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If you need to contact me , please write to me to this email ID : I will be happy to help.

Wednesday, August 31, 2016

How life style changes helped me to overcome premature ovarian failure ( POF ) - a real life infertility success story !

I got this very thoughtful email from my blog reader. Although , I do not support her view that eating organic food or doing yoga could help you conceive , I was really impressed by her detailed account. If it helps someone , inspires someone to make lifestyle changes , I would be very happy.

A word of caution - she is young and that could have made all the difference even if she is suffering from POF. Hope everyone gets lucky as she did.

Hi Manju,

I am an engineer by profession and work in the IT industry.  I am a long time follower of your blog. However,  haven’t gotten in touch with you before..The recent publication of  Sarah Marie’s post makes me write this to you. I have a tangential story to tell..

Me too a sufferer of infertility.  We have been searching for our baby luck for 9 long years and finally found our bundle of joy!. I had severe female factor infertility.  Premature ovarian failure was the diagnosis. I have had 8 failed IUI’s and 4 failed IVFs. At 28, I was told my menopause is  approaching. My AMH was very low.  I responded very poorly even to aggressive stimulation. Very few follicles . Even those follicles did not result in mature eggs. We  know very well, the pain of infertility is beyond anything that words can capture and the emotional trauma of giving up is bigger than continuing to try . Through my  struggles and fears, your blog had been a great moral support. Thank you so much!  I cried when you lost your twins, excited when you chose to have the embryo transfer yourself instead of the surrogate, delighted when you got pregnant and thanked God when beautiful Anisha was born. Indeed, I am so happy for you Manju!

 Coming back to my story, I had produced just 2 viable embryos in all those 4 IVFs combined! They too did not implant. For me, more than getting pregnant, producing a decent number of follicles itself was a huge challenge. I had one tube blocked and the other was clear. I was seriously advised to clip the other one too to prevent embryo implanting in the tubes.  

I came to know of Dr.Malpani through your blog.  I wrote to him, asking for a opinion before starting my 5th IVF. Even Doctors thought I was mad to go for one more IVF after the results I have had till then. But, I had come too far to go back. Dr.Malpani’s reply came back promptly with the treatment options ranging from aggressive stimulation to donor egg. Along with that he had prescribed some supplements and suggested to read the book “Inconceivable” by Julia Indichova. I least expected a book recommendation from an IVF specialist. I purchased the book and started reading it. It was the story of a woman who conceived naturally at the age of 42 after having been turned down by all IVF clinics. She had attributed her success to mind-body work, yoga practice, supplements,  some traditional medicines and a diet that included raw fruits and vegetables. The same list that was bashed and called as quackery in Sarah’s post. I too never took such unproven ways seriously because doctors have told me repeatedly there is nothing I can do to improve my egg quality.  Anyways, I liked the holistic approach. I  decided to try this keeping my next IVF attempt in suspension for a while. I had nothing to loose. I had already hit rock bottom 😃

I realized that I had totally started believing that my body is incapable of conceiving naturally because that’s what every Doctor  told me. I had to recover myself from that mindset first. The book helped me do that. I cannot exactly describe the process. It is about renewing one’s own connect with the body. IVF treatments had basically made me treat my body like a lifeless entity. I looked at it like an object - a place where  I let needles to be  punched in and then step aside to see if a  baby pops out. For five months I followed the suggestions in the book religiously. Grabbed every bit of information on diet that helped improve egg quality. Practiced yoga poses that  specifically help the pituitary glad.  Stopped all medications including DHEA. I saw my period length getting corrected. Getting closer to a 28 day cycle from 24 or 25 days and period blood looking healthier (It is only then, that I learnt how a healthy period blood should look like). On the sixth month I took acupuncture sessions for 20 days.I conceived my baby girl naturally the same month.  She was  born 2 months back. It was a normal delivery.  I  started approaching infertility specialists at the age of 28. I am 35 now :)

BTW, I did not pay for any other programs the author offered. It is easy to brush aside these alternative approaches  as unproven or not scientific. But, tell me  which pharma company is going to fund a research on yoga’s effect on harmonal balance. Who is going to make money  proving life style change can help in conception.  All the research happens only on the IVF drugs. It’s a race run by one man and no wonder he is the winner.  I am speaking from my experience.  My case may not stand scientific probing. I don’t have a  degree in biology. I am just an engineer. I am sharing my experience for  it might help someone out  there with a condition like mine. I just want to say there is hope even after multiple IVF failures.

