Making difficult decisions - a guide for IVF couples

While most IVF cycles are straight-forward, sometimes we come to a cross-roads when it's not always clear what the next step should be .For example, if have poor ovarian reserve, and have grown only 2 follicles after aggressive superovulation, should you cancel the cycle? Or should you continue?These decisions can be difficult to make, and it's especially when patients find they have to make a difficult decision that they expect their doctors to tell them what to do. After all, doctors are professional experts, and they have the experience and the skills to decide. How can a patient decide for herself ? She has never done this before, and is confused, and wants her doctor to decide on her behalf.                               It's very easy for a doctor to be paternalistic and tell you what to do, but I don't think this is a good idea . After all, even if the doctor's intention might be honest, if he tells you to go ahead and then fails to retrieve eggs, the patient is likely to feel cheated. She may feel that the doctor did it only to earn more money - and may resent the doctor for subjecting her to a futile procedure. After all, patients need to live with the consequences of the decision. We don't want them to feel afterwards - "I wish I'd done this," or, "I wish hadn't done that."A respectful doc...
Source: Dr.Malpani's Blog - Category: Reproduction Medicine Source Type: blogs

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Giving thyroid hormone replacement before conception didn't prevent miscarriages or other adverse pregnancy outcomes in euthyroid women with thyroid peroxidase antibodies, shows the TABLET trial.Medscape Medical News
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ConclusionFirst-time parents had varied experiences of proximity and intimacy after the birth. When they chose to prioritize each other, attraction increased, strengthening their relationship and even when busy, those who wanted to be intimate with their partner found sufficient time. During this process, there was sometimes an imbalance between the partners’ sexual needs. Intimacy was then challenged, but not necessarily weakened. New parents need information and guidance on changes that may affect proximity and intimacy in their relationship after childbirth, but receive very little information.
Source: Sexual and Reproductive Healthcare - Category: Reproduction Medicine Source Type: research
Publication date: Available online 22 March 2019Source: The Lancet Global HealthAuthor(s): Fernando Althabe, Elwyn Chomba, Antoinette K Tshefu, Ernest Banda, María Belizán, Eduardo Bergel, Mabel Berrueta, Jane Bertrand, Carl Bose, Maria Luisa Cafferata, Waldemar A Carlo, Alvaro Ciganda, France Donnay, Ezequiel García Elorrio, Luz Gibbons, Karen Klein, Jerker Liljestrand, Paul D Lusamba, Arlette K Mavila, Agustina MazzoniSummaryBackgroundDespite international recommendations, coverage of syphilis testing in pregnant women and treatment of those found seropositive remains limited in sub-Saharan Africa. W...
Source: The Lancet Global Health - Category: International Medicine & Public Health Source Type: research
Publication date: Available online 22 March 2019Source: The Lancet Global HealthAuthor(s): Freddy Perez, Philippe Mayaud
Source: The Lancet Global Health - Category: International Medicine & Public Health Source Type: research
Publication date: Available online 23 March 2019Source: European Journal of Obstetrics &Gynecology and Reproductive BiologyAuthor(s): Laura Sarno, Vedran Stefanovic, Giuseppe M. Maruotti, Fulvio Zullo, Pasquale MartinelliAbstractThrombotic Microangiopathies during pregnancy and puerperium are very rare and, if undiagnosed, can be lifethreating. Pregnancy and postpartum can represent a trigger in predisposed patients. Therefore, obstetricians are usually the first to observe clinical symptoms and laboratory abnormalities suggestive of Thrombotic Microangiopathies.The aim of this review is to briefly describe the obstetr...
Source: European Journal of Obstetrics and Gynecology and Reproductive Biology - Category: OBGYN Source Type: research
This week the Food and Drug Administration approved the first treatment specifically targeting postpartum depression, a condition that can impact women following childbirth, sometimes even starting during pregnancy. Symptoms can include sadness, loss of energy and feelings of guilt and worthlessness. Dr. David Agus joins "CBS This Morning: Saturday" to discuss how the new drug works and how a new personalized video game can help stroke victims.
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Publication date: Available online 22 March 2019Source: The LancetAuthor(s): Miriam K Laufer
Source: The Lancet - Category: General Medicine Source Type: research
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Source: The Lancet - Category: General Medicine Source Type: research
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