Why IVF patients are treated as guinea pigs
I am very critical about the overtesting which is so rampant in IVF today. This leads to overtreatment , and ends up wasting a lot of time and money , because no one really knows how clinically useful a lot of these test results are. Just because tests make logical sense on paper doesn't mean that this logic always translates into clinical benefits. The sad fact is that real life can be quite messy , and what sounds very sensible in theory often does not work out well in practice .I recently saw a patient who had failed multiple ICSI cycles. His doctor had told him that this was because of his high sperm DNA fragmentation,...
Source: The Patient's Doctor - July 23, 2014 Category: Obstetricians and Gynecologists Tags: Assisted reproductive technology DNA fragmentation Egg donation Embryo transfer In vitro fertilisation Intracytoplasmic sperm injection patient Preimplantation genetic diagnosis Source Type: blogs

To be or not to be ( pregnant !)
(Source: The Patient's Doctor)
Source: The Patient's Doctor - July 22, 2014 Category: Obstetricians and Gynecologists Source Type: blogs

Why some doctors are scared of Information Therapy
This article first appeared in the Autumn issue of the Private Practice Magazine, which is published in Australia. (Source: The Patient's Doctor)
Source: The Patient's Doctor - July 22, 2014 Category: Obstetricians and Gynecologists Tags: Evidence-based medicine Information needs Information Therapy Kahlil Gibran Latin patient United States Source Type: blogs

The difference between follicles and ovarian cysts
  Cyst ? Or follicle ?A patient just sent me this queryI am 29 and trying to conceive for past 4 years.I have irregular cycles. My doctor prescribed me Injection recagon 100units for 6 days from 12-May-2014. On 11th day of cycle during follicle study I got dominant follicles on both ovaries and doctor prescribed to take orgamed capsules for 14 days This month I didn’t get my periods and HPT is negative and even checked with doctor , it is negative again and she prescribed me regestrone tablets for 10 days I have a clarification . If I got dominant follicles on both ovaries, where the follicles would have gone? A...
Source: The Patient's Doctor - July 21, 2014 Category: Obstetricians and Gynecologists Tags: Anti-Müllerian hormone Antral follicle Follicle-stimulating hormone Irregular menstruation Luteinizing hormone Menstrual cycle Ovarian cyst Polycystic ovary syndrome Source Type: blogs

Great video on why human reproduction is so inefficient
Many infertile couples who do IVF are frustrated by the fact that the success rate is not 100%. After all, if the doctor is actually making embryos in the lab, then why shouldn't they get pregnant in the first cycle itself ? After all, isn't every embryo a potential baby ?Sadly, human reproduction is not very efficient, and even fertile couples take time to make a baby. To see why, check out this brilliant BBC video , Inside the Human Body: CreationInside the Human Body: Creation [1/4] by silichip (Source: The Patient's Doctor)
Source: The Patient's Doctor - July 20, 2014 Category: Obstetricians and Gynecologists Tags: Assisted reproductive technology BBC Embryo Hammersmith Hospital In vitro fertilisation Infertility Louise Brown Pregnancy Source Type: blogs

Hospitals can be dangerous to your health
Hospitals were originally designed to be places of sanctuary , where patients who are sick could be taken care off in a facility which was comprehensive because it brought lots of doctors and specialists and nurses and medical equipment together under one roof . It was much easier for the doctor. to provide care to ill patients in a hospital, as patients did not need to run around and all the medical facilities were available in one facility.Both patients and their family members and doctors felt safe when the patient was admitted to hospital because they knew that the latest medical technology and medical expertise were a...
Source: The Patient's Doctor - July 19, 2014 Category: Obstetricians and Gynecologists Tags: complaints dangerous hospitals hospital bed hospital complaints Indian hospitals Malpani medical complaints Source Type: blogs

Low cost IVF treatment in developing countries
" The unmet need in developing countries is higher still. That is partly because people have less money, but also because infertility is more common. Genital mutilation, unsafe abortion and poorly attended births cause infections that leave women with blocked Fallopian tubes, making normal conception impossible. Sexually transmitted diseases scar both men’s and women’s reproductive systems. The World Health Organisation estimates that around 50m couples worldwide have been trying to conceive for at least five years without success. Almost none of those in developing countries can hope to get treatment. The...
Source: The Patient's Doctor - July 18, 2014 Category: Obstetricians and Gynecologists Tags: Africa Asia Assisted reproductive technology Fallopian tube In vitro fertilisation India Infertility ivf Source Type: blogs