What changes she did ?

1. Practiced yoga for 45 mins morning and evening (mainly the poses that help with pituitary functionality  Headstands and Shoulder stands).  I had a teacher come home and teach me.

2.Took a green juice every day (wheat grass power or goose berries)

3.Changed from cooked lunch to Raw vegetable salad. Eliminated Rice and Sugar. Switched to millet based diet and organic produce.

4.Took supplements Royal Jelly, Coq10, Shatavari, Wheatgerm oil.

5.Took acupuncture sessions for 20 days straight to correct ying-yang energy balance  (Dr.’s observation was that I had immunity disorder due to stress and male energy was dominant compared to female energy).

I leave it to you if you want to publish Julia’s name or even the letter itself. You built the blog . You are free to not publish content that you don’t agree with :)  I am totally fine with whatever you choose..

If anyone wants her email ID , I will be happy to provide.

Warm Regards,



Warm Regards,


Tuesday, August 30, 2016

How to regulate commercial surrogacy in India ?

There are now so many articles in favour of , and against , Indian government's move to ban commercial surrogacy. I do not want to get into that debate. I have gone through infertility and I know how hard it can be when you are denied the right to have your biological child because of a medical problem. On the other hand , surrogacy in India , in its present form , is definitely not ethical enough. The most exploited person in a surrogacy arrangement is the surrogate. When Indian doctors claim that this surrogacy arrangement is OK , and it's a win - win situation for all , I wonder whether they have ditched their conscience. In terms of benefit , in a surrogacy arrangement , the surrogate occupies the bottom rug of the ladder - but she does the most important and tedious job. The IVF patient and doctor are happy partners who are keen on getting their much needed baby and money , respectively. Although , intellectually speaking , this arrangement looks perfect - everyone gets what they want and no one is harmed - but the truth is , surrogate , who in majority of cases is uneducated and desperate for money ,  is exploited.
So , what can the Indian government do to regulate surrogacy rather than banning it ?
Step # 1
Does a patient really needs surrogacy ?
Government must set up a panel of doctors to decide whether a patient must be allowed to take up surrogacy or not.
If it is decided that a particular patient needs surrogacy to conceive , they must be first encouraged to find a relative who is willing to be their surrogate. If it fails , then they must be encouraged to pursue commercial surrogacy.
Step # 2
Examining the candidate who wants to be a surrogate.

Why shouldn't a surrogate's basic qualification be fixed ? A woman with a functional womb - is this qualification enough to be a surrogate ? Isn't it a profession which needs a bit of intelligence and understanding too - in order to safe guard their rights , their body ? Apart from medical tests , the woman who wants to be a surrogate must be tested for their basic knowledge regarding IVF procedure , pregnancy , the risk involved in surrogacy , surrogacy laws etc. They must be able to read and understand the surrogacy document - the documents must be available in local language. 
Step # 3
Surrogate banks must be set up by the government.
Women who wants to pursue as surrogate must register their details in the bank. Whenever a patient needs a surrogate , the bank must supply the surrogate in the order they are registered. Surrogate bank must fix a minimum fee for surrogacy - it must be the same nationwide. A surrogate must also be allowed to fix her rate - it can be anywhere above the minimal rate which is fixed by the surrogate bank. When doctors can fix their rate - why can't surrogates do the same ? If the intended parents agree to the rate , they can continue the surrogacy procedure with that particular surrogate , otherwise , they can try bargaining with the next surrogate in line. This kind of arrangement gives an upper - hand for the surrogates - and I believe it's extremely important to give power to the surrogates.
Step # 4
The IVF doctor will carry out the IVF procedure on the surrogate whom his / her patient has chosen. This kind of regulation , takes away the burden from the IVF doctors. They do not have to run behind agents for recruiting surrogates , they do not have to act as a middle - man between the patient and surrogate - this will give them lots of time to concentrate on their profession.
Step # 5
Once the surrogate gets pregnant she must be taken care of the intended parents. This will encourage patients to select an IVF clinic and surrogate bank which is situated in the proximity where they live. In this way , the stigma surrounding IVF procedure , including  surrogacy , can be removed. After all , the surrogate is carrying their baby - who else will take care of surrogate's need better than the intended parents ?
Banning surrogacy altogether , and telling patients who need surrogacy to adopt , is definitely against the citizens' right to freedom. Banning commercial surrogacy altogether can lead to many underground activities. The patients will definitely go to other countries where surrogacy is legal to fulfil their rightful wish. Why should the government loose the income ?
If foreign nationals are allowed to do surrogacy in India , the surrogates must be paid equal to what they would pay for a surrogate in their place ? Why should Indian wombs be a lot cheaper ? The care of foreign nationals' surrogate must be again taken care by a government agency.
I don't know whether I am intelligent enough to propose something like this. Might be there are many loop holes in this proposal which needs to be mended. My idea is to give a lot of power to surrogates so that they do not get exploited. This kind of arrangement also protects patients from unscrupulous IVF doctors.

