Patient: Dr. Malpani, I've been hearing a lot about all these advanced tests and treatments available in IVF. Can you explain if they truly improve the chances of pregnancy?
Dr. Malpani: That's a great question. While technological advancements in IVF have certainly made significant strides, there is a growing concern about the overuse and misuse of some of these technologies. Often, they don't necessarily improve pregnancy rates and can lead to unnecessary expenses for patients.
Patient: Can you elaborate on why IVF success rates are still limited despite these advancements?
Dr. Malpani: Absolutely. IVF is indeed a complex process with inherent uncertainties. We've become quite adept at creating embryos and transferring them back into the uterus. However, the critical step of embryo implantation remains a bit of a mystery. Even the best doctors can't predict whether an embryo will implant or not—it's essentially a black box.
Patient: That sounds quite uncertain. Why do some doctors recommend so many advanced and expensive tests?
Dr. Malpani: Many patients, especially those who have faced multiple failed IVF cycles, seek assurance and confidence from their doctors. To differentiate themselves and offer something seemingly unique, some doctors suggest a variety of advanced and expensive tests. These include tests like the Endometrial Receptivity Array (ERA), Preimplantation Genetic Diagnosis (PGD), and various immune therapies.
Dr. Malpani: Many patients, especially those who have faced multiple failed IVF cycles, seek assurance and confidence from their doctors. To differentiate themselves and offer something seemingly unique, some doctors suggest a variety of advanced and expensive tests. These include tests like the Endometrial Receptivity Array (ERA), Preimplantation Genetic Diagnosis (PGD), and various immune therapies.
Patient: What are these tests supposed to do?
Dr. Malpani: Let's take a closer look:
- Endometrial Receptivity Array (ERA): This test, costing around ₹50,000, claims to determine the optimal time for embryo transfer.
- Preimplantation Genetic Diagnosis (PGD): This genetic test, costing about ₹1 lakh, aims to identify chromosomal abnormalities in embryos.
- Immune Therapy: These treatments are supposed to address immune-related implantation failures and can be quite expensive.
Patient: Are these tests really helpful?
Dr. Malpani: Unfortunately, no. These tests are often not designed to improve pregnancy rates but rather to increase the clinic's revenue. When IVF doctors conduct these additional tests, your chance of getting pregnant actually decreases. The high cost and perceived sophistication of these tests can mislead patients into believing they are necessary, which is far from the truth.
Patient: That's quite concerning. How can patients protect themselves from unnecessary tests?
Dr. Malpani: Patients should be well-informed and critical of the tests being recommended to them. A reliable resource for evidence-based information on fertility treatments and tests is the Human Fertilisation and Embryology Authority's (HFEA) website. It provides unbiased information on the efficacy of various tests without any commercial influence.
Patient: Are there ethical concerns about using these unproven tests?
Dr. Malpani: Definitely. Using unproven tests in clinical practice is ethically problematic. It's acceptable to use these technologies in a research setting where their efficacy can be properly evaluated. However, incorporating them into standard clinical practice without clear evidence of their benefits essentially turns patients into guinea pigs. This not only exploits their hopes and financial resources but also undermines trust between doctors and patients.
Patient: How can patients make better-informed decisions about their treatment options?
Dr. Malpani: Patients should be vigilant and proactive. Seek second opinions, thoroughly research proposed tests, and question their necessity and efficacy. This approach helps in making better-informed decisions and protects against unnecessary and costly procedures.
Patient: Thank you, Dr. Malpani. This conversation has been very enlightening. What should I do if I want more personalised guidance?
Patient: Thank you so much, Dr. Malpani. I'll definitely look into that.
Dr. Malpani: You're welcome! Remember, being well-informed and critical of your treatment options is essential for a successful and stress-free IVF journey.
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