Expert advise about IVF from an expert patient
This was a question a reader posed to Manju, our expert patient. Question:Need your advice - IVF . I have been on menopur 75 iu and gonal f multi dose 450 iu from 3/7/14 to date taking 225/0 in the morning and at night. I am 42 years old. Yesterday my scan and blood test showed estrogen level of 69 with 4 follicles. I have one ovary and the size of the follicles are 7.6, 6.4, 6.1 and 6.0 the nurse said they are not growing fast enough and we should cancel on Saturday I.e tomorrow if the estrogen level does not increase and if the follicles don't grow.  I need your advice.. I decided to give it my all and continue to t...
Source: The Patient's Doctor - July 18, 2014 Category: Obstetricians and Gynecologists Tags: Follicle-stimulating hormone In vitro fertilisation Infertility Manju Menotropin Ovary Pregnancy www.myselfishgenes.blogspot.com Source Type: blogs

Infertile Patient query - IUI versus laparoscopy ?
Hi, Dr Malpani. I have been reading your blog and have found it to be very helpful. My husband and I have started infertility treatments and options. Briefly, this is what has happened: -We have been trying for a year naturally (both 29 years old) -Did blood work to check all hormonal levels and everything is normal -Husband did semen analysis and that is better than normal -PCT was done twice (wish I had known this is kind of outdated and most doctors don't do this but oh well, what is done is done!) and both showed that sperm were not swimming like they should at all -Doctor/OBGYN had recommended using mucinex but cervic...
Source: The Patient's Doctor - July 16, 2014 Category: Obstetricians and Gynecologists Tags: Artificial insemination Dr Malpani endometriosis In vitro fertilisation Infertility Invasiveness of surgical procedures laparoscopy Surgery Source Type: blogs

IVF overtesting in the futile quest for certainty
When I review the medical records of patients who have done IVF in other clinics , I'm quite amazed by the amount of testing which they've undergone . A lot of these tests are extremely expensive  -and many are exotic ; of unproven value; and provide information which is of no clinical use. It’s a long list – and includes: NK cell testing; pregnancy destroying factor; TB PCR testing of the endometrium; and TORCH tests.Why do doctors do so many unnecessary tests ?There are multiple reasons.One is financial. It’s much more profitable to order the test , and it's often easier to do this. One of the reas...
Source: The Patient's Doctor - July 15, 2014 Category: Obstetricians and Gynecologists Tags: Assisted reproductive technology Health In vitro fertilisation Latin Medicine Natural killer cell patient Scandinavia Source Type: blogs

Fee for service results in overdoctoring
" The financial incentives for doctors are wrong. Sometimes a doctor should be rewarded for not intervening !" http://www.ehfg.org/839.htmlIf we pay surgeons for doing surgery, then why are we surprised that they respond rationally to these economic incentives by doing more surgery ?  It's not the surgeons who are unethical - it's the incentives which are irrational !If back surgeons were paid for not doing back surgery, I am sure many more of them would advise conservative non-surgical therapy ( just like so many orthopedic surgeons do , once they retire from active surgical practise) (Source: The Patient's Doctor)
Source: The Patient's Doctor - July 14, 2014 Category: Obstetricians and Gynecologists Source Type: blogs

IVF process versus outcome
The outcome of an IVF cycle is always uncertain . When a cycle fails, the patient is never sure whether the failure was because the right process was not followed, or because of plain bad luck or an intrinsic  biological problem ( for example, women with poor quality eggs have a low chances of success, no matter how good the quality of medical care they receive)How does the patient judge the quality of care provided – whether or not the doctor did a good job technically and followed all the right medical processes ?Sadly, most patients are never certain whether she should change the doctor for her next cycle; or...
Source: The Patient's Doctor - July 14, 2014 Category: Obstetricians and Gynecologists Tags: Clinic Health In vitro fertilisation Infertility ivf Medicine patient Reproductive Health Source Type: blogs

