MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'infertility'. Sat, 03 Sep 2011 01:49:05 +0100 http://www.medworm.com/index.php?rid=5181944&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fblog.drmalpani.com%2F2011%2F08%2Fi-was-just-talking-to-patient-whose.html . She had had a poor ovarian response and he wanted to know whether it was worth trying another cycle again on not. His question was simple . Is it worth subjecting her to the pain of an IVF cycle ? Do we have a chance of success ? Or is it futile ? Are we just breaking our head against a brick wall . He wanted my opinion, based on what we’d learned from the first IVF cycle. He loved his wife a lot , and was very protective of her. He didn't want her to go through the pain of another IVF failure , and while he understood that there were no guarantees, he still needed advise as to whether it was sensible to try again. The major problem with an IVF cycle is not the physical pain of course - it's the emotional pain of failure, because there's so much riding on the outcome of an IVF cycle.... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=5181944 Wed, 31 Aug 2011 04:03:00 +0100 5181944 http://www.medworm.com/index.php?rid=5181945&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fblog.drmalpani.com%2F2011%2F08%2Fhow-to-do-consultation-3-step-approach.html I was giving an infertile couple a tour of our IVF lab. The husband was a cardiologist and he was marveling over how complex IVF is . He knows I am a big believer in Information Therapy, and he started wondering aloud how I could explain something so intricate, involved and complex as IVF in a 15 min consultation. I explained that I have a standard three-stage format for doing a consultation. In step number one , I explain normal fertility - how babies are made when everything is working properly. I review normal anatomy and physiology ; the role of the cervical mucus and the fallopian tubes; the concept of the fertile time; when ovulation occurs and how to track this; and the importance of frequent intercourse to maximize normal fertility. This is a review of the basics , just to make su... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=5181945 Tue, 30 Aug 2011 04:19:00 +0100 5181945 http://www.medworm.com/index.php?rid=5174691&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fblog.drmalpani.com%2F2011%2F08%2Fhow-to-do-consultation-3-step-approach.html I was giving an infertile couple a tour of our IVF lab. The husband was a cardiologist and he was marveling over how complex IVF is . He knows I am a big believer in Information Therapy, and he started wondering aloud how I could explain something so intricate, involved and complex as IVF in a 15 min consultation. I explained that I have a standard three-stage format for doing a consultation. In step number one , I explain normal fertility - how babies are made when everything is working properly. I review normal anatomy and physiology ; the role of the cervical mucus and the fallopian tubes; the concept of the fertile time; when ovulation occurs and how to track this; and the importance of frequent intercourse to maximize normal fertility. This is a review of the basics , just to make su... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=5174691 Tue, 30 Aug 2011 04:19:00 +0100 5174691 http://www.medworm.com/index.php?rid=5174693&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fblog.drmalpani.com%2F2011%2F08%2Fhow-do-i-decide-which-treatment-is.html Many infertile couples are confused as to which treatment to select. There seem to be so many choices – and even worse, so many different opinions from different doctors ! It’s hard for them to figure out if IUI is better for them ( as recommended by their gynecologist) or whether they should move on to IVF ( as suggested by their RE) ! This is why it's very important to create a comprehensive treatment plan right from the beginning . For example, I recently saw a young patient with polycystic ovarian disease . I sat with her and explained her options to her. Step number one would be ovulation induction with metformin , and if that didn't work, then we’d use ovulation induction drugs such as letrozole or clomiphene. If that failed, then one option would be laparoscopic ovarian drill... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=5174693 Mon, 29 Aug 2011 03:14:00 +0100 5174693 http://www.medworm.com/index.php?rid=5159259&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fblog.drmalpani.com%2F2011%2F08%2Fwas-that-embryo-which-fell-out-after-my.html The mind plays games after the embryo transfer. Every little cramp or discharge can excite hope - or lead to despair ! This is especially true when the IVF cycle fails and patients get their menstrual period. They often imagine that they can see a little clot of tissue or a little ball of cells in the menstrual flow, and they feel that they have miscarried the embryo. This actually reinforces their feelings of low self esteem. Not only can’t they get pregnant in their own bedroom, their body could not even hold on to the beautiful embryos which the doctor grew in the lab and transferred to the uterus ! Please remember that an embryo is just a small microscopic ball of cells , which is not visible with the naked eye. If the embryo fails to implant , it gets silently reabsorbed about 2 o... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=5159259 Mon, 22 Aug 2011 04:01:00 +0100 5159259 http://www.medworm.com/index.php?rid=5140182&cid=t_99549_136_f&fid=37846&url=http%3A%2F%2Fhealthinfoispower.wordpress.com%2F2011%2F08%2F18%2Fmesothelin-antibodies-occur-in-some-women-with-an-epidemiologic-risk-for-ovarian-cancer%2F Researchers at Rush University Medical Center discover mesothelin antibodies in the bloodstream of infertile women, who possess a higher risk of ovarian cancer. Using a new approach to developing biomarkers for the very early detection of ovarian cancer, researchers at Rush University Medical Center have identified a molecule in the bloodstream of infertile women, who [...] (Source: Libby's H*O*P*E*) Libby's H*O*P*E* blogs http://www.medworm.com/rss/comments.php?id=5140182 Thu, 18 Aug 2011 16:32:48 +0100 5140182 http://www.medworm.com/index.php?rid=5096656&cid=t_99549_117_f&fid=37824&url=http%3A%2F%2Fwww.doctorkalitenko.com%2Fblog%2Fmale-infertility-risk%2F A young couple, just married, wants to have children to grow their family and have someone carry on their genes and traits and looks.  That is how it should be.  But often a young couple faces an unusual problem that they should never encounter: infertility. Traditionally a woman is to blame first.  But nowadays more and more often a man is to be blamed. Have you ever heard about the “Disappearing Male Syndrome” (1) or “Vanishing Male Syndrome?”  It is all about toxins shutting down the male reproductive system.  But doesn’t the declining fertility rate portend the disappearance of human beings? I think it does. And it is not only a decreased sperm count (2,3): it is also testicular cancer, genital congenital abnormalities, etc. So what are the reasons? Toxins from alm... Doctor Kalitenko antiaging blog blogs http://www.medworm.com/rss/comments.php?id=5096656 Wed, 03 Aug 2011 16:09:23 +0100 5096656 http://www.medworm.com/index.php?rid=5086580&cid=t_99549_177_f&fid=38134&url=http%3A%2F%2Fbabybound.wordpress.com%2F2011%2F08%2F01%2Fwoah-where-the-fuck-have-i-been%2F Wow. It’s been almost 2 years. A lot can happen in 2 years. Lives can change, people can grow, horrible tragedies can happen…. …yeah some of that happened but let’s not get crazy here. It’s really not all that exciting. In fact it’s kinda downright boring. So last I posted I was moving to Seattle. Yay for me! Holy crap that was a long time ago. Sorry I just can’t get over that. Yeah I moved to Seattle for 10 months and decided that I would be insane to continue living there. Depressed infertile divorcing people should not move to Seattle. There should be a law about it. The sky is a unique shade of grey. Let’s just leave it at that because there is good and bad up there but overall I had a hard time. (And to be fair to the lovely residents of... B a b y B o u n d blogs http://www.medworm.com/rss/comments.php?id=5086580 Tue, 02 Aug 2011 05:59:57 +0100 5086580 http://www.medworm.com/index.php?rid=5062317&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fblog.drmalpani.com%2F2011%2F07%2Fis-it-egg-or-sperm.html Whenever an IVF cycle fails, the commonest question patients ask is - was there a problem with the eggs ? or with the sperm ?Logically, one would expect the answer to be 50-50 - after all, both are gametes which contribute the 50% of the DNA to the embryo.In fact, this is one of the reason there are so many tests for testing sperm "quality" - ranging from the zona free hamster egg penetration assay ( which is now obsolete) to the newer sperm DNA fragmentation tests ( which are very fashionable and popular right now, but will also soon get relegated to the dustbin).However, these tests are useless in clinical practise.Why do I say so ?Let's consider a couple who does ICSI treatment for a low sperm count, and gets poor quality embryos . They are disheartened and upset, so they get a second o... