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But I need only one embryo to get pregnant !
Patients with poor ovarian reserve can be extremely hard to counsel, especially when they're young and have regular periods because they can't understand why they're not being able to get pregnant and why they're failing repeated IVF cycles. After all, they have eggs, t...
Why IVF patients feel helpless
One of the most worrisome aspects of an IVF cycle is the uncertainty involved. The patient never knows whether the next cycle is going to work or not - and neither does the doctor ! The problem is compounded by the fact that they know very little about what happens duri...
Why do so many Indian gynecologists believe that all infertile women have TB ?
I recently attended an IVF conference in Delhi, and came away with the impression that a lot of IVF doctors there seem to feel that every Indian patient who's infertile has tuberculosis. They feel that it's a ubiquitous disease, and that the only reason we don't diagno...
Why IVF doctors continue to order useless tests and offer wasteful treatment
Patients who fail an IVF cycle are extremely vulnerable . This failure is often the last straw, because they are not sure what to do next. They have no idea why the cycle failed, even though the doctor was so optimistic at the time of the transfer. They are usually comp...
A free simple way of improving patient engagement
Patient engagement has become a buzzword today, and lots of efforts have been made to involve patients in their own health care. Here's a free simple way which any doctor can use to empower their patients . After telling the patient what medicines he needs to take, he...
Why we should do only Day 5 transfers for poor ovarian responders
Lots of clinics do Day 5 ( blastocyst) transfers, but they usually reserve them for patients with a good ovarian response - patients who have good eggs and lots of embryos , because they're pretty confident that they will get Day 5 embryos. However, they will use dou...
What can we do get doctors to answer patient's questions ?
One of the commonest complaints patients have about doctors is that they don't bother to explain anything to them. Most of their explanations are short and sweet - curt and to the point. They're full of medical jargon, which means that the patient usually doesn't have...
IVF doctors should stop advising unproven treatments to their patients
An excellent paper, authored by some of the world's leading IVF clinicians, appeared in Human Reproduction, the leading IVF medical journal, in Jan 2017. Adjuncts in the IVF laboratory: where is the evidence for ‘add-on’ interventions? "Those advocating and recommen...
IVF patients need to learn that doctors don't have all the answers
Dear Dr Malpani, I read your recent email with interest, as it relates directly to me. After 5 years of IVF and only one successful transfer, which occurred last year at the age of 49 (2016) and I was pregnant for 11 weeks. Unfortunately the embryo failed at 11 wee...