The 2014 budget and the Indian healthcare industry
The healthcare industry was very hopeful that the 2014 budget would provide lots of incentives for health care service providers. There was a lot of buzz that the government would place a lot of stress on education and healthcare; and that they would make universal healthcare a reality for all Indians.Unfortunately , none of that has come to pass, and hospitals, doctors and patients are quite disappointed. The only sweetener is the fact that healthcare checkups ( upto a cost of Rs 5000 ) have been made tax exempt. This is actually a regressive step ! It will only encourage people to get health checkups done. However, a lot...
Source: The Patient's Doctor - July 12, 2014 Category: Obstetricians and Gynecologists Tags: budget budget 2014 Health insurance healthcare Healthcare in India Jaitley Source Type: blogs

SCOPED helps patients make better decisions
Making decisions when you are ill is hard. Patients are often confused - and the overload of poor quality information on the internet just makes a bad situation worse.Doctors are often not very helpful, because they can be quite directive, and are likely to push patients into doing what they think is right for them, rather then allow patients to make up their own mind.Jeff Belkora developed SCOPED as a checklist for making decisions. SCOPED stands for: Situation, Choices, Objectives, People, Evaluation, and Decisions. People use SCOPED to think, talk, read and write about decisions.  Situation: clarifying known f...
Source: The Patient's Doctor - July 11, 2014 Category: Obstetricians and Gynecologists Tags: Conditions and Diseases Evidence-based medicine Health Health care Joint Commission Objectives United States Source Type: blogs

For patients considering surgery, knowledge is power
 Clear, specific patient education helps patients - and surgeons !  Decision and communication aids used in orthopaedic practice had benefits for both patients and surgeons. These findings could be important in facilitating adoption of shared decision-making tools into routine orthopaedic practice. Some surgeons are worried that if they tell the patient all the possible risks and complications of surgery, they will  be scared and refuse the surgery.As this study shows, this is not true ! Surgeons need to respect their patient's intelligence, and help them to make the right decision for themselves b...
Source: The Patient's Doctor - July 10, 2014 Category: Obstetricians and Gynecologists Tags: Health Invasiveness of surgical procedures Medicine patient Patient Education Surgeon Surgery United States Source Type: blogs

Malpani Clinic specialises in treating women with failed IVF cycles
After a failed IVF cycle it's often hard to bounce back. Even though your head understands that IVF doesn't have a 100% success rate, it's hard to deal with the failure. In their heart of hearts, every patient who starts an IVF cycle believes that this cycle is going to work ! ( If they didn't, it'd be very difficult to even start the cycle ). However , failed IVF cycles are a fact of life and over 50% of cycles will end up as failed IVF cycles, no matter how good the IVF clinic. The failure rate is much higher in poor quality clinics.Many IVF doctors do not like treating these patients, because they believe they have redu...
Source: The Patient's Doctor - March 26, 2014 Category: Obstetricians and Gynecologists Tags: ICSI In vitro fertilisation Infertility Intracytoplasmic sperm injection ivf Malpani Infertility Clinic Poor ovarian reserve Source Type: blogs

When more is not better in IVF - PGS/CCS reduces IVF success rates
PGS and CCS seems to be the hottest new flavour of the month in IVF. Many patients come to us and ask that we do PGS/CCS for them. Typically, these are older women or those who have failed IVF cycles elsewhere. They have read about this new technique online, and want us to do it for them, because it is supposed to improve IVF success rates.There is a good reason why PGS/CCS is so appealing. It allows us to screen embryos , so that we can selectively transfer only the genetically normal embryos. Isn't it common sense that doing so will improve IVF success rates ?  And since it's the newest technology around, it's being...
Source: The Patient's Doctor - March 25, 2014 Category: Obstetricians and Gynecologists Tags: Embryo Health In vitro fertilisation Infertility Intracytoplasmic sperm injection PGS Preimplantation genetic diagnosis Reproductive Health Source Type: blogs

