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Showing posts with label Malpani Infertility clinic. Show all posts
Showing posts with label Malpani Infertility clinic. Show all posts

Thursday, October 2, 2014

The Easy Breezy 2WW



A view of Mumbai from the hotel we stayed (Photo courtesy: Virender)

We entered the most exciting yet dreaded part of an IVF cycle - the 2ww! Surprisingly it felt good, I was happy that I got one more chance to enjoy the thrill of a two week wait. Rajender was adamant that we must stay in Mumbai for five more days. I told him that it would be very expensive to stay back but he said, "we are together on our own after long, long time, we have spent a lot until now, what will happen if we spend a bit more?" True, after coming to India we were either in his home or in my home. Even worse, the last couple of weeks I was in Madurai and he was with his parents. We did miss our togetherness without any interference. So, we stayed back. Five days just flew by. We used get up late, have breakfast, troddle around the hotel area, do window shopping, drink tender coconuts, go back to our room, sleep. I also got to eat lots of Jamuns, one of my favourite berries! It is a seasonal fruit and I was lucky to have them everyday. In the evening he would take me to a nearby small restaurant, I would taste different chaat items (an assorted savoury snack) each day, while he would sit and watch me devour it with a cup of tea. He is such a picky eater. He wouldn't touch any food he is not familiar with (even if it is presented to him in the most tempting manner). New food and new tastes never pleases him. I, on the other hand, will never say no to new food varieties; I could taste and even enjoy them all. The agreement between us is, I can eat whatever I would like to, but I must not force him to have it :) He is not greedy for food or for anything else in his life. This attitude of him has made my life much peaceful, pleasant and enjoyable. 


In the hotel, where we stayed, everyone knows us; they even know the reason for our visit. We stay in the same hotel during each of our visit. Everyone there is very friendly. They try their level best to keep our spirits high. This time everyone were saying, "The room you stay now is a very lucky one, for sure you will come with your little one next time". The most beautiful place in that hotel is the terrace restaurant. They have aptly named it as serenity restaurant and the view of Mumbai from there, during night, will be so beautiful. You do feel serene when you sit there for some time.


After five days of stay in Mumbai, we were gettig ready to leave to the airport. It was early morning and I was brushing my teeth. When I touched the inner corners of the mouth with my brush, I gagged violently. Rajender came and peeked inside. What happened was the question in his eyes. This gagging sound, when I brush, was very familiar to him. I gagged when brushing teeth all the five months of my pregnancy with our twins. He got to hear it every day, every morning. We both looked at each other but we dared not to talk about it. I knew what he was thinking and he knew my thoughts too. Then, I was trying to wear a new top which I brought there a week before and it didn't fit me quite nicely as it fitted the day when I brought it. I was quite frustrated. We got ready, went to the airport, and boarded the flight to Madurai. I sat and tried to fasten the seat belt. I looked at my tummy and was shocked! It looked as if I was three months pregnant. Slowly I touched it, it was hard. I remembered that I decided not to take cabergoline, a prolactin suppressing pill, which was prescribed in the clinic to prevent ovarian hyperstimulation syndrome. Rajender told me several times to have it. Dr. Anjali asked me too whether I was taking it after egg collection. But, my stand was that, it makes me depressed and even more I have gone through 6 IVFs and I never suffered OHSS once. So, I decided not to take it!  I regretted my decision. Am I developing OHSS ? I was scared.


We reached Madurai. I was so happy to meet my mom again. On that day night, I had a dream, an erotic dream. I woke up being close to an orgasm. I touched my lower abdomen - is my uterus contracting was the immediate question in my mind. This has happened to me now a few times. It happens during 2ww (when you are on hormones after IVF) or during pregnancy and never on other times. In short, it happens when you are afraid to have sex or orgasm. Is it due to all the hormones we take, or due to long abstinence from sex? Is it our body's way of saying that we are in need of increased blood supply to uterus and hence it coaxes our brain to produce images which ultimately leads to an orgasm? Then, does it mean orgasms are actually beneficial and are we avoiding them? I would be happy if someone could share their experience - does an orgasm in 2ww lead to your BFP? 


