all, who is to say what works and what doesn't ? And even if it does not help, it cannot do any harm, so why not ?

What about the element of chance ? This plays a huge role in everyone's life - and this is true for IVF clinics as well. We all have good months, when everyone seems to get pregnant - and then bad months, when the pregnancy rate drops for no good rhyme or reason. The IVF process is complex and is impacted by many factors, and we still cannot tease apart and isolate all the variables, no matter how good our quality control is !

So does this mean that if the result of an IVF treatment is a matter of chance and destiny that patients should leave everything upto God ? Of course not !

A matter of choice 

Choice still has an extremely important role to play ! Infertile patients have to make many choices themselves - all of which can have a major influence in the final outcome.

Firstly, they have to choose to do IVF treatment - and when to do this. They then have to choose which clinic to go to - and this can make a world of a difference ! It's important for you to choose to be well-informed and actively engaged as I believe this plays a major role in ensuring a positive outcome.

Patient participation helps your doctor to design a better treatment plan, tailored to your needs; and well-informed patients can help to prevent errors and slip ups ! Patients need to speak up - and they can do this confidently if they have done their homework properly !

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

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