I must mention about my surrogate here. If you are reading my blog for a long time now , you will know that I have attempted surrogacy once. Even though it didn't work out and I abandoned the option , I still have contact with my surrogate , Rita. Such a lovely soul she is. She keeps in touch with me via WhatsApp. She calls me didi ( sister ) and showers me with so much love and affection. On seeing the news about shootings in Germany , she was the first to enquire about our well being. She was so excited to see Anisha and loves her very much. She was so happy for me when I had Anisha. Her son talks to me too , especially when I and Rita couldn't communicate deeper because of the language barrier. Once I offered Rita to pay her children's education fees as long as they study. Do you know what her reply was - " thanks didi , I have enough ". What a rich woman she is ! I know her well. She was ready to carry my child for a mere 3500 dollars. Imagine how important is money for her. She gently refused to take money from me when I offered her. I am so gifted to come across her and she carried our embryo for six weeks :) 

Indian surrogates need to be paid better and they shouldn't be treated as cattles by hoarding them all in a small place when they become pregnant. Why should others earn more , and benefit more , at their expense ?
I would be very happy to hear reader's views and suggestions , please leave your comments below !

Wednesday, July 27, 2016

Infertility hurts - and you are not alone !

This post ,  I found in a IVF support group ,  written by Sarah Marie ( Sarah Wu ). She is an herbalist and permaculture teacher , living in Costa Rica .

This is how people who go through infertility feel. She has poured her heart out. This post will help others who are in a similar situation as her's to realize that they are not alone. May her infertility journey have a happy ending , and so be all yours !