NK cell testing – yet another way to exploit the vulnerable infertile patient!
This is a guest post from our expert patient, Manju.I get mails from patients saying that their NK cell number or NK cell activity is high and hence their doctor has asked  them to undergo  immunotherapy , using either IVIG infusion ; or intralipid therapy; Lymphocyte Immunotherapy (LIT) ; or tumour necrosis factor alpha blocking agents and steroids , or a combination of these, in order to 'treat' this abnormality.  They are advised that, by doing this, they can improve their chance of having a baby. Is this claim justified ? What are NK cells ? What are their functions in human body ? How are they connected...
Source: The Patient's Doctor - March 24, 2014 Category: Obstetricians and Gynecologists Tags: Asia Biology Biotechnology Blood Cell Biology Embryo immune therapy ivf NK cells NK testing Pregnancy Stem Cells Source Type: blogs

The older newly married couple and infertility
We are now seeing a different kind of patient in our clinic these days. These are couples who are older and have got married recently , so typically the wife is more than 35 ; the husband is more than 40. They are usually professionals who have had very busy lives and fulfilling careers . They are doing very well for themselves ; and chose not to get married for many years because they couldn't find the right person. Now that they have finally found the right person ( often online , thanks to sites like shaadi.com; or through friends, neighbors, relatives),  when they finally hook up with someone they then need to dec...
Source: The Patient's Doctor - March 24, 2014 Category: Obstetricians and Gynecologists Tags: ICSI In vitro fertilisation Infertility Intracytoplasmic sperm injection ivf Malpani Infertility Clinic Poor ovarian reserve Sperm donation Source Type: blogs

The noncompliant doctor
A lot has been written about patient compliance . Lots of doctors ( and pharmaceutical company executives) believe that if patients learn to be compliant and follow the doctor’s instructions , they will get better. Patients are expected to do what the doctor orders them to and doctors believe that patients will follow their instructions.Interestingly, while the traditional  belief was that compliant patients did better than those who did not follow their doctor’s orders, we now know that noncompliant patients are of two different kinds . One doesn’t follow instructions because they cannot afford the ...
Source: The Patient's Doctor - March 23, 2014 Category: Obstetricians and Gynecologists Source Type: blogs

Infertility in Hindu Mythology - Dr Devdutt Pattanaik
This is a guest post by my friend and renowned mythologist, Dr Devdutt PattanaikHaving children has always been important since time immemorial, and the continuity of the family unit has been of major significance in Hindu culture. Infertility is a social stigma even today, and Indian mythology is full of stories about what couples have done in the past to overcome their problem of infertility.Ancient tales hold the key to the unconscious desires of a people. They help us appreciate the fears and insecurities of people who visit state-of-the-art infertility clinics. In this article, sacred narratives from ancient scripture...
Source: The Patient's Doctor - March 22, 2014 Category: Obstetricians and Gynecologists Source Type: blogs

The perfect IVF doctor !
If you want an IVF  doctor who:1.  Answers all your questions 2.  Responds to your email ( usually within 24 hours)3.  Doesn't force you to come in for every little problem4.  Treats you like an intelligent adult, and invests in patient education and information therapy5. Is open and transparent and provides clear documentation of all your IVF treatment7. Provides a receipt for 100% of your payments8. Has a high success rate9. Uses proven technology10. Does not over-test or overtreat11. Is focused on doing IVF because he does only IVF treatments and nothing else12. Is always available because he ha...
Source: The Patient's Doctor - March 21, 2014 Category: Obstetricians and Gynecologists Source Type: blogs

Why do doctors order so many tests ?
One of the things doctors do most commonly is order tests. The uncharitable explanation for why they do so many tests is for financial reasons. It’s an open secret that the diagnostic laboratories and scan centers often give doctors a kickback (commission ) on each test, which means that it makes financial sense for them to do lots of tests . However, there are lots of ethical doctors who do not get kickbacks , and yet they order lots of tests. Why is this so ?One of the reasons is a very common psychological fallacy most of us are fooled by. We often believe that the more the data we have , the more accurate will be...
Source: The Patient's Doctor - March 20, 2014 Category: Obstetricians and Gynecologists Source Type: blogs

