We treat many challenging patients, and because their treatment is complex , they are often unsure what to do next. For example, they have failed 2 IVF cycles elsewhere, and have grown only 3 follicles in the current cycle, even though we have superovulated them aggressively.

They are not sure whether they should cancel the cycle , or whether they should continue because they know that we may or may not get an egg; the egg may or may not be mature; it may or may not fertilize; and it may or may not form a good quality blastocyst.

If they go ahead, they will end up spending a lot of money , and if they don't get to the stage of embryo transfer, this can cause major heart burn.

They want the doctor to decide, and because we are IVF specialists , they expect us to tell them what to do.

The problem is that we can't predict what the outcome is going to be ! We can tell them what the right process is , and offer high quality care technically, but we're not fortune tellers. If we tell them in good faith to go ahead and we don't get any eggs , the patient may feel cheated - she may feel that we did the procedure just in order to earn money, whereas the reason we did it was to give her the best possible shot at getting pregnant - after all, there is no certainty that she will grow even 1 follicle if we try again.

This is the process we use to counsel our patients. We tell them - As professionals , we will not allow you to make a decision which is medically wrong, but when there are choices , we will help you to make the decision which is right for you. However, you do need to listen to your heart to find out what this is !

What to find an IVF clinic which respects your time and intelligence ?
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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