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

Tuesday, November 20, 2012

How to prepare yourself physically for an IVF cycle ?



Going through an IVF cycle is exciting and very stressful too. You will be tormented by a variety of emotions. You will be happy that you are taking treatment that might give you a much longed-for baby ;  and at the same time , you have to cope with the fear that the cycle may not work! You want to do everything as perfectly as possible , so that you have given yourself the best chance of success. Your mind will be full of doubts and questions , and you are not sure how to find the answers. You may be needle-phobic and scared to death of all the injections you have to take. Did I inject the medicine properly ? Did I take the proper dosage? What if I forget to take my medicines at the right time - will this affect my cycle? What should I eat and what should I avoid? Will the type of food I eat affect my IVF success? What supplements should I take? Where do I find the much needed emotional and intellectual support?  There are so many questions in the mind of first time IVFers. Most of them search for answers to their questions on the internet , and will get lots of different answers - some reliable and some not.  I hope this article will help you to resolve your doubts . This is reliable information because I am a biologist and have gone through several IVFs myself . Good Luck with your IVF cycle and keep reading!

Life style

Life style factors do have an impact on your fertility , whether you are trying to conceive in your bedroom or when you are doing IVF! Preparing yourself physically is important so that you can maximize your chance of conception.

Below are some common life style habits and behaviors which can be modified in a positive way , so that you give yourself the best chance of succeeding in an IVF cycle.


Weight

It is a well-known fact that both obesity and excessive leanness affect fertility. When you decide to go through an IVF cycle , it is wise to concentrate on your body weight and try to bring your BMI to normal. You can calculate your Body Mass Index by using the online BMI calculator. Normal BMI should be within 18.5-24.9 Kg/m2.

Obese women need a significantly higher dose of injections for superovulation ; and their egg yield is also reduced when compared to woman of normal BMI. Their chance of pregnancy is lessened; and they also carry a higher risk of miscarriage. Underweight woman also produce fewer eggs when compared to woman of normal BMI ; and their risk of miscarriage seems to be elevated too. These  are documented facts.  Try to bring your body weight to the optimum level before starting an IVF cycle. Even if you are not able reach your ideal weight range, modest weight loss if you are obese (or weight gain if you are underweight) will help in improving the outcome of your IVF cycle. Many women find that signing up for an IVF cycle provides excellent motivation for optimizing their body weight.

A rapid change in your weight can affect your IVF cycles adversely, so if you plan to make changes to your weight , do it gradually and slowly by following a healthy diet plan and exercise. Do not follow any fad diets and starve yourself. Proper nutrient intake is very important for optimum reproductive functions.

Exercise

Exercise makes you feel good physically and mentally. It will help you to lose weight and will also aid in maintaining an ideal body weight. Exercise releases many feel good hormones called endorphins which will help you to have a healthy psyche too. It also increases blood flow to various organs ( thus helping in optimal oxygenation) , including your reproductive system.  However, too much of a good thing can be harmful too. Rigorous exercise (more than four hours of strenuous exercise per week) can negatively affect IVF cycle outcome , Such an exercise regimen can reduce your fat reserves drastically , and this will prevent proper functioning of your reproductive hormones. Yoga and pranayama (breathing exercises)  are excellent.  They keep your body flexible and help in blood circulation. Select an exercise which you feel comfortable with. A good exercise schedule will help to reduce your physical and mental stress greatly during an IVF cycle. Avoid doing any strenuous exercise when you are undergoing ovarian stimulation. There is a danger of ovarian torsion as superovulated ovaries are heavier and larger during this time.

Smoking 

It is a well-known fact that smoking can cause enormous harm to various organs in our body. Smoking affects our reproductive organs too. Women who smoke reach menopause earlier than their non-smoking counterparts. Epidemiological studies have repeatedly shown that women of child bearing age who smoke have higher rates of infertility, spontaneous abortion, ectopic pregnancy, tubal infertility, and intrauterine growth retardation than nonsmokers. Smoking decreases ovarian reserve as well. This reduces  oocyte yield and decreases fertilization rates,  leading to a poor prognosis in ART cycles.  In men, cigarette smoking adversely affects sperm quality and causes damage to the sperm DNA. This can lead to male infertility and has been found to adversely affect IVF/ICSI outcome. Passive second hand smoke is dangerous as well !