How the fear of failure hurts IVF patients
It is often the fear of failure which causes many infertile patients to stay away from exploring IVF treatment.  This fear can be a major emotional hurdle, which stops them from exploring IVF. Even though they know that IVF is the one treatment option which has the highest success rate, they will refuse to consider the option. They prefer keeping it “ in reserve” – as a last resort, in case everything else fails. However, this decision to defer IVF does carry a major opportunity cost , because ovarian reserve declines the longer the decision is postponed.This is the reason many infertile couples will...
Source: The Patient's Doctor - March 19, 2014 Category: Obstetricians and Gynecologists Source Type: blogs

Dealing with the risks of IVF
One reason patients find it so hard to start an IVF cycle is because of the risks associated with IVF. The good news is that the medical risks are very low – and in a good clinic, these are virtually zero. The major risk is financial , and this can be a major hurdle for many patients, However, it can be quantified and patients can make a well-informed decision as to whether or not they want to take on this risk .The major intangible risk which puts many patients off IVF is the emotional risk – how will I cope if the cycle fails. Patients are often not able to express this risk , because the fear of failure para...
Source: The Patient's Doctor - March 18, 2014 Category: Obstetricians and Gynecologists Source Type: blogs

How entrepreneurs can extract maximum value from angel investors
Let’s start of by looking at the world from the angel investor’s perspective. What do angels want from entrepreneurs ? The simple answer is that they expect them to make a lot of money for them  ! After all, angel investors are not in the business of doing philanthropy . They are investing their hard earned money and expect a return on their investment.  However, most angel investors are also mature enough to know that most startups will fail off . They understand that backing a startup is a risky venture , and that most startups will go belly up, giving them a zero return on investment . Even though ...
Source: The Patient's Doctor - March 17, 2014 Category: Obstetricians and Gynecologists Source Type: blogs

Did I cause my IVF cycle to fail ?
Dealing with the failure of an IVF cycle can be one of the hardest things that an infertile couple has to go through . One of the unexpressed concerns which the wife often has is – Was I responsible for the failure of the cycle ? Did I do something wrong which caused the cycle to fail ? Was it because I lifted a bucket or sneezed after the transfer which caused my beautiful embryos to fall out of my uterus ? Is there something wrong with my body ? Is my uterus rejecting my embryos ? Is my immune system out of whack ? Is my body too hot ? Or am I too fat ?These are all concerns that a lot of times patients do not get ...
Source: The Patient's Doctor - March 16, 2014 Category: Obstetricians and Gynecologists Source Type: blogs

Stress and IVF Cycle Failure
The procedure of IVF is tough to handle physically as well as emotionally. Every patient undergoing the treatment experiences tremendous stress regarding the procedure outcome.  Since IVF is often the last resort for infertile patients, it is obvious that the patient will be anxious about the treatment and its outcome. The problem arises when the IVF cycle fails . Many doctors will cruelly blame the patient for the failure, by saying that her high stress levels caused her uterus to “reject” the embryos they transferred into her. After a failed IVF cycle, patients have very low self-esteem, and many of them...
Source: The Patient's Doctor - March 14, 2014 Category: Obstetricians and Gynecologists Source Type: blogs

When Over testing is Harmful for Infertile Patients
Medical testing helps the diagnosis process by providing the physician with a clearer view of the patient’s problem. All patients expect the doctor to order tests when they go for a consultation – and this is true for infertile patients as well. Ideally, tests should be ordered judiciously, in order to help improve the patient’s treatment and increase her chances of having a baby. However , these days doctors seem to mindlessly order a battery of tests for all their patients.  This is often because following a fixed protocol is much more cost-effective for them.  It also seems to provide reassur...
Source: The Patient's Doctor - March 13, 2014 Category: Obstetricians and Gynecologists Source Type: blogs

Avoiding the blame game after a failed IVF cycle
The period after a failed IVF cycle is very stressful for the patient. Most of the time  the patient is not prepared to accept the failure. The failure of the cycle comes as an unexpected shock to her and her relatives. In such a situation, the patient looks for a target to blame the failure on. After spending so much money, and taking so many injections, she is understandably upset that she has got nothing in return. The easiest target in sight is the IVF doctor.  This is especially true when the doctor over-promises success . Part of the problem is that at the time of the first IVF consultation, most IVF doctor...
Source: The Patient's Doctor - March 12, 2014 Category: Obstetricians and Gynecologists Source Type: blogs