" I am asking only for an open heart and an open mind...
I need to get this off my chest, it weighs so heavy...
My life is wonderful and I am beyond blessed.
And I have done everything I can think of... And now I want to share, with my friends, family, community, allies, acquaintances, connections and the world...
I have cast spells, prayed to the Mother, prayed to the Father, called to my ancestors, I have lit candles night after night, I have had akashic karmic healing, past life regressions and energy work. I work with crystal, plant and animal medicines. I read tarot, medicine cards, runes and pendulums. I have done mikvahs.  I have burned, buried, drowned and blown away that which doesn't serve me. I gaze at the moon, sun and stars. I have died and been reborn with Ayahuasca. I have used blood magik. I have chanted and prayed to the Virgin Mary, Durga, Kwan Yin, Juno, Inanna and Diana. I never stop reading and researching. I use western and Chinese herbs. I follow diets and eat what I want. I have had and regularly receive Acupuncture, massage, reiki, kinesiology, cranial sacral, abdominal massage and guided meditation. I have been hypnotized and I lucid dream. Have had my Vedic and Western astrological charts read. I have a therapist, Drs., friends and family.  I read my Basal Body Temperature daily, weekly, monthly.  I have taken handfuls of supplements. I try to keep my weight up. I manage stress and work hard. Have had endocrine tests, blood tests, and sperm tests. Have had my tubes checked, multiple ultrasounds and endometrial biopsies. I have given myself so many shots in the stomach, ass and thighs that it doesn't scare me anymore. I have felt my ovaries swell and lost my mind to hormone overload. I have had three rounds of IVF, two IUIs, intravenous immunoglobulin treatments and paternal lymphocyte therapies. I had a hysteroscopy and a polyp removed from my uterus. My ovaries sometimes have cysts.
I know my body, mind and heart better than most people will ever know and I still don't understand.
I have felt my heart break more times than I thought humanly possible. I have felt incompetent, insufficient, depleted, hopeless, scared, ashamed, useless, pitied and like I wanted to die. I have felt bad for myself, jealous of others, angry, sad, depressed, alone and numb. I have felt empowered, brave, healthy, loved, supported, nourished, held and faithful. I feel alive, I feel strong, well, confident, I love myself and I love all life.
I ask why almost every day. Why me? What did I do? Who did this to me? Why is this my karma? What is the lesson? Will this help me to be a better person? A better woman? A better mother? A better friend, lover and wife? A better teacher and better healer? Will this help me to help others? Will it happen? When?
This is my struggle and pain... These are my lessons, my inspirations and reflections.
With every month, comes the bleeding of disappointment and sadness, comes the blood of empowerment and gratitude.
Will I give up one day? Will it happen? Will my biological child be the ultimate gift from the Goddess? Will she help me? Will we adopt? Will we?
I still don't know...
I will stay my course...  listen to my heart and keep trying... I feel my baby near...
In gratitude... "
Sarah Marie

Monday, July 18, 2016

Dr.Malpani's Blog: Book Release - Patient Safety - Protect yourself f...

Dr.Malpani's Blog: Book Release - Patient Safety - Protect yourself f...: Please do come to our book release - Patient Safety - Protect yourself from Medical Errors on July 19 at KEM Hospital at 2 pm. This will...

