There are times when the quality of embryos in an IVF cycle isn’t up to the mark and it’s natural for the patient to be upset and she wants an explanation. Typically, a credible and good embryologist will sit down and make every effort to explain to the patient the different causes that can result in poor embryo morphology. However, it’s not uncommon to find doctors who will simply dismiss the patient off the bat and give her an unclear and untruthful explanation.

One of the most common reasons that doctors will proffer is that the sperm was of a poor quality. They will very seriously tell the patient that her husband’s sperm morphology was abnormal. Sometimes they will say that there were very high DNA fragmentation levels and that her embryos were of a very poor quality.

ICSI- the purpose of the procedure

These explanations that doctors give their patients are nothing but eyewash. It’s important to keep in view the fact that that we are doing ICSI precisely because the husband has poor sperm morphology. Once the sperm has been injected into the egg, the doctor has almost no role to play in the way the embryo develops, regardless of what the DNA fragmentation level is, or how abnormal it looks.

The sad truth is that the most common reason embryos will be of a poor quality is poor lab condition.  Running an IVF lab is no mean feat; it requires very close and constant monitoring of the equipment and full-time expertise. In addition, it requires that quality-controlled culture media be used and that the plastic disposables be of high quality too. Unfortunately, despite the fact that IVF is such a crucial and expensive treatment, most clinics cut corners and:

  • They may not use good-quality medium
  • Their incubators may shut down because of electricity failure
  • They may not have full-time embryologists to ensure that quality control is being maintained

If there are no stringent quality control measures in place, it’s very likely that the embryos won’t grow well in the lab and they will start fragmenting.

Read more- Why were my embryos of such poor quality?

When this occurs instead of coming clean and telling the patient the truth, the doctor will typically come up with a volley of pretexts and excuses. It’s not very difficult to blame abnormal sperm for the abnormal embryos. As a matter of fact, this makes perfect sense to the patients and they are more than willing to accept this explanation.

If this is what you have been told, it’s important that you recognize that it isn’t the truth. If you do ICSI at a credible and reputed clinic you will get much better quality embryos. It’s also important that you ask the embryologist to show you the embryos of the other patients, who are being treated at the same time. If those embryos too are of poor quality, it is clearly an indication that the lab conditions are to blame, and not your husband.

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.

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