Alcohol consumption

There are studies which show that maternal and paternal alcohol consumption decreases live birth rate after IVF .  As few as four alcoholic drinks per week decreases IVF birth rate. Female alcohol consumption was associated with decreased egg yield, and an increased risk of miscarriage.  Many people have the misconception that red wine is OK to consume as it has an anti-oxidant called resveratrol.  While it is true that resveratrol has a positive effect on several health parameters and is touted as an anti-aging agent, humans have to consume a bottle of red wine everyday to ingest the amount of resveratrol which is found to be effective in mice experiments (yes in mice! So the amount of resveratrol needed to produce a positive effect on human health will even be higher). So do not use resveratrol as an excuse for drinking alcohol. Few glasses of red wine cannot give you enough resveratrol and on the other hand it can affect your chance of conception when undergoing an IVF cycle.  Remember, moderation is the key here. If you feel relaxed after a drink , go ahead and have it , but avoid going beyond the stipulated limit. You will feel emotionally better if you stop consuming alcohol during an IVF cycle because even if the cycle fails , you will not blame yourself!

Diet

Healthy food intake is very important for your fertility and a healthy preconception diet increases the chance of ongoing pregnancy in women undergoing IVF/ICSI treatment. A good diet consists of fresh fruits and vegetables, complex carbohydrates, lean meats, dairy products and healthy fats, all in moderate amounts. There are no special foods that can increase your chance of IVF success and there are no foods that can hinder your chances of success (when not taken in excess!). Adding a wide variety of foods to your diet and taking them in the proper amount is very important for your reproductive health. If you search on the internet, you will find loads of advice on which food to take and which one to avoid when undergoing IVF. But I can vouch that all are just nonsense. Look at the women who conceive naturally; do they take any special food or do they avoid eating any particular food ? Then how could come a particular food either increase or reduce your chances of IVF success ? It is widely speculated that reducing caffeine is good and that increased caffeine intake can reduce your chances of IVF success. But I have found no scientific studies to support this notion.  If you are drinking 2 cups of coffee a day I find no valid reason to cut it down but if you are drinking 10 cups of coffee a day , then it is time to reduce your coffee (caffeine) intake. I have seen people avoiding fat as if it is a poison.  Remember, many sex hormones need cholesterol for their biosynthesis.  It’s fine to take healthy oils and fats in moderate amounts. There are some women who need a special diet, for example women with PCOD and women with diabetes because of the insulin utilization issues they have. Such women should talk to their doctor or dietitian and modify their diet accordingly.  But the basic diet rules are:

1)   Do not follow any fad diets.
2)  Include a wide variety of foods in your diet. Add color to your life by adding different coloured  vegetables and fruits.     
3)   Watch your caloric intake.
4)  Limit your intake of refined , calorie dense, nutrient depleted foods  like white sugar, white bread, white rice; and increase your intake of nutrient rich, calorie sparse foods such as  fresh vegetables and fruits.
5)   Remember, moderation is the key!

Supplements

Should I take any supplements?  Of course yes! The most important supplement which every woman who is trying to conceive should take is folic acid. Folic acid is proven to prevent neural tube defects in developing embryo. Taking folic acid can prevent 70% of neural tube defects. So make sure you take a supplement containing at least 400µg ( 0.4 mg) of folic acid at least 3 months prior to starting your IVF cycle. If you are diagnosed with mutation in your MTFHR gene you are supposed to take 4mg of folic acid . If you haven’t started taking it 3 months before, do not panic. Better late than never-so start taking it from today!  The internet is full of long lists of supplements ; and many women who have had IVF babies attribute their success to these.  Sometimes I really panic looking at these lists. From fish oil to wheat grass, there are just too many things to take !  Remember, what is good for the goose need not have to be good for the gander. So do not buy and gulp down supplements just because someone else is using it. Most nutrients can be obtained via a good diet. If you think your diet is not good enough , it is wise to start pre-natal vitamins prior to your IVF cycle.  There are some supplements which are helpful for women with a particular condition, for example, DHEA is a supplement which is found to help some women with poor ovarian reserve. So talk to your doctor regarding which supplements can benefit your particular situation. If taking lots of supplements helps you feel better emotionally ( lots of women feel that pills are good for their health) then please use supplements which are proven not to cause any harm ; and buy these from a reputed pharmacy! Some herbal supplements might interfere with your IVF cycle in an unknown and unpredictable manner. Always let your RE know if you are taking any herbal supplements when undergoing an IVF cycle.

