IVF patients versus IVF doctors

When patients come to an IVF clinic, they expect to be treated by an IVF expert. Having spent many years in medical school, we have mastered technical skills such as egg collection and embryo transfer. However, some patients want only the doctor’s technical help , and not their professional advice. This includes carrying out laboratory procedures that the patients cannot do by themselves at home.

Such patients are normally familiar with the whole IVF process and may only want the doctor’s technical help. However, in such cases where patients are interested only in the doctor’s technical expertise , they may end up clashing with the doctor's professional views. For example, older women may insist that the doctor do IVF with their own eggs, instead of choosing egg donation , even when they know that their ovarian reserve is low and that their chances of getting pregnant are very slim. 

They do not want a doctor's advise - they have already made up their mind. They get upset when their doctor insists on offering them alternative options they are not emotionally prepared to explore.

If they do not accept the doctor's advise, he may feel that the patient is questioning his competence and authority and may consequently get annoyed.

The best approach is for both the patient and the doctor to agree on the kind of help the patient will be offered; whether technical or professional. Most importantly, patients should be open to diverse medical views as opposed to prematurely choosing only those options that seem appealing to them initially. They need to make well-informed decisions , based on a wide knowledge base. Equally, IVF doctors needs to be supportive and not judgmental - after all, patients and doctors are on the same side !

The second IVF baby

Upon having their first child via IVF, most infertile couples are understandably relieved and are filled with so much happiness that they feel their family is complete. They find their first child completely fulfilling, and do not even dream of having another baby.

However, about five or six years later, the very couple that successfully had their first child via IVF will walk into a clinic and give IVF another try, this time more enthusiastic and confident of their chances of success. Mostly, they explain that their first child is lonely and needs company.

Such patients need to understand that as much as their chances of their second IVF succeeding are normally high following the success of the first cycle, it does not mean that the second cycle has a 100% chance of succeeding. Dr. Malpani says the best approach would be to always plan for the future just after the successful completion of the first cycle by asking your IVF doctor to safely store the frozen embryos for you if you had arranged for them to be frozen. Those embryos are from the cohort that succeeded during the first cycle and therefore their chances of getting you a baby are high.

The most encouraging element of the IVF cycle however is that you will have established a good rapport with your doctor and you will know how to get him/her to adequately respond to your complaints and questions. Moreover, you will have lots of IVF knowledge carried over from the previous experience.

Managing an IVF patient’s expectations

Managing the high expectations of patients concerning the outcome of an IVF cycle is one of the hardest tasks that IVF specialists have to face. It is only natural for infertile patients to have high hopes of success after IVF and it’s only natural for doctors to be always optimistic and keep their patients’ hopes alive.

However, the problem arises when the outcome is negative and the patient feels cheated. This is normally the case when a doctor is overenthusiastic about IVF treatment and fails to clearly disclose to the patient the possibility of failure for fear of loosing out to doctors in other IVF clinics. This can be traced back to the fact that doctors are naturally confident in their work and they never want to appear doubtful about their job.

Good IVF specialists should be open with their patients and try to make them understand that there is always the possibility of failure regardless of the clinic they visit. The way forward would be for patients to arm themselves with information therapy ; and seek independent counseling to prepare them psychologically for all possible outcomes.

The guaranteed pregnancy option is another way of helping patients cope. It reduces complaints and information about the Malpani IVF clinic program can be found at http://www.drmalpani.com/guaranteedpregnancy.htm. 

IVF patients should stop viewing IVF as a single-cycle treatment, and understand that it can take them time to achieve their goal ; that patience and persistence pay off ; and that the reward is well worth the time and effort !

The problem with websites of Indian clinics and hospitals

While it is a fact that Indian physicians are highly respected all over the world; and that Indian hospitals are among the very best in the world , because they have the some of the best specialists and equipment in the world, the same cannot be said about their websites. Indian hospitals offer medical services at slightly cheaper costs than those in the US. However, the websites run by even the very advanced hospitals in India lag behind as compared to such elite hospitals as Mayo Clinic and apollohospitals.com is nowhere near mayoclinic.com 

The sad part is that hospital CEOs in India have failed to take advantage of the country’s advanced IT industry . They are neglecting the needs of over 200 million Indians who are actively using the internet. The truth is that thousands of Indian hospitals have functioning websites, but the problem is in the detail; these websites do not have what patients look for - symptoms of various ailments and the treatment options available. If you review these sites, they are filled with information about the hospitals. Patients want information about their health and illness - not about the hospital. This is poor marketing strategy because all surfers who visit hospital websites are potential clients.

Indian physicians and hospital CEOs should therefore pull up their socks and upgrade and review the contents of their websites so as to increase their client base in India and beyond , if they hope to remain competitive in this tech-savvy world.

Why don’t you ask your doctor?

I get great pleasure in offering a free second opinion to infertile patients However, I find it frustrating when patients ask me questions that should be directed to their own IVF doctors. Patients find it almost impossible to ask their doctors questions pertaining to their treatment . In India, this culture can be traced back to our country’s educational system in which students find it hard to challenge their teachers and carry on with the behavior into adulthood.

The reason in most cases is that they feel intimidated by the doctors or they don’t want to appear ignorant . They are worried that the doctor may feel that they are challenging his authority or competence by asking his questions. What most patients fail to realize is that it is actually their doctor’s responsibility to answer their questions; clarify their doubts; and respond to their complaints 

This means that there is a huge void that needs to be filled by the medical fraternity. Doctors could save the situation by developing a pool of information and posting it online in websites for patients to access and read for themselves. This would save patients the trouble of constantly going to doctors to get answers. Doctors would also save themselves a lot of time and reduce their workload.

Why aren’t infertile patients better informed?

It is disheartening to see how ill-informed infertile patients are concerning their medical condition, especially in this new world order, where lots of information is available online and can be accessed 24/7 via smartphones. It is even more disturbing when most of these patients happen to be the elite who spend a lot of time surfing the internet , but never bother to do medical research.

Doctors certainly aren’t omnipresent and will therefore never be able to answer all the questions and complaints of patients all the time. Dr. Malpani says this is an opportunity that infertile clinics should make the most of. Even though the information available online today online is of large volume and potentially confusing, IVF clinics should invest money and energy in developing straightforward patient educational materials, so that patients have realistic expectations of their treatment, and do not feel cheated just because their IVF cycle fails.

Providing reliable educational information helps IVF clinics, as their doctors and IVF specialists don't need to spend as much time in educating patients about the procedures. This information can be provided much more effectively through online video, which is a much more engaging medium and ensures patients will remember that they see. They can review this many times as well , to reinforce their learning; and share it with their spouse and family members , if they need to.