Is IVF success a matter of Skill or Luck ?
IVF is now a mature medical technique that has helped many infertile women worldwide in having a baby. Even though IVF has the best success rate amongst all the treatment options available to infertile couples,  the outcome of an individual  cycle is always uncertain. No specialist can predict whether the cycle is going to succeed or not. Does this mean that IVF outcome depends upon fate ? Is it just a matter of chance? There are many educated patients who choose to do the embryo transfer on an auspicious day. They have an astrologer who tells them the perfect date , when they will have the highest chances of con...
Source: The Patient's Doctor - March 11, 2014 Category: Obstetricians and Gynecologists Source Type: blogs

Fresh or frozen embryos: Which is the better option ?
The decision of whether to use fresh or frozen embryos for IVF has become a contentious issue only recently.  In the past, the decision was easier and fresh embryos were the best option for many years. This is because the procedure for freezing embryos was not well developed enough, which meant that the quality of the frozen embryos after thawing was often poor. This is why the success rate of IVF with fresh embryos was much higher than with frozen embryos in the past.With time, the medical technology has developed newer and better techniques for freezing the embryos. Initially, the viability of the embryos was lost d...
Source: The Patient's Doctor - March 10, 2014 Category: Obstetricians and Gynecologists Source Type: blogs

What to expect during an IVF pregnancy?
The first trimester of any pregnancy – whether normal or by IVF - is always an emotional roller coaster ride. A woman who is pregnant for the first time is bound to be filled with anxiety and excitement about her pregnancy. A positive pregnancy test is always a memorable moment in a woman’s life. In the case of a normal pregnancy, a woman does a urine pregnancy test after missing her period, and she then visits her OB-GYN. The situation is quite different for a woman who has undergone IVF treatment because she has been through the dreaded 2ww after the transfer. The HCG test is a test of patience and fortitude ...
Source: The Patient's Doctor - March 9, 2014 Category: Obstetricians and Gynecologists Source Type: blogs

The Infertile woman with Pelvic Pain
Pelvic pain and infertility are both common complaints in young women of reproductive age. Since they are both so common, many patients will have both pelvic pain and infertility.  There are various conditions which can cause these symptoms, including  endometriosis and pelvic inflammatory disease ( PID). Each of these needs a different line of treatment.When a patient comes to me with these complaints, then it becomes imperative to decide what to treat first.  For most patients, getting pregnant takes priority. The beauty is that getting pregnant will automatically take care of the pain as well ! Tackling t...
Source: The Patient's Doctor - March 8, 2014 Category: Obstetricians and Gynecologists Source Type: blogs

Why do doctors get paid so little ?
When I see patients haggling over the doctor’s fees, I am often confused by their behavior. There is not enough recognition in society about the value of a doctor’s hard work. I feel doctors and medical specialists are overworked – and underpaid.The general perception is that doctors are rich. It is a common complaint of patients that doctors overcharge for their services , while the fact is that their fees are not commensurate with their efforts.Let’s compare doctors and lawyers.  These are both learned professions , and medical students and law graduates need to put in a lot of hard work in o...
Source: The Patient's Doctor - March 7, 2014 Category: Obstetricians and Gynecologists Source Type: blogs

Why infertile patients should make their own decisions
At Malpani Clinic, sometimes I see patients who have already made up their mind regarding what treatment they want. This poses a dilemma for me , as to whether I should comply with the patient’s wishes,  or use my medical experience and expertise to decide the right course of action . Whatever I decide , each has its own set of advantages and disadvantages. No decision can be considered completely right or wrong. In one such incident, I was visited by a 28 year old woman with a diagnosis of unexplained infertility. Based on my clinical experience , I suggested that she should go in for IUI (Intra Uterine Insemin...
Source: The Patient's Doctor - March 6, 2014 Category: Obstetricians and Gynecologists Source Type: blogs