Tuesday, November 6, 2012

Can an EmbryoScope help me in achieving IVF success?





Why is embryo selection important in the field of ART ?

Not all embryos which are transferred to the uterus implant and develop into a healthy baby. This shows that not all embryos are equal in their developmental competency. Fewer than 2 out of 10 embryos actually implant. This scenario underlines the importance of embryo selection before transferring them to the uterus. An ideal IVF cycle would produce a live birth when a single embryo is transferred to a receptive uterus. But even after 3 decades of IVF invention we are still far away from an ideal IVF cycle. Most clinics around the world have a success rate of 40-50% per cycle and this means the chance of failure when undergoing an IVF cycle is higher than the chance of success. During an IVF cycle several embryos are produced. The embryologist normally selects the best looking embryo(s) to be transferred to the uterus. The remaining embryos which are viable are frozen and are transferred to the uterus during the subsequent IVF attempts. How does an embryologist decide which embryo(s) should be transferred to the uterus?  There are a set of well-defined rules for selecting the best embryos (the embryos which are viable and most likely to implant) based on their morphological appearance under the microscope. Depending on those criteria, embryos are graded, the best ones are selected and are transferred to the uterus. But this technique is not fool-proof ! Fifty to sixty percent of the time , even the best looking embryo (called a top quality embryo, selected based on the embryo grading rules) fails to achieve a pregnancy. On the other hand, sometimes less than optimal looking embryos implant and give rise to a healthy baby.  If we are able to correctly pin-point which embryo will implant ( by being able to assess the developmental competency of an embryo accurately !) and become a baby then the success rate of an IVF cycle will greatly improve. A good embryo selection technique will be able to reduce the time taken to achieve a viable pregnancy when undergoing ART, even if it doesn’t lead to a 100% success rate.

What criteria should a good embryo selection tool have?

A good embryo selection technique must provide meaningful (it should be possible to make use of this information in routine clinical practice), quantitative information and should be non-invasive. It must be able to differentiate between ‘viable’ and ‘non-viable’ embryos as well as ‘normal’ and ‘abnormal’ embryos. For example an embryo which is viable need not always be genetically normal. Many viable embryos implant but fail to produce an ongoing pregnancy  because they are genetically abnormal . On the other hand , if the embryo is not viable , then it fails to implant and achieve a pregnancy.

Why don’t all the embryos produced via IVF implant and develop into a baby?

This is a million-dollar question ! Scientists are trying hard to decipher this puzzle. As per the present state of our knowledge, there are two major reasons for the failure of an embryo to implant:

1)      Lack of genetic competency in embryos

It has been found that 50 – 60 % of embryos created via IVF are genetically defective. Women of Advanced Maternal Age (AMA) produce an even higher percentage of genetically abnormal embryos. Such embryos are called aneuploid. Aneuploid embryos carry an abnormal number of chromosomes in them. Chromosomes are the structures which carry the genetic information necessary for creating a healthy baby. Abnormal chromosome number leads to abnormal genetic content which in turn prevents the ability of an embryo to implant and develop into a healthy baby.

2)      Lack of  receptive endometrium

The endometrial layer ( the uterine lining) plays an important role in embryo implantation. For the embryo to implant, a successful cross-talk between the endometrium and the embryo has to take place. If the endometrium fails to express proteins which are crucial in assisting embryo implantation, then even if the embryo is genetically competent , it will fail to implant in the uterus.

So, for an embryo to implant and develop into a baby, it has to carry accurate genetic information and the endometrium should be receptive enough to allow it to implant and grow.

What are the methods which are employed in the field of ART to select the embryo which is more likely to develop into a baby?