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=5062317 Mon, 25 Jul 2011 02:46:00 +0100 5062317 http://www.medworm.com/index.php?rid=5036615&cid=t_99549_167_f&fid=36994&url=http%3A%2F%2Fnutrition-news.blogspot.com%2F2011%2F07%2Fpcos-poly-cystic-ovary-syndrome.html PCOS - UKNutritionists have many strategies for getting to the bottom of some the causes of infertility. Poly Cystic Ovary Syndrome or PCOS is an increasingly common culprit in infertility problems but it's not just fertility that can concern patients but a host of other health problems too.Ask an experienced, qualified, insured clinical nutritionist about the solutions they have to help deal with PCOS , the symptoms and how to enhance the choices offered by your doctor.Email Nutritionists London or Nutritionist New Forest  for a free video on PCOS case studies or contact  leading UK nutritionist Yvonne Bishop-WestonNutritionists London (Source: Healthy Eating and Nutrition News) Healthy Eating and Nutrition News blogs http://www.medworm.com/rss/comments.php?id=5036615 Sat, 16 Jul 2011 11:54:00 +0100 5036615 http://www.medworm.com/index.php?rid=5028518&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fblog.drmalpani.com%2F2011%2F07%2Ffinally-pregnant-after-frozen-et.html Here's a heartfelt success story from one of our patients.I think our journey to IVF started like for most couples. First, we got married and were perfectly content childless. Then, we started thinking about when to have kids and soon decided that “now” was the right time. After a few months, I started to read more and more on the internet about the fertile days, printed out ovulation calendars, and made temperature charts. Finally, I bought one of those electronic ovulation kits and invested quite some money in these gadgets. Well, but that still didn’t make me pregnant.My gynecologist said everything was fine, apart from two fibroids, but that shouldn’t matter. My husband, reluctantly, had his sperm tested and it seemed fine, too. So why did it not work?I tried a few rounds of cl... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=5028518 Thu, 14 Jul 2011 02:55:00 +0100 5028518 http://www.medworm.com/index.php?rid=5028520&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fblog.drmalpani.com%2F2011%2F07%2Fwhen-things-go-wrong-in-ivf-cycle.html There are lots of hopes riding on an IVF cycle - and every patient thinks in their heart of hearts that the cycle is going to work for them . This is why when something goes wrong, patients are often extremely upset and frustrated , and will often take out their anger both on themselves & on the doctor. Unfortunately IVF is a biological process and no matter how competent your doctor, sometimes bad things do happen. IVF obeys Murphy’s law which clearly states , Anything that can go wrong, will go wrong. This is why it’s important to be prepared and have realistic expectations. Every IVF cycle has multiple moments of truth. Think of it like a series of hurdles, and you need to cross all of these in order to reach the finish line. You can trip up on any one of these hurdles.Taking a ... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=5028520 Tue, 12 Jul 2011 03:02:00 +0100 5028520 http://www.medworm.com/index.php?rid=5008348&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fblog.drmalpani.com%2F2011%2F07%2Fwhy-do-doctors-blame-stress-for.html As an infertility specialist, I see a number of infertile couples who’ve been to other gynecologists before coming to me. Often they will have a simple problem such as irregular cycles which are because of anovulation, and which can be treated by taking medicines to induce ovulation . Ideally, the doctor should explain that the irregular periods are a result of not ovulating; that the cause for this can be diagnosed with ultrasound scans and blood tests; and that this can be treated by taking medicines to induce ovulation.However, a lot of doctors will glibly say “ Oh , don’t worry, your irregular periods are because you take too much stress – it’s “all in your head” ! They tell the patients that if she gets rid of the stress , the periods will become regular. Of course that�... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=5008348 Fri, 08 Jul 2011 15:57:00 +0100 5008348 http://www.medworm.com/index.php?rid=4960137&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fblog.drmalpani.com%2F2011%2F06%2Fis-success-rate-higher-with-fresh-or.html In the past, everyone agreed that the success rate was much higher with fresh embryos. This was primarily because the embryo freezing technology was not very good. We used a technique called slow freezing, and unfortunately, as a result of the freezing and thawing, upto 50% of embryos ( or the cells in the embryo) would die. This is because embryo cells ( called blastomeres) contain a lot of water; and the freezing process would lead to ice crystal formation within these cells. When these embryos were thawed, these crystals would cause cell death. Obviously, embryos will dead cells have a much poorer chance of implanting, and most labs were resigned to this fact that the process of freezing and thawing would cause damage to some embryos. However, it was still well worth freezing, because t... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4960137 Wed, 22 Jun 2011 02:20:00 +0100 4960137 http://www.medworm.com/index.php?rid=4953028&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fblog.drmalpani.com%2F2011%2F06%2Fhow-to-improve-vitrification-of.html This is a guest post by our embryologist, Sai Gundeti.Vitrification is the newer alternative to the traditional ‘slow freezing’ technique of cryopreservation of embryos for storage and future use. It is far more efficient and effective than the older technique, which is why we now use only vitrification in our clinic for cryopreservation of eggs and embryos.It is the duty of the embryology team to learn this new technique, so they can offer the best possible care to their patients.Here’s how we vitrify embryos in our lab.It’s usually the supernumerary embryos which are vitrified, which is why embryo vitrification is generally carried out after the best ( top ) embryos have been transferred in the fresh IVF cycle . However, in some cases we may electively freeze all embryos , and no... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4953028 Sat, 18 Jun 2011 03:12:00 +0100 4953028 http://www.medworm.com/index.php?rid=4934397&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fblog.drmalpani.com%2F2011%2F06%2Fis-my-ivf-doctors-treatment-correct-is.html As an IVF specialist, one of the commonest questions patients ask me is - Is my IVF clinic offering me the right treatment ? Are they using the right protocol ? Are they monitoring me properly ? Was the treatment which was offered to me correct ?This often puts me in a spot ! It's hard to know what another doctor did, without having complete and accurate documentation. This is why I do not like second guessing other doctors or commenting on their treatment, as every doctor does things differently !Sometimes I do cringe when I see how poorly the IVF treatment cycle was done . This is especially true when the treatment was done at a small clinic, which does less than 100 IVF cycles per year; or in a clinic which batches patients, and depends upon an IVF specialist who flies down once a month... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4934397 Thu, 16 Jun 2011 04:04:00 +0100 4934397 http://www.medworm.com/index.php?rid=4934399&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fblog.drmalpani.com%2F2011%2F06%2Fwhy-patients-need-to-take-initiative.html I am always amazed by how smart some of my patients are ! While I am an IVF expert and know a lot about the technical minutiae of IVF, I do not know much about how to solve the additional challenges patients face when they need to travel to India for their IVF treatment. I am happily impressed by how well organised some of my patients are ! Travelling to India from the US for IVF treatment is quite a challenging exercise - but something they do with ease !What I like about these patients is that they take the initiative, thus making it easier for me to help them. For example, they will design their own IVF calendar ( using Excel or Word ), so it's easy for me to review and approve. This helps them to arrange their logistics efficiently - and makes it easier for me to OK their travel plans.... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4934399 Tue, 14 Jun 2011 15:54:00 +0100 4934399 http://www.medworm.com/index.php?rid=4911599&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fblog.drmalpani.com%2F2011%2F06%2Fhappy-patient-from-kolkata.html Hi, We are from Kolkata and this is our story that we would like to share.First of all, would like to extend our warm gratitude to Dr.Aniruddha & Dr.Anjali Malpani, and their staff making our IVF treatment a SUCCESS !!!I am on the ninth week of pregnancy now and hoping and always pray it will be a SUCCESS until the baby is born.We tried 4 times IVF in Kolkata but every time we were disappointed, then from the website of Drmalpani we come to know about Dr Malpani.We were extremely happy by his instant response of all our queries by email . We reached Mumabi and went through the blood test where we found that my AMH level is low and we totally lost our hope. But Dr. advised us to go and take a chance with IVF and we followed his advise.And in my first attempt with him I got pregnant.The ... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4911599 Thu, 09 Jun 2011 02:37:00 +0100 4911599 http://www.medworm.com/index.php?rid=4734247&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fblog.drmalpani.com%2F2011%2F04%2Fpgd-cgh-is-it-of-any-use.html The newest IVF technology uses a fancy new technique which marries IVF and genetics. This is called PGD ( preimplantation genetic diagnosis) with CGH ( comparative genomic hybridisation) and there are lots of press releases and articles touting this as the newest breakthrough !Doctors , like all big boys, love to play with new toys - and the newer the better ! This is especially true when they have expensive new technological tools, which no other competitor has. Doctors can be very competitive - and are always trying to be one-up on each other. An easy way of being different is to use the newest technology - but the trouble is that never is not always better ( though newer is always more expensive !)Because these new tools are so expensive , doctors need to use them extensively, to justif... