While IVF technology has miraculously made successful pregnancy possible for almost every couple, not all IVF Clinics are created equal. Protect yourself from ineffective treatment and possible physical damage by learning how to differentiate between a good IVF clinic and a bad one.

There is no doubt that IVF technology represents one of modern medicine's success stories. Using IVF , we can help couples who could never have a baby with any other technique to start their own family.

However, woe betide the patient who ends up in a bad IVF clinic ! For example , one of the IVF clinics in New Delhi is owned by a skin specialist. This doctor, who is not even a gynecologist , offers IVF treatment ! Not only are your chances of getting pregnant in a bad IVF clinic very low, you also run a major risk of losing a lot of time, money and energy. Not only do you pour your money down the drain, you also end up losing confidence in IVF technology, thus depriving yourself of your best chance of having a baby . And when you do find out afterwards that the IVF clinic you selected was a bad one, there is little you can do about it ! Blaming yourself or cursing the doctor afterwards does not help, which is why you need to be very careful when deciding which fertility clinic in which to do your treatment ! Caveat emptor - and this is why it's very important that you do your homework carefully - you are making a major investment !

Some useful guidelines to help you find the best IVF doctor are here.

How do you identify a bad IVF clinic ? It's important to be critical and careful, and not to take everything the IVF clinic says for granted. A common problem is that even bad clinics will quote high pregnancy rates because these are published in the medical literature, rather than share their own success rates.

Unfortunately, many patients naively assume that all IVF clinics are equally good. They often select a fertility clinic because it is close to them; because they charge less; or because they know of someone who took treatment there and got pregnant. However, remember that there is a world of a difference between a good IVF clinic and a bad IVF clinic - not all IVF clinics are equally good ! It can be far more cost-effective to fly down to a good IVF clinic with a high pregnancy rate, even if this does cost a little more, as your "cost per baby " is likely to be much less, rather than to do IVF in a local fertility clinic with a low pregnancy rate !

Some IVF clinics in India depend upon the services of a part-time embryologist, who flies down only once or twice a month to perform the IVF or ICSI procedures. These fertility clinics batch all their patients together, and then perform about 5-20 treatments over a period of 2 days. This can be dangerous for you ! Not all patients grow eggs at the same rate ! Suppose yours grow too slowly ? Or too fast ? The doctor has no choice, but to perform your egg collection on the pre-scheduled date, thus resulting in a major drop in your chances of conceiving.

Other IVF doctors are only "part-time" IVF doctors. They spend most of their time delivering babies or doing hysterectomies ( which is often far more profitable). They do IVF simply to provide an additional service. Such an attitude often results in their providing a sub-optimal service because they cannot devote the time and energy needed to provide high pregnancy rates. Full-time IVF doctor who do nothing else have much higher pregnancy rates, because their entire reputation and income depends upon their IVF pregnancy rates !

Other IVF doctors enjoy jetting around or travelling from place to place. They set up a "chain of IVF clinics" all over the country to get more patients, and then spend their energies running around from clinic to clinic. This often means that they are not available to monitor your treatment. You may find that you only see the "big-name" doctor once - for your first consultation. Afterwards, this doctor is never available for you !

Other fertility clinics cut corners and compromise by using underhand methods and dirty tricks. They "share" your eggs with other patients without informing you, thus earning an additional income from their egg sharing programs, which they advertise to attract infertile women who need donor eggs ! However, not only is this grossly unethical, it also means that your chances of getting pregnant are drastically reduced !

Many bad IVF clinics do not offer the full range of services a good IVF clinic does. Thus, they do not offer embryo freezing facilities, and they "bad-mouth" embryo freezing technology, claiming that the pregnancy rates with frozen embryos are poor ! Fertility Clinics which cannot freeze embryos are technically inadequate; and will often "donate" your spare embryos to other patients without your consent !

Others buy second-hand incubators; or poor quality equipment. They try to save pennies by not servicing their microscopes; using cheap IVF culture medium ; or "recycling" disposables such as catheters and egg collection needles, thus increasing your risk of acquiring an infection and reducing your chances of getting pregnant. Many have very old, poor quality ultrasound scanners, which make it hard for them to see the follicles or do an egg collection.

I agree that it's very hard for the average infertile patient to judge the technical competence of an IVF clinic. Ideally, your clinic should be open and above-board ; and should be happy to show you around, and share information with you during your treatment.

Signs of a bad clinic include:

  1. When they refuse to show you their equipment or facilities
  2. When you do not get a chance to talk to the same IVF doctor
  3. When they do not show you the ultrasound screen during your monitoring or tell you how many eggs you are growing
  4. When there is a major discrepancy between the number of follicles you grow on scanning and the number of eggs they collect from you
  5. They do not show you your embryos under the microscope
  6. They do not offer embryo freezing facilities
  7. They do not give you a discharge summary at the end of your treatment

What happens in many IVF clinics is very distressing. It pains me when I see patients who have been through many IVF treatment cycles, but know pathetically little about their treatment details, because the clinic never provided them with this information.

Embroidering pregnancy rates is an art some ART clinics are very good at. I know of some doctors who deliberately give their patients repeated HCG injections after embryo transfer, ( Inj Profassi, or Inj Pregnyl) and then measure the blood level of beta HCG a few days later to prove to the patient that she conceived ! Since the beta HCG level is positive, the patient naively believes she did get pregnant (when it become negative, the doctor explains that she miscarried) , little realizing that the positive test result was just a result of the HCG hormone administered to her in the injection !( If the doctor gave her husband the same injection, he would have a positive pregnancy test too ! ) Such a cruel trick not only gives the patient false hope which is dashed to pieces, it also hooks her to the clinic for life, since she "nearly" got pregnant in her previous cycle.

Even "internationally reputed" clinics resort to some underhand practices - and perhaps this is even more dangerous, because few patients dare to question them , given their reputation. Thus, some push unproven treatments such as immunotherapy for recurrent pregnancy losses, offering their patients false hope after making them spend lots of money. Since these treatments are still controversial and unproven, it would only be fair to offer them as part of a controlled clinical trial, at no charge to patients. However, these patients are often so desperate, that they are happy to grasp at straws - especially when these are cloaked in the garb of scientific gobbledygook.

Since knowledge is power, the best way of protecting yourself is by becoming well-informed, so you can critically assess the "facts" for yourself. Books are excellent starting points in your quest for information, and you can start by reading our book, How to Have a Baby, which is available free online !

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

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