The most widely used method or ‘traditional’ method for embryo selection is based on assessing the morphological appearance of an embryo under the microscope (embryos are graded according to their cell number, amount of fragmentation and cell size). You can learn here how the embryos are graded according to their morphological appearance. The bitter truth is that not all ‘perfect’ looking embryos survive in utero and become a baby. On the other hand, sometimes even the worst looking embryo can give rise to a beautiful baby. Since looks can be deceiving, as always, there is a need to develop techniques which could accurately say whether an embryo is viable and competent enough to develop into a baby or not. At present there are two new developments which promises to increase the success rate of IVF. The first one is called comprehensive chromosome screening. This technique screens all the 23 chromosomes of the embryo for genetic abnormalities and thus helps in selecting embryos which are genetically normal. Since genetic incompetency of the embryo is said to be the main reason for IVF failure, this technique theoretically should improve IVF success rate. But this technique is invasive by nature and still in its infancy. Further clinical trials are necessary to determine whether CCS is a panacea or a pipe dream. You can read my blog post about CCS here.

There is one more recent invention which promises to increase IVF success rate by improving embryo selection criteria and this technique is based on time lapse embryo imaging. The instrument which is used for this purpose is called an EmbryoScope.

What is an EmbryoScope ?

A new technological advance which promises to improve IVF success rate is an EmbryoScope. It is an incubator (an instrument which maintains ideal temperature, humidity and proper oxygenation in order to support the optimal growth of embryos) with a built-in camera which can be used to monitor the growth of the embryo continuously without the need to remove them from their cosy culture conditions. The EmbryoScope thus provides a time-lapse , slow-motion picture of your embryo’s growth, minute by minute.

What information does an EmbryoScope provide ?

EmbryoScope provides information about an embryo’s morphokinetics (changes in morphology with time). It can be used to monitor the embryo’s development , minute by minute , and is capable of generating several images of embryos growth over a period of time. As a result an EmbryoScope can give details like - the time taken from fertilization to the first cell division; time taken to complete first cell division; time period between the subsequent cell  divisions; how many cells the embryo had at a particular time point; details about the cell nuclei and so on.

How useful is the information generated using an EmbryoScope  ?

The company which developed the EmbryoScope and many IVF specialists who own it claim that an EmbryoScope can improve IVF success rate. It is true that an EmbryoScope generates hundreds of beautiful pictures of an embryo’s growth. But how useful are these pictures / data in real life ?  For example, if an EmbryoScope is programmed to take pictures of an embryo every five minutes and if the embryo is monitored continuously for 3 days, then the instrument generates 864 pictures of an embryo, during its different stages of development. How will these pictures help in determining an embryo’s developmental competency? The company which sells the EmbryoScope provides software into which these pictures are fed . The software then says whether the particular embryo complied with the ‘optimal cell division rules’ during its development.  The key question is – how many randomised clinical trials ( not sponsored by the manufacturers) have been done to study the utility of the Embryoscope ? What is the proof that it is better than the ‘traditional’ method of embryo grading which relies on five or six single conveniently scheduled observations during its in vitro development ?  There are lots of unanswered questions and a lot more has to be done before someone can claim that EmbryoScope can improve IVF success.

Will the EmbryoScope help me in achieving IVF success?

As patients, we should welcome any new technological advance with utmost caution. Already the field of IVF is plagued with flawed technologies, flawed analysis and erroneous conclusions which affect us – the patients. We should not forget that the main aim of the company which sells this instrument ( and of the IVF clinics which buy this costly instrument ) is to sell this technology and reap a profit. As patients, our main aim should to get a baby with minimal expenditure. So if you are lured into selecting an IVF clinic based on their promise to use an EmbryoScope for improving the IVF outcome , you need to be careful. This is true especially if you have poor ovarian reserve or if you are a poor responder to IVF drugs and yet the IVF specialist promises that ‘come to us because we have an EmbryoScope, and can use it to help you in attaining success’ . The best thing you can do is to avoid that clinic because this clearly shows that even the IVF specialist is himself not aware of the limitations of an embryoscope or he just wants to earn more money. Remember, an EmbryoScope cannot give you more embryos or better quality embryos. It is just an instrument to select better quality embryos. The truth is that the selection criteria for embryos using an EmbryoScope are not well-defined at the present moment. A poor responder normally produces few embryos and what is the point of subjecting those embryos to monitoring using an EmbryoScope ? With few embryos , selection often becomes unnecessary because beggars cannot be choosers, and the doctor has very limited choices in the first place, because of the paucity of embryos !

At present, the EmbryoScope is a novel technological advance which might or might not prove to be helpful in improving IVF success. It is definitely not a magical solution for conceiving a baby via IVF. Until then , an EmbryoScope is just an instrument which provides beautiful pictures of your embryos - and if you have to do it for an added cost , it is definitely not worthwhile to use it!