IVF scams - and how to protect yourself
It is very disappointing to see the cluelessness most IVF patients have about what happens in the IVF lab. Sometimes, as with any biological system, things do not work out as expected – for example, the sperm may fail to fertilise any of the eggs, and this is called total failure of fertilisation. It is important for the doctor to take responsibility in such cases and be open and transparent with the patient, so he can troubleshoot the problem and offer a solution. Unfortunately , most IVF doctors are completely unaware of IVF lab procedures . They are clinicians, trained as gynecolgists , and they leave all the work...
Source: The Patient's Doctor - March 5, 2014 Category: Obstetricians and Gynecologists Source Type: blogs

Why you must make sure that your IVF clinic has A Full Time Embryologist !
Infertility is a growing problem in India. Reviews show that almost 10% of married couples need fertility treatment to have a baby . The number of infertility clinics keeps growing because of this rise in demand. IVF treatment is expensive, which is why many gynecologists start doing IVF, so they can maximize their income ( rather then refer their patient to an IVF specialist).  They conveniently ignore the fact that the success of the IVF clinic depend completely upon the expertise and experience of the embryologist .The sharp increase in the number of IVF clinics across India means the demand for qualified embryolog...
Source: The Patient's Doctor - March 4, 2014 Category: Obstetricians and Gynecologists Source Type: blogs

Information Therapy: A Valuable Tool for Patients
Information therapy is the right information given to the right patient at the right time, in order to help her make the right healthcare decision. It is a doctor’s duty to educate a patient about the treatment options Unfortunately, it is a common complaint that the same does not happen always. Most of the time doctors are too busy, and patients are forced to get the required information through internet research.Sadly, the quality of health information on websites varies widely, and patients are often not sophisticated enough to be able to separate the wheat from the chaff. The right information should be ideally b...
Source: The Patient's Doctor - March 3, 2014 Category: Obstetricians and Gynecologists Source Type: blogs

Unexplained Infertility or Improperly Evaluated Infertility ?
Infertility is the inability to conceive and in some couples, the exact cause is undetectable. This is known as unexplained infertility. In these couples  all the investigation reports come back as normal. However, only 10% of infertile couples can be labeled as having unexplained infertility. It is also one of the most misused diagnoses by doctors and IVF specialists.Many doctors do not have time for their patients as they run assembly line clinics.  The doctor prescribes a regular panel of tests and once these tests come back as normal , the doctor is in a hurry to label the patient as having unexplained infert...
Source: The Patient's Doctor - March 1, 2014 Category: Obstetricians and Gynecologists Source Type: blogs

How accurate Medical Records help in increasing IVF success rates
IVF patients understand that their treatment’s success is the result of the combined effort of the doctor and the patient herself. They know that they can play a vital role in ensuring IVF success. This is why infertile couples gather as much information about IVF treatment before starting a cycle. They weigh their options well and judge what is best suited for them. Based on this research , they take efforts to find the best IVF specialist. Given this background, and the amount of time, energy and effort patients invest in IVF treatment, it is surprising to see how apathetic patients are towards seeking and obtainin...
Source: The Patient's Doctor - February 28, 2014 Category: Obstetricians and Gynecologists Source Type: blogs

Too much IVF ?
Many doctors believe that IVF specialists are now doing too much IVF. A friend, who is a gynecologist, pointed out that he is seeing patients who went to an IVF specialist who advised them to do IVF, who then promptly got pregnant in their bedroom the next month !He felt that we are seeing an epidemic 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 specialists are advising IVF left, right and center, even for couples who could get pr...
Source: The Patient's Doctor - February 27, 2014 Category: Obstetricians and Gynecologists Source Type: blogs

Reasons Why Infertile Couples Do Not Opt for IVF Treatment
IVF treatment can be a boon for many infertile couples. It has established itself as an effective treatment option and has a high success rate. Inspite of this, why is it that even today many infertile couples opt out of this option? There are many educated couples who are aware of IVF , but who refuse to do IVF,  thereby reducing their own prospects of having a baby. There are several arguments that these couples put forward against IVF. Sometimes it is their own attitude which is responsible, while at other times it is relatives, family doctors or other IVF patients who turn them away from IVF. Not all infertile cou...
Source: The Patient's Doctor - February 26, 2014 Category: Obstetricians and Gynecologists Source Type: blogs