Monday, July 11, 2016

Detox your way to IVF conception

I went through a website which is very popular among infertile women. They offer nutrition and exercise advice ; sell imagery CDs - which they claim , " they are as powerful as fertility drugs " ; and moreover , they offer emotional support. So , it's a complete package - and , it's completely natural ! They call it as natural fertility treatment. How I wish I could start something like that - who doesn't want to earn money !
Their website is full of word play - you get nothing useful from there until you pay money. And even if you pay , I wonder , what you will get out of it ! But nevertheless , they are very famous and have many glorious testimonies to their credit !
Let me come to the point - how to detox your body ? Before that , let me ask you some questions :
1. Do you have a very stressful life ?
2. Don't you eat organic food ?
3. Do you eat genetically modified food ?
4. Do you use lots of chemicals at home - shampoos , cleaning and washing lotions , soaps , etc., ?
If your answer is 'yes' for the above questions , it clearly shows you have poisoned your holy body ! This is the reason why so many diseases exist in modern world - from cancer to infertility ! It's a punishment imposed on humans for going against nature. Your body has accumulated so much of toxins - as a result , your ovaries have stopped functioning properly ; your embryos haven't implanted because your uterus is not embryo friendly as a result of all the toxins it has accumulated over the years ! If you could get rid of these toxins , you get your fertility back !
On reading the above , how many of you feel scared ? How many of you feel guilty ? How many of you are wondering what I can I do to get rid of the toxins ? This fear and guilt you feel is the raw material for many peoples' business - and unfortunately , many fall as prey for such scams , yes , scams !
Why do people believe such scams ? The foremost reason is , they lack knowledge about how human body works. Next comes the glorious advertisements and testimonials they see , read and hear - and ,  when it comes from a friend or doctor they trust , they easily fall for it.  The third is , when they meet a person who claims that treatments like detoxification works , and sells it too , they get carried away by their bedside manners - their promises , concern , care , consideration , reassurance and sympathy can feel like an oasis in their desperate attempt to hold on to hope and faith. As a result , many turn out to be loyal customers even if the treatment doesn't lead to what they wanted - they will find ways to suppress their rational part of the brain , because , all they remember is how emotionally pampered they are when going through such treatments. They stay loyal forever irrespective of the outcome !
Our body has amazing ability to remove any harmful substances that enters in. Organs like liver , kidney , skin , lungs , etc ., work to remove all the waste products that form in our body as a result of digestion and metabolism. The detoxification programmes claim that they help your body to eliminate wastes ( toxins ) better by making your liver and kidneys function better. They sell several herbs  and supplements for the same - and , what attracts people most is the word ' NATURAL .' Unfortunately people fail to understand that natural doesn't mean it is without unpleasant side - effects ; natural doesn't mean it's free of harmful chemicals ; natural doesn't mean it's safe. Actually , the herbs , herbal cocktails , vitamins and other supplements sold by them doesn't have FDA approval. This means ,  they are not checked for the ingredients they claim that it contains ; they are not checked for appropriate dosages - and hence there is no guarantee for their safety or efficacy. As a result , they can actually prove to be much harmful than you might imagine ! You are in danger of not only loosing your hard- earned money but also your precious health. You can't enhance your liver or kidney's ability to clear wastes. If your kidney and liver function tests are normal , they are working just fine. Just because your liver and kidney cleans your body's metabolic wastes , doesn't mean they accumulate toxins and slowdown in function  ! You do not have to detoxify  them regularly in order for them to work properly.
Organic food doesn't means it's pesticide free. Produce that are not organic is perfectly OK to consume after washing them ( of course you have to wash the organic produce , too ) . By consuming them you are not accumulating toxins in your body ! Organic food is definitely not more nutritious - it is just more costly ! Genetically modified food is not poison. No one will get cancer by consuming them , nor do they carry toxins ! Genetically modified foods don't deserve the negative propaganda they are receiving by the people who really don't care to understand how genetic engineering works ! I have learnt from some infertility forums that some patients' IVF doctors have insisted that they go organic and remove all chemicals from their lives ! How unreasonable such suggestions are ! How easily doctors too fall for cognitive biases ! Or , is it a strategy they ploy to blame their patients' life style for the IVF failure ?
Just like , you can't detox your way to IVF conception , you can't use your visualization power to bring on a powerful ovulation ; you can't use imagery CDs to make your egg quality better ; you can't make your embryo stick by imagining that they are doing so ! If it works so , majority of us don't need an infertility doctor.
So , why so many patients swear by the efficacy of such unscientific practices ? The answer is simple , those websites provide enormous emotional support. They give you so much personal attention and reassurance , provided , you pay them ! When we are going through a difficult journey , we all need someone to hold our hands and say that all will be well and we can get through it ; we need real life examples , real life success stories ;. and moreover ,  we need someone with whom we can can confide our fears , insecurities , hopes and dreams. They offer all this ,  and much more. I feel they work like a cult with their own unscientific doctrines and principles. They know how exactly to brainwash their customers. Since , infertility is an emotionally  stressful and tiring journey , we easily fall for their promises. Infertility makes us emotionally vulnerable. Many of us lack proper support system when infertility strikes - it is still a taboo in many parts of the world. All these factor earns a lot of customers for such quacks.
When you find yourself getting lost in the stress of infertility , please try to do the following :
Educate yourself about your problem scientifically - this will help you to build realistic expectations , it will also strengthen your hope and make you confident.
Have an open mind and have alternate plans  - don't get desperate for success !
Build proper support system - your family ,  online infertility forums and your doctor can play a major role in keeping you sane and hopeful , amidst the enormous stress.
Please do not waste your emotional and financial energy by believing in quackery ! You can ask me , " If , what they offer makes me feel better , if I find solace there , why not follow it ? "  The problem here is ,  people who sell such ' alternative therapies ' claim that it can make you conceive or make you fit for conception , which is totally false. They are promoting something which is not scientific and trying to make a business out of it by playing with your emotions.  I understand that we need to find a middle path - but , middle path doesn't mean you need to mix delusion and reality and end up with heart ache when the treatment doesn't work ! Mixing placebo sugar solution and real medicine isn't going to enhance the medicine's effect , it can even make the medicine ineffective - that's not the real middle -path ! Many a time , alternative therapies distracts you from your real goal.  The real middle path is , understanding your problem , working on what you can really improve scientifically and let go of things what is not in your hands ( for example , if your ovarian reserve is exhausted and your ovaries are no more responding to drugs ! ) - instead of repeatedly hitting the dead end and wasting your physical , financial and emotional energy. When you hold on to false promises and hopes for support , when you fall , you fall really hard - the pain will be enormous. When you hold on to reality , even if it is bitter to accept , when you fall , you do so gracefully - the pain will be lot lesser and you will spring back to action very soon.

