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A number of doctors feel that IVF specialists are now doing too much IVF. A friend, who is a gynecologist, pointed out that he is seeing patients who go to an IVF specialist even when it’s not necessary to do so. In one such case, one of his patients had gone to a clinic and had been told by the doctor there that she should do IVF. Surprisingly, she got pregnant in her bedroom, the very next month.

He felt that we are seeing an onslaught of IVF overtreatment, simply because there are too many IVF clinics around, and each one wants to do as many IVF cycles as possible. It is true that IVF is an effective treatment for infertility, but he was very critical of the fact that current day specialists are now randomly advising it even for couples who have chances of getting pregnant with less complex treatments. In his opinion, this wasn’t fair to the patients.

He felt the problem is that IVF specialists have a stereotyped view. The first thing that comes to their mind (since he is an IVF specialist) is to recommend IVF treatment- that’s what he does  for a living, isn’t it?

If the IVF cycle fails, they approach another IVF doctor for a second opinion. If that doctor too provides that exact same advice, it confuses them even further.  The only difference in the opinion is that the latter doctor suggests  that the patient do the IVF at his clinic, instead of at the other doctor’s. Now, it’s important to keep in mind that IVF is a very expensive treatment and when faced with this kind of dilemma, patients are completely lost about what they should be doing - and even whether they really need to do IVF at all. 

The Paradox

The entire scenario is a paradoxical one. Infertile patients with modest incomes are unable to get IVF treatment, even though they need it, while the very rich get too much of it, only because they are able to afford it.  However, a lot of this may be unnecessary. In retrospect, it’s very difficult to judge whether IVF treatment was really necessary or not. There are a number of cases in which patients who are craving to have a baby, go directly to an IVF doctor as they know that the chances of success are high in this treatment.

The Right Path?

In most instances, they are also aware that there may be simpler and less expensive treatment options available, but they still opt for IVF. It’s not true that all IVF specialists are just out to make oodles of money by doing IVF for anyone who walks into their clinic! The reality is that IVF is the most effective infertility treatment we have available today.

A lot of infertile couples are focused on results, rather than the treatment path which gets them to their final goal. Since it has high success rates, it also ends up being more cost-effective for a number of patients, despite the fact that it’s expensive. They overstep the conventional path of doing scans with timed intercourse, followed by IUI treatment cycles; and it saves them a lot of time.

At the end of the day, it's important that patients make these decisions for themselves; and select the treatment which is right for them. It’s the best way of solving the problem of overtreatment. A well-informed patient will be aware of the less expensive treatment options available, and if she decides that IVF will be the most cost effective option for her, then I wouldn’t say that it is an overtreatment for that patient.

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 better!

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

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