The do nothing consultation
The last few consultations I have done have been what I call “ do-nothing consultations “. This is when I tell the patient that they do not need my help in order to get pregnant ; and that their best course of action would be continue trying in their bedroom. This might seem to be very unusual advice coming from an IVF specialist . Because I am a senior specialist, most patients come to me for a second ( and often third ) opinion , in order to have their tests and investigations reviewed by an expert. Often they have been advised surgery by a gynecologist or infertile specialist, and they need to make sure they a...
Source: The Patient's Doctor - August 18, 2014 Category: Obstetricians and Gynecologists Tags: Endometrial polyp Health In vitro fertilisation India Infertility Medical ultrasonography patient Uterus Source Type: blogs
Police shut down IVF clinic in Thailand
Police and health officials have raided and shut down an obstetrics and gynaecological clinic in Sathon on suspicion it has been operating as an in vitro fertilisation (IVF) clinic without authorisation. http://www.bangkokpost.com/news/politics/426783/police-shut-down-new-life-clinicI think it's great that the Thailand government is cleaning up its system. This will help to protect patients.My prediction is that we are going to see the same scenario play out in India as well. There are many fly by night cowboy clinics, which are out to make a quick buck in India as well. There are at least 1300 so-called IVF cli...
Source: The Patient's Doctor - August 15, 2014 Category: Obstetricians and Gynecologists Tags: Assisted reproductive technology Clinic Gynaecology ICMR In vitro fertilisation India Indian Council of Medical Research patient Source Type: blogs
Did I harm my embryos by sleeping on my stomach ?
I recently got this email from a patient. Dear Dr, Please help me because I am very worried. I had embryo transfer two days ago and have since slept on my stomach. This morning I awoke with one arm underneath, across my belly and abdomen, squashing it in. I thought maybe this should not be done, and so I looked it up online and there are lots of woman and even clinics who say very strongly you should NOT sleep on your stomach/front after embryo transfer. Have I ruined everything? I so don't want to stop implantation because I slept on my front, with my arm across my stomach. Thanks Sophisticated patients ...
Source: The Patient's Doctor - August 15, 2014 Category: Obstetricians and Gynecologists Tags: Embryo Embryo donation Embryo transfer In vitro fertilisation ivf patient Pregnancy Uterus Source Type: blogs
Why you don't need to rest after your embryo transfer
When an IVF cycle fails , patients often blame themselves, especially when their embryos were perfect. They feel they must have done something wrong, which prevented their embryos from implanting. One woman told me - Doctor, I feel I killed by beautiful embryos ! I coughed right after the embryo transfer and I think they got expelled as a result of this !The truth is that there is nothing you can do to harm ( or help) your embryos after we have transferred them into the uterus. Bed rest does not help at all - and just adds needlessly to your stress levels during the long 2ww.This video shows dramatically that implantation ...
Source: The Patient's Doctor - August 13, 2014 Category: Obstetricians and Gynecologists Tags: Embryo Embryo donation Embryo transfer In vitro fertilisation Infertility ivf Pregnancy test Uterus Source Type: blogs
Can I get pregnant with a low AMH ?
This is one of the commonest questions I am asked.The answer is – It depends !After all, the chances of a pregnancy in a woman with a low AMH will be completely different if she is 26 years old and has been trying to have a baby for only 5 months; as compared to exactly the same AMH level in a 46-year old women with irregular periods, who has failed to conceive even after trying for over 2 years.The point is that doctors do not treat numbers or lab results – we treat humans !In order to interpret an AMH level intelligently, we need lots more information . How old is the patient ? What’s her antral follicle coun...
Source: The Patient's Doctor - August 3, 2014 Category: Obstetricians and Gynecologists Tags: Anti-Müllerian hormone Antral follicle Copenhagen University Hospital European Society of Human Reproduction and Embryology Follicle-stimulating hormone In vitro fertilisation Ovarian reserve patient Source Type: blogs
A letter to my darling embies
I am always amazed by how courageous and resilient infertile women can be. Here's a touching email which Manju received recently. If anyone deserves to become a mom, she does !Dear Babies, I want to call you by your name which we had thought of when we had just got married.. We had never known in our wildest dreams that you might not come easily or it could be delayed and we would not know when you would come.Every time you are transferred to me(i think i have had 10 embies inside me till now)..I pray to god to let atleast one of you stick to my uterus..I literally beg you to stick to me.. I have spo...