Seven days after my transfer I couldn't bear the suspense anymore. I just want to do a pregnancy test and move on. It was becoming unbearable. During all my previous 2ww I got the nerves not to test early. I never tested until 12 days after transfer. But, this 2ww was killing me. I just want the suspense to end so that I could plan further. The thought that I have 6 frozen blastocysts, and the possibility of transferring them to Rita did give me some peace of mind; after all, I have a plan B! So I decided to test on 7dp5dt. Dr told me to buy two different brands of home pregnancy tests to be sure. In the morning I collected urine, added few drops of it to the test kit. I and Rajender held our hands and waited anxiously. And ...


Friday, September 26, 2014

Embryo Transfer (7th IVF cycle)



Transferred embryo (Grade 2AA)
                                   


Embryo transfer to Rita 

Embryo transfer TO MANJU!


Let me explain. When I told Dr. Malpani that I will do one more ovarian stimulation cycle he said, “Manju, I suggest that you transfer one blastocyst to your uterus". He also said, “If that doesn't work, we will transfer the supernumerary embryos, we freeze, to Rita". Until that day nobody was able to convince me for having an embryo transfer again. I was adamant that I cannot go through another pregnancy. But, when my Dr said so, I didn't have any second thoughts. He is my Dr and if he says so, there must be a valid reason behind it. We all have a person in our life whom we admire and respect a lot, whom we look upon as our inspiration. He is one such person for me and I immediately agreed to what he suggested. But, I was not as optimistic as Dr. Malpani was. I thought, first let the stimulation start, let my ovaries respond to the drugs; let me produce eggs and embryos! After seeing my AMH value I became even more pessimistic. I was not even sure whether I will have embryos which will grow to blastocyst stage and whether we will have blastocysts to freeze. If I am left with less than 3 blastocysts, there is no point of transferring them to me. I was very confused. I thought, let me decide whether to transfer the embryo to my uterus or not after the day 5 fertilization report. As you all know now that I had 7 blastocysts at the end, we decided that I will have one (two?) transferred to my uterus. The happiest person about my decision was of course my husband. His positive spirit has always amazed me. His only complaint was that, I didn't budge to his words and when Dr said so I listened to him. But he was like, “atleast you listen to someone’s words in your life!” :)

Dr. Anjali asked me during one of my scans, "What have you decided regarding embryo transfer, how many embryos are you planning to transfer?" I had no answer then, I told her that I was very confused. I said, "Ma'm, sometimes I think I want to transfer two, sometimes one and sometimes nothing at all". This is how my mind was until the very last moment.

The day of embryo transfer came. I went to the clinic. My mind was unable to decide between how many blastocyst to transfer - one or two? I am 36 years old. For my age, chance of having aneuploidy in the resultant blastocyst is more than 50%. If it is so, 3 (minimum) of my 7 blastocysts might have chromosomal abnormality. If that is the case, isn't it wise to transfer two instead of one? On the other hand, I was scared to death of another twin pregnancy. After going through so much, I couldn't understand how my heart was greedy to even think of transferring more than one? Human mind is strange, it forgets pain so quickly! I thought, Dr. Sai will be there, Dr will be there, I will ask them both before coming to a conclusion.

In the clinic, we both entered our allotted room; I wore that wonderful hospital gown and waited eagerly for my turn :). I was also very eager to meet Dr. Malpani. I had met him only for 5 seconds during my entire stay there. I find embryo transfer stress free when he performs it. He keeps on talking something funnily and I forget that I am laying there in the most uncomfortable position, allowing people to poke and prod my private parts. If I am not comfortable during such procedures, I could feel my vaginal muscles tightening, my legs shivering uncontrollably. Sometimes because of getting so tensed, I get cramps in my leg muscles too; if that happens the whole ET episode could become very painful and scary. 

