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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 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 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 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 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 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 ! 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 !
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