Source: The Patient's Doctor - August 2, 2014 Category: Obstetricians and Gynecologists Tags: expert patient In vitro fertilisation Infant Infertility Manju Pregnancy Spanking www.myselfishgenes.blogspot.com Source Type: blogs
A real life infertile story - straight from the heart
This is from an email Manju sent me, which a reader shared with her.It's full of valuable insights, which both doctors and patients can learn from , and I am privileged to share this with you.My Infertility story...I am 33 years old and DH is 38 and we have been married for around 9.5 years. Ours was a love marriage and there was no pressure from either family on babies. We started planning for a baby 6 years back and that was when my gynae told us that I had PCOD. I was put on Metformin and folvite and asked to lose weight(I am 5'5" tall and weighed around 70 kgs). I took the advice pretty seriously and joined a gym and s...
Source: The Patient's Doctor - August 1, 2014 Category: Obstetricians and Gynecologists Tags: Artificial insemination Erectile dysfunction In vitro fertilisation Infertility IUI ivf Polycystic ovary syndrome Pregnancy Source Type: blogs
What can I do to make my embryos stick ?
Patients who have failed an IVF cycle are often understandably desperate . It can be hard to come to terms with this failure, because most were very sure they would get pregnant in their very first attempt ( few patients would have the courage to start an IVF cycle if they did not secretly believe in their heart of hearts that it would work for them !) They start hunting for solutions to increase their chances of success in their next IVF cycle.Most will have had good embryos and an easy embryo transfer . When the cycle fails, it’s obvious that the reason for the failure is that the embryos did not implant – what is gr...
Source: The Patient's Doctor - July 30, 2014 Category: Obstetricians and Gynecologists Tags: Embryo Embryo transfer Endometrium Implantation (human embryo) In vitro fertilisation Menstrual cycle patient Uterus Source Type: blogs
Why do infertile women spend so much time on the net ?
Lots of infertile women spend hours on the Internet , hunting for information and looking for treatment options and the best possible doctor. This is especially true when they have failed an IVF cycle and are trying to find what they can do differently the next time , in order to improve their chances of success.Infertile women need lots of emotional support , which is why they often glued to the PC, reading posts on bulletin boards ; searching for nuggets of information on blogs ; and posting information about their problem and looking for solutions from other infertile women .This is because husbands are quite poor...
Source: The Patient's Doctor - July 28, 2014 Category: Obstetricians and Gynecologists Tags: anjali malpani Gynaecology In vitro fertilisation Infertility Intracytoplasmic sperm injection patient semen analysis unexplained infertility Source Type: blogs
More patient complaints and compliments for Malpani Infertility Clinic
Patient Compliments for Malpani Infertility Clinic 2013 We understand it's hard for patients to judge how good or bad an IVF clinic is based on just their website. After all, most websites looks very similar ! This is why we have included excerpts from our Complaints and Compliments book at our clinic, so you can read the unvarnished truth, as to what our patients think about the care we provide them. (Source: The Patient's Doctor)
Source: The Patient's Doctor - July 25, 2014 Category: Obstetricians and Gynecologists Tags: Aniruddha Aniruddha Malpani dr malpani complaint Dr Malpani complaints dr malpani compliments dr malpani reviews In vitro fertilisation India Infertility Mumbai patient patient complaints Source Type: blogs
Patient Compliments and Complaints for Malpani Clinic
Patient Compliments for Malpani Infertility Clinic (Source: The Patient's Doctor)
Source: The Patient's Doctor - July 23, 2014 Category: Obstetricians and Gynecologists Tags: Aniruddha Malpani Artificial insemination Clinic Dr Malpani complaints dr malpani reviews In vitro fertilisation India Infertility Malpani Infertility Clinic Pregnancy Source Type: blogs
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
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
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 grie...
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 17, 2014 Category: Obstetricians and Gynecologists Tags: Follicle-stimulating hormone In vitro fertilisation Infertility Manju Menotropin Ovary Pregnancy www.myselfishgenes.blogspot.com Source Type: blogs