Sunday, November 4, 2012

How I Selected My IVF Doctor !



Can you share your experience about Malpani Infertility Clinic ? This is the most frequent question I answer now-a-days. People who read my blog contact me and ask the same question in different ways. That is what prompted me to write this post. I hope it will be useful for people who are looking for obtaining good quality infertility treatment in India.
Dr. Malpani Review

When I started searching for IVF clinics in India, there were lots of doubts in my mind. I was really, really afraid to take treatment in India. I live in Germany and I have done 5 IVFs and 1FET here but unfortunately nothing worked. Doing IVF in Germany was not stressful. I do not have to travel to a far off place. The IVF centre is just 15 minutes travel distance from my home. I do not have to wait endlessly to get appointments because IVF centres are not that crowded here. I do not have to take off from my work and because of that I do not have to give any explanation to anyone. All is well and good but my IVF cycles didn’t result in a baby.  The financial and emotional strain was becoming high too. I started to realize that the embryo protection laws in Germany will not help me in obtaining success soon. Embryo selection is banned in Germany. The IVF specialists are forced to select embryos for transfer when the embryos are still in the zygote stage and the number of patients they got to treat is also very less. As a result, the IVF specialists here lack experience and most of them are not so long in the field of ART.  I know that the IVF laws in India are not as strict as in Germany. But to be very frank I am afraid of Indian IVF clinics. How good the clinics are in their profession? Do they follow proper guidelines and business ethics? Are they just money minded? Will they treat us with care and respect? Will the doctors be knowledgeable enough? How to contact them? Will they give a prompt reply? There were so many unanswered questions and so much of insecure feeling within me!
Dr. Malpani Review

During that time we went to India. We decided to visit an infertility specialist in my place. We took an appointment and went to meet that doctor. I was still in a German mindset then. I thought I will go, meet the doctor, get the necessary information and come back. But to see that doctor I waited from morning till late afternoon, almost 6 hours! There were so many other women waiting to see the doctor too. Whenever I enquired about the whereabouts of doctor, I was given some explanation like; doctor is in operation theatre she will come soon and so on. The reality of Indian IVF clinics and the way it is managed started to dawn on me. I could see my fellow patient’s agony. Their face showed so many different emotions – they were sad and desperate, worried and afraid! The long waiting time made them restless but they could not do anything to make their situation better – I really felt like a beggar and beggars can’t be choosers! In order to get rid of the loneliness I started to make eye contacts with the people there, smiled at them and started to chat with them. The women waiting there were so warm and compassionate. I could talk with them in my own language. Within minutes they started to share with me their infertility stories in a very innocent way. I will never forget those moments. Some stories brought tears to my eyes. I started to realize how better my situation was when compared to them. At last the doctor came. We met the doctor. She is a kind woman. When I told her we have tried IVF 5 times without success she just said try here once let us see. I could sense the hopelessness in her words. When we are coming out of her room I met the embryologist. I introduced myself and told him my story (5 IVF story!) and his immediate response was ‘why can’t you try donor eggs’? I was really gutted by that response, I forced my lips to smile, and my eyes had tears unable to bear that sudden emotional attack. We left that place with many more new fears in mind.

That was my first Indian IVF clinic experience. My DH told me ‘we are not going to that place anymore’. But I am ready to face anything (long waiting hours, unempathetic people etc) for the sake of my much desired baby. When we came back to Germany I started to look for IVF clinics all over India. I contacted few IVF specialists via e-mail but no one replied except Dr. Malpani! I could not explain my happiness in words. At last some Indian IVF specialist answered my e-mail. But even then I am not convinced. I was wondering, is it the doctor who replied or someone else replied on behalf of him. After this e-mail from him I started to gather information about Malpani Infertility Clinic. I saw their website. It had so much of useful information regarding infertility. I was impressed. But more than that Dr.Malpani’s blog helped me a lot – both emotionally and intellectually! I started to gain faith in their service. Can a doctor who talk about patient education and patient rights, can a doctor who spends so much of his valuable time educating his patients and in preparing patient education materials, can a doctor who understands his patient’s emotional suffering, do any harm? I started to mail him asking about my doubts and concerns. I always got a mail within 24 hours from him. He always gave a very crisp answer (mostly a single line) and it conveyed the message very clearly. I understood that he is very, very intelligent too! We decided to go to him for treatment! Dr. Malpani Review