Thursday, July 7, 2016

Elective Single embryo transfer ( eSET ) - is it for me ?

The answer to this question depends on a number of factors :
1. Your age
If you are of young maternal age , the chance that more than one of your transferred embryos being genetically normal increases. Hence , it is wise to opt for single embryo transfer ( SET ). If you are less than 35 years of age , with good ovarian reserve and good quality embryos , you must consider transferring only one embryo.
2. Your ovarian reserve ( the number of embryos obtained in a particular IVF cycle )
If you get many eggs and embryos in your IVF cycle , it is better to grow them to blastocysts and do a SET.
3. Having good looking embryos
If the embryos that were created are of high grade , then doing eSET can be beneficial, provided , you are of young maternal age with good ovarian reserve.
4. Blastocyst transfer
If 40 % of your embryos develop into blastocysts , it shows that they are following a normal growth pattern. In such cases , elective SET can be beneficial.
5. Your clinic's success rate
If your clinic has high success rate for women of your age , then it is important to listen to your doctor's suggestion regarding how many embryos to transfer. You have high chance of having multiples if you transfer more than one embryo in a clinic which has high success rate.
6. When using donor eggs and embryos
Women who donate eggs are usually of young maternal age , so , the chance that many of the obtained embryos are genetically normal increases. Donor embryos are mostly got from couples who have completed their families using the same cohort of embryos. This is a sign that the remaining embryos may be good enough , too. And moreover , majority of the time , only couples who are of young maternal age will have ample embryos to donate  . So , when using donor eggs and embryos , it is good to go with single embryo transfer.
7. When using embryos which are tested for genetic competency
When using embryos which are tested using advanced genetic testing techniques ( for example , embryos tested using NGS ( next generation sequencing,  where all 23 pairs of chromosomes are screened )  , SET must be preferred.
In short , if you are of young maternal age ( ideally , below 35 years ), with good ovarian reserve ; if 40% of your obtained embryos grow to blastocysts and are of good grades allowing you to select the best ; if you use embryos which are tested for chromosomal normalcy ,  and if you are with a clinic which has high success rate , or , if you are using donor eggs and embryos , you must opt for SET - this will greatly reduce your chance of having multiples. 
Remember , a successful IVF cycle is not about getting a positive pregnancy test. Only when you take home a healthy baby ( healthy babies )  healthily , your goal has been achieved. Multiple pregnancies can be  disastrous , many a time.  Having premies in hand is heart - wrenching and losing healthy babies can break your heart. The chance of something going wrong in multiple pregnancies is several times higher when compared to singleton pregnancy. So , aim for eSET whenever possible - aim for a healthy IVF pregnancy.

Tuesday, June 28, 2016

Happy Birthday , Dr !

Dear Dr ,

Many more happy returns of the day ! May you live a very long , happy and healthy life , and let no harm come near you. May all your dreams and ambitions come to fruition. Keep smiling , and have a very beautiful life ahead !

Thanks a lot for making Anisha happen ! She has made our life happier and purposeful. We learn a lot from her , everyday. Not even a day goes by without wondering how dull and colourless our life would have been without Anisha ! Thanks to you and your team for all the technical help and support !

For me , your presence has been a great support. When I was shattered beyond words by the loss of our twins , the thought that you are there gave me enormous strength. I wouldn't have fought this battle gracefully without your blog , my blog and you. Thank you , you are a wonderful doctor , and moreover , a beautiful human being.

Have a great day , Dr ! Stay blessed , always.

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