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Understanding the Uncertainty and Setting Realistic Expectations in IVF

Patient: Dr. Malpani, when I think of IVF, I see it as this advanced medical procedure, full of science and technology, promising to give us a baby. But is it really that straightforward?

Dr. Malpani: You're right—it involves a lot of science and technology. However, surprisingly, IVF can also feel a bit like gambling. The outcome of any given IVF cycle is always uncertain. No matter how well we do the treatment, the future remains unpredictable.

Patient: That sounds a bit unsettling. Isn't IVF supposed to have a certain outcome?

Dr. Malpani: I understand your concern. We are very good at making embryos in the lab, but not every embryo becomes a baby because we cannot control the process of implantation inside the uterus. It’s quite literally like buying a lottery ticket each time. It's not very reassuring, but that's the reality.

Patient: So, does that mean success is just a matter of luck?

Dr. Malpani: Not exactly. What patients often seek is certainty, but false certainty can be more harmful. It's important to be realistic about your options and understand that it's a probability game. Sometimes, it may take two or even three cycles before you get pregnant. The more cycles you do, the better your chances—this is called the cumulative conception rate.

Patient: But how many cycles should we keep trying? Is there a limit?

Dr. Malpani: You need to be responsible about this. You can't keep doing cycle after cycle indefinitely. It's crucial to set a limit and be well informed. You need to have realistic expectations, learn from each cycle, and then decide. If after a certain number of cycles it doesn't work, then you might consider Plan B or Plan C—such as using donor eggs, donor embryos, or even adoption.

Patient: It seems like there are so many decisions to make. How do we know we're making the right one?

Dr. Malpani: It's important to be well-informed, to keep an open mind, and to use your brain to make the best decisions for yourself. It's also about listening to your heart and not getting completely carried away, risking valuable time, energy, and money.

Patient: This is a lot to process. What if I need more help?

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