First, we were lead to the embryology lab. Dr. Sai was waiting for us. He showed us our embryos. He also showed the one which will be transferred to me. He said, “this is ahead of other embryos in its growth, so we decided to transfer this to you". I slowly asked him, “Dr. Sai, can I transfer two embryos, will it give me a better chance of success rather than transferring one?" He couldn't give me a conclusive answer. Who will suggest me something after knowing my history of twin loss? I said him, "Ok, I will ask Dr. Malpani, is he in his room? Should I meet him there or can I ask him when he comes for embryo transfer". He said, ask him when he comes to the embryo transfer room. So, I entered the ET room and saw Sister Mary and Vinayak (he works as an assistant). Both are very nice people. On seeing them I felt much comfortable. I just sat there on the ET table and started chatting while they were getting ready with the necessary items for embryo transfer. Vinayak asked, "can I call ma'm" and I looked at him shockingly!

I asked Vinayak, “Isn't Dr around?". He said, I don't know but ma'm said she will come to do the transfer. I was about to cry, my face was becoming grim. I told Vinayak, “will you please look whether Dr is in his room, if he is not going to do the transfer, I will not undergo this embryo transfer at all”. I know it was not very nice on my part. Vinayak looked at me as if his eyes would pop out. I actually ordered him, “go and look whether Dr is in his room", my intention was not to order, but, then, that was how I could react. He left the room. Sister Mary was listening to all this silently and she spoke. “Manju, ma'm will be upset if she hears this. She does embryo transfers very well. Do you know that women come from many different places in order to have embryo transfer done by her? She does embryo transfers equally good" On hearing this I felt guilty. True, how will ma'm feel if she hears what I said. How stupid I was! But I couldn't accept that Dr will not do the embryo transfer. I thought, “he didn't even care for me the least”. I wondered whether he even remembered that I have my embryo transfer on that day! I brought with me my children's foot prints (they gave them to me in the clinic after their birth) to show to him, I wanted him to hold it for some time, he only transferred them to my uterus and above all he is my Dr whom I shared my happiness and pain during my twin pregnancy. He was patient and kind enough to give me a shoulder to cry on during my very difficult times. It was hard to accept that he will not do my embryo transfer this time. It was very hard to accept the fact that my last chance for meeting him was no more viable. He didn't even wish me good luck! I remembered a patient e-mail where she asked whether Dr. Malpani will treat patients like me who writes blog like a VIP, I thought sarcastically, "yea, he does!" Vinayak came back. He said, " Dr is not there, only ma'm is there."

Dr. Anjali came. I always say that she has lucky hands. I think that expression is very unfair, and it somehow underplays her talents. She is the most talented person around. Several years of experience and her dedication has sharpened her skills a lot. Since Dr. Malpani is net savvy people know him better than Dr. Anjali, but, she is the best in the clinic :) The first question I asked her, as soon as she entered the room was "Ma'm, where is Dr?". She said, "He is busy nowadays, he went somewhere out". From that moment onwards till the embryo transfer all I did was to cry. Not just tears I was sobbing!

Dr. Anjali asked me, "Manju, how many embryos do you want to transfer?" I asked her, " how many should I transfer, can I transfer two?" She was not able to suggest me something too. She said, “you must decide". I was baffled. Lying down with legs on the stirrup and trying to think logically was not an easy task. I looked around and said, "I will ask my husband, where is he?" Normally, when Dr. Malpani transfers the embryos, Rajender will be with me. I wondered why he is still not there. Dr. Anjali told me “I don't want husbands inside the embryo transfer room". Even at that moment I actually appreciated her. I always felt that Rajender was more tensed than I was during embryo transfers. Instead of him trying to keep me calm, I have to hold his hand tightly to give him some assurance that all will be fine. Even after coming out of the embryo transfer room, he will be replaying several times in his mind whether all went well. He would say, “I saw some blood in the catheter after transfer, is that OK. Doctor was taking long time, he was moving something here and there, and would he have done it correctly?” His questions and doubts are enough to send me to a panic mode destroying the joy and peace of having a little embryo inside. So, Rajender was not available too to get an answer for the most important question - should I transfer one or two embryos? My mind was racing, I had only few minutes to decide, I was angry with Dr. How to decide, I had no clue! And, then an idea flashed inside me.