Why patients dropout after a failed IVF Cycle
In vitro Fertilization is one of the most complicated treatment options for infertile couples. Infertile couples who choose to undergo IVF know that it is their last chance at having their own baby. All their hopes ride on the procedure’s outcome. Many patients undergoing IVF have unrealistic expectations about the results. When their first cycle of IVF fails, many women then stop further treatment, although they know that they are denying themselves the possibility of success by doing so. The number of dropouts after the first IVF cycle fails is very high. These women stop any further trials for having a baby. Vario...
Source: The Patient's Doctor - February 25, 2014 Category: Obstetricians and Gynecologists Source Type: blogs

Reflections of an Indian Cancer Surgeon by Dr Luis De Souza
Reflections of an indian cancer surgeon from Aniruddha MalpaniHELP is very happy to share this great book by a senior Indian surgeon. Though Indian doctors have a wealth of clinical experience and a lifetime of wisdom, sadly we do not take the trouble to share this with others. This is a gem of a book, and we hope more doctors will follow Dr De Souza's footsteps. We are happy to help !  (Source: The Patient's Doctor)
Source: The Patient's Doctor - February 24, 2014 Category: Obstetricians and Gynecologists Source Type: blogs

Should I freeze my eggs ?
We are increasingly seeing a different kind of woman  in our clinic these days. They are not infertile. These are women who are in their 30s, who want to learn more about testing and preserving their fertility.  They are not interested in getting pregnant right now - and some of them are not even married. However, they just want to ensure that by postponing child bearing in order to pursue their career, they are not risking their future fertility.This is because these are smart, well-informed women, who have done their homework for themselves. They are finding out that some of their friends are having problems co...
Source: The Patient's Doctor - February 24, 2014 Category: Obstetricians and Gynecologists Source Type: blogs

Minimising the risks of IVF
The outcome of IVF , like any other biological procedure , is uncertain. The definition of risk is the possibility of an undesirable outcome , so patients need to evolve strategies which allow them to deal with the risks of IVF . There are basically two sets of risks. First, is the medical complications associated with IVF , which are basically the risk of ovarian hyperstimulation syndrome ( OHSS ) and that of multiple pregnancy . The good news is that both these complications can be prevented, which is why you should choose a good IVF clinic which is experienced in dealing with and managing these problems . These risks ar...
Source: The Patient's Doctor - February 22, 2014 Category: Obstetricians and Gynecologists Source Type: blogs

How to prevent embryo mixups in IVF
  The biggest fear that IVF patients have is that the lab may mix up their embryos with some other patient's.  If the embryos get mixed up , then their embryos may go to someone else ; and they will receive someone else’s. This is a valid concern, and embryo mixups have been well documented, even in  the best of IVF labs. This is an IVF clinic’s major nightmare as well, and because they are aware of this possibility, good clinics develop lots of safety checks , safeguards and processes , to prevent this from happening.Since every patient’s embryos look like every other patient’s embry...
Source: The Patient's Doctor - February 21, 2014 Category: Obstetricians and Gynecologists Source Type: blogs

How do I interpret my ovarian reserve test results ?
Modern IVF technology is very effective, and we are every good at making embryos , no matter how poor the sperm quality . The biggest challenge we encounter today is treating patients with poor ovarian reserve, because poor quality eggs result in poor quality embryos.However, there’s a lot of confusion about testing ovarian reserve and egg quality. Just because a woman has poor ovarian reserve does not mean she will necessarily be infertile.  After all, all testing has its limitations and flaws. Just like men with low sperm counts can father a pregnancy if their spouse is super-fertile , similarly young women wi...
Source: The Patient's Doctor - February 20, 2014 Category: Obstetricians and Gynecologists Source Type: blogs

How good is your IVF doctor ?
One of the biggest fears for any infertile couple is that they may end up taking treatment in an IVF clinic where the doctor is incompetent; or the embryologist is not skilled; or the equipment is not properly maintained ; or the quality control standards are inadequate; or the doctor is not available because he is travelling all the time, and the care is delegated to inexperienced assistants and juniors, who do not know much.It’s perfectly normal to  have these worries and concerns, because of the cloak of secrecy which shrouds most IVF clinics. All their websites look exactly the same , but there is a lot of d...
Source: The Patient's Doctor - February 19, 2014 Category: Obstetricians and Gynecologists Source Type: blogs