But I found a complaint about him sometime later in an Indian consumer complaints forum. To tell the truth I was not upset about what I read. By the time I read that post I had been in frequent contact with Dr. Malpani through e-mail. I had satisfactory answers to all my questions. The cost of IVF was clearly mentioned in his website and his writings in his blog are very honest and truthful. He was concerned about the poor medical care patients receive; gets upset with patients who do not care to learn about the details of their treatment; empathizes with infertile women; and his blog posts showed many of his emotions very clearly without any pretension. I asked myself ‘can such a person even think of cheating anyone?’ Can such a doctor cheat his patients?’ Dr. Malpani Review

Even though, I convinced myself to go to Mumbai for taking treatment under Dr. Malpani, I was nervous too before my first visit. What if I see a very different environment in his clinic? What if he is a very different person-not like the digital avatar I knew through his blog and his e-mail? What if my nightmarish first Indian IVF clinic experience repeats again? I was afraid for sure. But I tried my level to be neutral in my mindset. I do not want to look at everything and everyone with suspicion – this will kill my peace of mind. So I went with a clean slate of mind. We waited to meet Dr. Malpani in his compact and cozy clinic. His staff are very kind and compassionate. I felt at home. My mind surprisingly was at ease and peace. Within few minutes we were called in to meet the doctor and my first fear ‘Will I have to wait forever to meet the doctor?’ vanished! Dr. Malpani Review

When I am waiting to see the doctor another interesting incident happened. There were two medical representatives waiting to see Dr. Malpani too. I was just observing and listening to what they are talking. One person asked the other "what kind of person is Dr. Malpani ?" The other medical representative answered, he is a very staright-forward and honest person. I was so happy to hear this; whatelese you want to know about an IVF doctor ? Soon Dr. Malpani called the medical representatives inside his room. I thought, now I have to wait another hour to see the doctor, because usually that is what happens when a medical rep goes into a doctor's room. To my utter surprise the medical rep returned within few seconds - I started to respect my Dr ! Dr. Malpani Review

I saw Dr. Malpani, in person, for the first time. He looked very respectable, he carried himself the way a doctor should ; and the way he took my infertility history showed his intelligence. We spent just 10 minutes with him during the first meeting and my expectation about a person whom I knew only through e-mail and his blog didn’t go wrong. But he is not as expressive as I would have expected him to be after reading his blog. I felt he is a bit reserved! Then we waited for the ultra sound scan . Just 15 minutes of waiting and Dr. Malpani saw us in the waiting room. He was asking the nurses – hasn’t Dr. Anjali come yet ? We met Dr.Anjali Malpani very soon. A very charming, sweet and expressive person she is! Within few minutes I felt I was talking to a friend. She is a very down to earth, friendly person who could provide you with immense emotional support in times of need.

So after this initial meeting half of my fears just vanished. The clinic is comfortable, the staff are very friendly, the doctors are knowledgeable and compassionate, they treated us well ad most importantly no long waiting hours!

I went to the clinic for further ultrasounds. All my doubts were answered patiently by the doctors. I always got to meet the doctors without any mediators in between. For blood tests, to measure hormone levels I just have to give the blood in their clinic and they transport the blood samples themselves to the lab where the hormone levels are measured. This is very comfortable and I was as comfortable physically as I was in Germany! I took all my other blood test results with me. So I am not asked to repeat any tests. I paid the amount which is mentioned in their website and to my surprise we received a proper bill for each and every penny we paid! Most Indian clinics fail to do this.

Dr. Anjali performed the egg collection. After the egg collection was over she came to the room where I was resting, and asked whether I was feeling better. She collected 24 eggs and 20 eggs were mature enough for fertilization. I was so happy because I didn’t get these many mature eggs even if I combined all my previous 5 IVF cycles ! The next day I got the fertilization report from Dr. Sai (embryologist). He said you have 17 embryos and all are looking good. I had a day 3 transfer. They froze 5 more good quality embryos that day. The remaining embryos were allowed to grow further from which I got 2 blastocysts. I saw all my embryos. I got the picture of my embryos which are transferred to my uterus. On the whole, my cycle went very beautifully and that is the best IVF cycle I ever had!