Vinayak, was near my eyes reach. Sister Mary and Dr. Anjali were preparing my nether region for transfer. I called Vinayak. He looked at me with little fear, “what is this stupid woman going to order me now was the question in his eyes” :) He was tensed. I showed him two of my fingers and said (ordered!) touch one of the two. He was totally clueless. He blinked for a moment and touched both my fingers. I really went mad for a moment, that's my last effort and he is trying to spoil that too. I said, "Vinayak, touch only one". People in that room were looking at that drama. He reluctantly touched one of my fingers. I calmed down. I looked at Dr. Anjali and said very confidently, "ma'm please ask Dr. Sai to bring only ONE embryo".

Dr. Anjali proceeded to transfer the embryo. She realized that I was crying. She asked me several times why I was crying. She was saying, “See, at one point we were wondering how many embryos you might get; now you have many. I thought you will be so happy and smiling today, why are you crying?" I gave no answer; all I did was to cry dutifully. Dr. Anjali asked me to breathe like the way when we do pranayama. She said, “I must see your stomach moving up and down”. All I did was to sob. She asked, "aren't you happy Manju?" I couldn't answer. She asked this for few times until Sister Mary interfered nervously. She said, “Oh, she is happy, heyna Manju”, she asked. I realized I am behaving stupidly. I said, "yes ma'm, I am happy". Dr. Anjali before transferring the embryo asked me to visualize it. I could see that she was saying a little prayer when she pressed the piston of the embryo transfer catheter. The transfer went on smoothly. I didn't feel any pain or I was not in a mood to feel what was going down there. She did it very carefully and with so much ease. After the transfer I thanked her amidst tears. I could see a very frustrated look in Dr. Anjali's face (due to all my tears!). She said, "I have to leave now, I will meet your husband and then leave"

After Dr. Anjali left, Sister Mary was telling me, “during transfer you were crying, because of all your sobbing I could see the cervix moving up and down". I just gave a blank expression. She said again "do not worry ma'm did the transfer very well". I was still on the crying mode. Vinayak on seeing this was trying to console me. He said, "There was a patient, her name is Manju too. She now has twins after many failures. This time all will go well for you" This further increased my sobbing. He was near my head. He kept his palm on my forehead and said, "Don’t cry Manju". That was such a compassionate gesture. I felt instantly better. I told him with smile on my lips and tears on my eyes, “if I do not get pregnant, for sure I will come and kill you, you are the one who said that I must transfer only one embryo".

Ten minutes I was there in the transfer room. Sister Mary and Vinayak made me feel so comfortable with all their pep talks. Sister Mary never fails to ask me a question whenever we meet, "your husband seems to be a very nice person, isn't he?" :) Previous time she even said, " when I fist looked at you, I thought you were proud but after talking to you I understood that you were not like that" :) Thank God! Mary Sister goes on talking and talking, she talks in Hindi, I reply in English, language doesn’t really matter!

I was allowed to go to my room after 10 minutes. Rajender was eagerly waiting for me. If he sees my tears he will panic, so I wore a smile on my lips. I told him that everything went on well and lay down. I said that ma'm did the transfer and that is why he was not allowed in the embryo transfer room. Before telling him that Dr was not there, tears once again appeared. He said, "please do not start again Manju, atleast not now". He looked at me for some time and said, "who knows I am not there in the transfer room and that might be your lucky charm". I looked at him angrily, didn't want to respond. I just closed my eyes. I thought, "Where will this decision of mine take me to? Why can't I have a crystal ball to predict my future?"

After half-an-hour I was ready to go. Rajender wanted me to rest for some more time but I wanted to leave. I said good bye to everyone. When I was about to leave, Shonali told me, “Manju, you should never come here again". I was very thankful for those words. I knew she meant well. With a heavy heart I came out, I thought, "I will never ever talk to Dr again, and if this embryo doesn't implant then I will see" :(

Where did my decision take me to? Will it lead me to happiness and bliss or to sadness and grief once again? Keep reading!

Thursday, March 27, 2014

A query about Malpani Infertility Clinic


This query which I got from one of my blog reader is very honest. Many will hesitate to ask these questions but she was so good in putting her doubts in words.

