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Bouncing Back After a Failed IVF Cycle

A failed IVF cycle causes a lot of heartache – for both patients and doctors. Aside from pain and grief, many of people start playing the blame game. Was the doctor negligent or incompetent? Did the patient fail to follow medical advice?Egg-Freezing-2.jpg

The truth is that we can learn much from a failed cycle, and this is why it's important to create a framework, so that we can analyze the failed cycle and increase the chances of success for the next attempt.

Basically, the problem could be either with the clinic or with the patient. I understand this is an oversimplification, but we can use this simplified model so we can drill down intelligently. If the problem was because the clinic was poorly equipped or the doctor was not experienced, then this is an easy problem to fix by just changing the clinic for the next cycle. However, many cycles will fail inspite of the physician doing everything humanly possible and providing the best medical care.

Unfortunately, patients have a hard time pinpointing what the reason for the failure was – especially if this was a result of medical incompetence (for example, an inexperienced embryologist who ends up killing many eggs while doing ICSI). Some doctors will deny the truth (for example, by saying the sperm were of bad quality, and were not able to fertilize the egg!).

This is why openness and transparency are so important in an IVF clinic. It’s true that patients are upset when the cycle fails, and doctors don’t like having to handle angry and tearful patients. However, when the physician refuses to meet them or discuss the reasons for the failure or provide intelligent information as to why the cycle failed, this angers the patients even more. They suspect the doctor is hiding the truth from them.

Strengthening the Doctor-Patient Relationship

In fact, a failed cycle can actually be an opportunity for a good doctor to create even more trust in the patient. He should be willing to analyze exactly what happened and why, so he can discuss the next action steps with the patient. This is why good documentation, including embryo photos (which should be provided routinely and proactively at the time of the embryo transfer) are so important.

Sometimes the problem is a biological problem, such as poor egg quality. In these patients, no matter how good the clinic, the chances of being able to create good quality embryos are slim. This is why counseling patients honestly before the cycle starts is so important, so that they have realistic expectations of what the technology can do for them. Sadly, doctors often over promise at the time of the first consultation, because they want the patient to come to them for treatment, as a result of which they quote highly inflated success rates.

However, biology being what it is, sometimes the unexpected does occur, and even when the doctor has certain expectations, these don't always pan out. In life, we need to deal with some of these ups and downs. The best way of doing so is by being frank and forthright. A good doctor will say – This is what we expected, and this is why we expected this; however, this is what actually happened, and these are the possible reasons for this. Based on this analysis, this is what we can do differently the next time.

One option of course is to change the clinic, but this is not always the right choice and should not be your knee-jerk response just because you are upset the cycle has failed. If you are happy with your doctor and the way he has treated you, you should continue with him – after all, he is likely to be more incentivized to try harder the next time around!

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Infertility treatment IVF

Dr. Aniruddha Malpani

Dr. Aniruddha Malpani

Dr. Aniruddha Malpani is an IVF specialist with a brilliant career with numerous awards, educational distinctions and prizes. Dr. Malpani completed his postgraduate degree in Gynecology from the University of Bombay in 1986. He received further training in IVF from UCSF, San Francisco, and U.S.A. As a medical student, he studied at Harvard, Johns Hopkins and Yale. He practices in Mumbai, India along with his wife Anjali. He can be contacted at info@drmalpani.com, or learn more at http://www.drmalpani.com.

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