Dr. Malpani did the embryo transfer. He was continuously talking with me I didn’t even feel the stress of the process. He did it with so much ease without causing any major discomfort. When we are preparing to leave the clinic I met Dr. Malpani again. I told him that my mom and DH are compelling me to lie down in a particular position (always with my leg straight!), he told them, ‘please leave her alone, nothing she does will dislodge the embryos’. I was so grateful for the support he provided me.Dr. Malpani Review

My 6th IVF was again not a success. I was obviously broken down. When I mailed Dr. Malpani with the result of my pregnancy test, I received a mail in couple of hours with few words of comfort and those few words can mean a lot, especially when you hear it from the IVF specialist who has treated you. Recently I had another FET at their clinic , but this didn’t result in a pregnancy either. But I sincerely wish that my further attempts will be successful (My recent FET in Malpani Infertility Clinic resulted in a positive pregnancy test !). I know the uncertainty that is inherent in these kinds of treatments. But I am happy that I found a clinic where doctors care to give their best for their patients.

Still I keep wondering what prompted that anonymous person to write such harsh complaints against Dr. Malpani? (might be some of his competitor or an angry patient who failed in IVF attempt !) How could someone even think of spoiling a doctor’s hard earned reputation just by writing an online complaint? Why was Dr. Malpani was never given a chance to produce a rebuttal letter? Why don’t such online consumer complaint forums follow the basic ethics? People who wrote a negative review in that forum attacked Dr. Malpani’s character. They are not talking about a product, they are talking about a human being, a doctor who works hard to educate his patients and arm them with information therapy. A doctor who talks about patient rights and tries to improve the medical care they get. Even if they found his service defective or less than optimal they should have the guts to tell him directly. A good doctor will always be ready to learn and correct himself and I am sure Dr. Malpani is one of them.Dr. Malpani Review

These are the main complaints against him in the forum:

He cheats foreigners by collecting more money from them where Indian patients are charged less.
The waiting time for the ultra sound is high.
This is the worse, perverted complaint – he steals embryos, sells patients eggs and embryos!
He makes the patients come to him again and again by wantonly making sure that they do not get success in their first attempt!

Dr. Malpani has mentioned clearly the cost of IVF treatment in their website. If you are OK with the costs , go to them , otherwise do not. They give you a bill for the money you pay. If they collect less money for treatment from poor patients it is none of our business! They have a waiting time of 30-45 minutes for the ultrasound and it is a very reasonable waiting period. Other patients also want to talk to the doctor and the doctor’s time is taken only by a fellow patient! Dr. Malpani is in the field of IVF for more than 15 years. To accuse him of stealing eggs and embryos is the most perverse complaint anyone could have. When an IVF cycle fails it hurts badly. But it doesn’t mean that you can turn vengeful and write things which could tarnish the image of a reputable doctor. Every IVF doctor wants every IVF cycle to succeed as much as the patient desires! Every successful IVF cycle is the success of their entire IVF team. In short, many of anonymous complaints listed in that online forum are written with a malicious intent to spoil his reputation.
Dr. Malpani Review

I am a biologist. I hold a doctorate degree. I will not be foolish enough to go to a doctor who just works for the money I give. I am not even a person who got success after getting treatment from them. I am just a patient who got good medical care. I can differentiate between good medical care and bad care because my education. My sister is a gynaecologist too!
Dr. Malpani Review

Does Dr. Malpani cheat his patients? Definitely not! If you go to him for treatment:

You will be treated with care and respect
You will be informed clearly about your different treatment options
You can become a patient who is well-educated about your illness
You get the best medical care
You can see the doctors without the intervention of any mediators inbetween
You can get enormous intellectual and emotional support
Your IVF journey becomes less difficult
You can expect a good service for the money you pay
Dr. Malpani Review

I have written this article without any bias. One good side effect of the consumer complaint forum incident is that you will get much more care and pampering from their clinic because no doctor wants unhappy, unsatisfied patients! Personally I will always thank Dr. Malpani and their team for the good quality medical care I receive and all the emotional support I get from them. Thank you very much Dr!

I will be happy to answer your queries or concerns regarding taking treatment from Malpani Infertility Clinic. Please do mail me ! manjupadmasekar@yahoo.com
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