Question : 
 I am a regular visitor of your blog and found very useful information.  We are facing fertility problem since long. We are living in Delhi and belong to a medium family. Two failed IVF(ICSI) cycles in Delhi.  Reason for IVF failure was poor embryo quality. They were little  fragmented. So doctor suspected my egg quality is poor. I am taking Coq 10 now and planning for next round in November. We are planning for Dr Malpani guaranteed Success program, although it cost too much , which is bothering us. To manage such a large fund is really very difficult for us, but we will try to do. As we became so much frustrated with this issue and want to give our  best and final. Here I need your opinion as an elder sister, i am 32 now. I have read about doctor Malpani and one of my friend told me that he is too commercial, but whenever I  saw your blog I was convinced you would tell me the truth.
Now my decision depends on your reply , so please try to answer my queries- 

1. Does Dr Malpani pay attention to all his patient or only to  some specific VIP patients like you who is a blog writer((Please do not get angry))
2. My husband has motility issue, does it make our case weak ?
3. Does IVF protocol make any difference in embryo quality.
4. Is it safe to fly after embryo Transfer. 
5. Is it ok to do follow up with other doctors after positive pregnancy test.
6. Why did you choose Dr Malpani over others ?
7. Is doctor Malpani commercial ?
8. Do they handle each case on their own or handover to associates ?

How can I contact you by phone.

I am waiting for your reply.
 
Answer :
Nice to hear from you. I appreciate your questions :) and I am not a bit angry ! I am sorry that two of your attempts failed - Is your husband's sperm motility issue the reason for IVF ? Can you please send me the photos of embryos transferred to you ? This will give me a better idea about their quality. You should remember quality of an embryo also depends on the competency of the embryology lab. Can you send me the complete details of your IVF cycle in Delhi ? What is your AMH value ? Dosage of meds used ? How many eggs retrieved, how many fertilized and how many transferred ?

 1.  
Does Dr Malpani pay attention to all his patient or only to  some specific VIP patients like you who is a blog writer
 He treats all his patients the same, including me ! I had a chance to see him and talk with him less than 10 mins this time. I had nothing much to ask and my FET is quite straight forward. He gives the same treatment to all his patients and  treats everyone as a VIP. Dr. Anjali does the egg collection and scan, the embryologist , Dr Sai, does all the fertilization work and loads the embryo into the catheter and Dr. Malpani does the consultation and ET.
 
2. My husband has motility issue, does it make our case week.
No, definitely not ! ICSI will give you the best chance for success.
3. Does protocol make any difference in embryo quality?
I think so, because better eggs will give rise to better embryos.
4. Is it safe to fly after embryo transfer?
I did fly after my ET :)
5. Is it ok to do follow up with other doctors after positive preg test.
Sure, you have to !
6. Why did you choose Dr Malpani over others.
1.    I am comfortable with his conservative approach (He doesn't order unnecessary tests and therapies)
2.     He is very knowledgeable (He knows what he does!)
3.    It is very easy to contact him (available 24/7 via e-mail)
4.    He is not over optimistic nor does he promise the moon; he doesn't think he is God or the final authority on IVF. He clearly understands that only certain things are in his hand and does that part of the work well good. They are very transparent in what they do, from embryo photos to medical bills everything is open and documented !
5.    The clinic is so compact there is no need to run around. I felt very comfortable.
6.    I believed in him - this is my intuition! When you select a doctor you can't know 100% about their honesty or competency. Our intuitions play a major role. I like his honest writings and I believed him whole-heartedly. The vibes we create around us (the way think about a person) play a very important role about how the opposite person reacts with us :) I went with good vibes. I didn't look at Dr Malpani with suspicion. Once I selected them I believed them :)
    
7. Is doctor Malpani commercial ?
Every doctor needs money to survive-aren't they humans? What do you mean by commercial? His clinic is in a costly area and he has staff to feed. They charge a bit more than others but it is all worth at the end because of the service they provide. They don't charge anything extra.
8. Do they handle each case on their own or handover to associates ?
    No, Dr. Malpani and Dr. Anjali handle everything themselves. They do not have any assistants.

I hope this helped ! :)
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