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4734247 Tue, 19 Apr 2011 02:45:00 +0100 4734247 http://www.medworm.com/index.php?rid=4723805&cid=t_99549_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Folympian-impregnated-with-the-wrong-embryo%2F2011.04.17 Olympic winner and motivational speaker, Jim Stovall once said “Integrity is doing the right thing, even when no one is looking.” In September 2009, I wrote about a blog about Carolyn Savage, a 40 year old woman with a poor obstetrical history. Savage married her college sweetheart and had an uncomplicated first pregnancy. However, her second child was born prematurely. She had 4 subsequent miscarriages and ten years later she became pregnant through in-vitro fertilization (IVF). Because the Savages wanted a large family, they tried IVF again. Unfortunately, Savage was impregnated with the wrong embryo. To their credit, everyone rose to the highest level of integrity. The infertility clinic informed the Savage family as soon as the mistake was discovered and then gave them the option o... Better Health blogs http://www.medworm.com/rss/comments.php?id=4723805 Sun, 17 Apr 2011 18:00:26 +0100 4723805 http://www.medworm.com/index.php?rid=4723980&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fblog.drmalpani.com%2F2011%2F04%2Fwhy-i-love-being-online-ivf-specialist.html This is a guest post from Carina Freeman, the Fertility Coach. I think it's time to take the time and share my story. To help you understand why I am passionate about Hold your Hand fertility coaching. In 1997 I was able to conceive a son with no problems at all. I had no idea what my future would hold. I have always had very severe menstrual cramps. However, I never went to get them checked out because I thought it was "normal." My mom, her sisters, and their mom also had severe cramps. I always wanted more children after my son was born in 1997, but thought maybe it just wasn't my time yet. So, we kept trying for years with no success. This made me feel like less than a woman. Why could I not give my husband a child? After several years, my husband suggested I go to the doctors to ha... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4723980 Sun, 17 Apr 2011 09:55:00 +0100 4723980 http://www.medworm.com/index.php?rid=4704734&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fblog.drmalpani.com%2F2011%2F04%2Fhappy-couple-from-canada.html Hi, We are from Canada and this is our short story that we would like to share as noted below:First of all, would like to extend our warm gratitude to Dr.Aniruddha & Dr.Anjali Malpani, and your staff making our IVF treatment a SUCCESS !!!I am on the eleventh week of pregnancy now and hoping and always pray it will be a SUCCESS until the baby is born.Planning/deciding to undergo IVF is not a joke/easy. There are a lot of things to consider.1. Financial - IVF involves a huge amount of money like travelling expenses, hotel,food,medicine and might affect the job as well2. Stress - Need to manage your stress - IVF involves a lot of stress. 3. Taking the risk a. Job - Ready to quit the job to have full rest if required according to case to case basis before and after the treatment until... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4704734 Tue, 12 Apr 2011 03:12:00 +0100 4704734 http://www.medworm.com/index.php?rid=4670183&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fblog.drmalpani.com%2F2011%2F04%2Fwhat-to-do-when-you-make-mistake.html I see many patients who have failed IVF cycles in other clinics. In order to improve their chances of success, I ask them basic questions about their earlier cycle: How many follicles did you grow ? How many eggs were retrieved ? What was your embryo quality ? Surprisingly, many are quite clueless , and know very little about the medical details of their treatment cycle, because " my doctor did not tell me anything " ! They are often upset and angry- and resentful that their doctor did not share more information with them.After realising how much their doctor has kept them in the dark, they conclude that they made a mistake in the doctor they selected. They feel cheated and start believing that they can no longer trust any doctor.One of the reasons for their bad choice is because they did... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4670183 Fri, 01 Apr 2011 14:28:00 +0100 4670183 http://www.medworm.com/index.php?rid=4664287&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fblog.drmalpani.com%2F2011%2F04%2Fwhat-to-do-when-you-make-mistake.html I see many patients who have failed IVF cycles in other clinics. In order to improve their chances of success, I ask them basic questions about their earlier cycle: How many follicles did you grow ? How many eggs were retrieved ? What was your embryo quality ? Surprisingly, many are quite clueless , and know very little about the medical details of their treatment cycle, because " my doctor did not tell me anything " ! They are often upset and angry- and resentful that their doctor did not share more information with them.After realising how much their doctor kept them in the dark, some of them feel they made a mistake in the doctor they selected. They feel cheated and start believing that they can no longer trust any doctor.This is not a happy situation, because they then lose the opport... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4664287 Fri, 01 Apr 2011 14:28:00 +0100 4664287 http://www.medworm.com/index.php?rid=4664220&cid=t_99549_107_f&fid=36672&url=http%3A%2F%2Fwww.sciencebase.com%2Fscience-blog%2Ffive-more-science-stories.html Sperm condensation – Protamines are small basic proteins that condense the genetic material, the DNA, in mature sperm helping to form the head of the sperm. They are rich in the amino acid arginine whose residues are distributed in a number of stretches separated by neutral amino acids. The amino acid accounts for between 60 and 80 percent of the protamine. Now, a team in Spain has used Fourier transform infrared spectroscopy to investigate, for the first time, the secondary structure of protamines in sperm nuclei. The Forgotten Greenhouse Gas – In a carbocentric political environment, dinitrogen monoxide, is almost the forgotten greenhouse gas. Enormous volumes are released into the atmosphere naturally from soils and the oceans. This accounts for about two-thirds of the atmos... Sciencebase Science Blog blogs http://www.medworm.com/rss/comments.php?id=4664220 Fri, 01 Apr 2011 08:00:05 +0100 4664220 http://www.medworm.com/index.php?rid=5118934&cid=t_99549_136_f&fid=39027&url=http%3A%2F%2Fwww.cancerlifeandme.com%2F2011%2F03%2Fblood-isnt-always-thicker%2F About four years ago, I went to a doctor appointment that, until now, only my wife knew about. It was a visit to a urologist. The subject of the meeting was to evaluate my fertility. My wife and I were recently married, and so naturally the idea of children came about eventually. I dreamed of having my own kids someday. But, I also tried avoiding any conversations about procreating. This is because I highly suspected I might be infertile due to the chemo/radiation treatments I had received, yet I didn’t want it to be official. I wanted to keep hope alive through denial and avoidance. But the question kept bugging me: Can I have kids? And then I thought about what it was doing to my wife, the uncertainty. We needed to either accept bad news and move on, or realize good news and begin ... Cancer, life, and me blogs http://www.medworm.com/rss/comments.php?id=5118934 Tue, 29 Mar 2011 16:00:56 +0100 5118934 http://www.medworm.com/index.php?rid=4653516&cid=t_99549_136_f&fid=39027&url=http%3A%2F%2Fwww.cancerlifeandme.com%2F2011%2F03%2Fblood-isnt-always-thicker%2F About four years ago, I went to a doctor appointment that, until now, only my wife knew about. It was a visit to a urologist. The subject of the meeting was to evaluate my fertility. My wife and I were recently married, and so naturally the idea of children came about eventually. I dreamed of having my Continue reading Blood isn’t always thicker… (Source: Cancer, life, and me) Cancer, life, and me blogs http://www.medworm.com/rss/comments.php?id=4653516 Tue, 29 Mar 2011 16:00:56 +0100 4653516 http://www.medworm.com/index.php?rid=4642718&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fblog.drmalpani.com%2F2011%2F03%2Fwhat-infertile-couples-go-through-and.html (Source: The Patient's Doctor) The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4642718 Sun, 27 Mar 2011 06:53:00 +0100 4642718 http://www.medworm.com/index.php?rid=4636491&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fblog.drmalpani.com%2F2011%2F03%2Fhow-many-weeks-pregnant-am-i.html Many IVF patients get very confused about how the doctor calculates the age of their pregnancy( = gestational age, in medical jargon). Logically, shouldn't it be from the day of the embryo transfer ? After all, it's only after the embryos are transferred that a woman can be considered to be pregnant !However, doctors are not always logical, and we usually use the menstrual age when talking about the length of the pregnancy. This is because obstetricians usually see women who have got pregnant after having sex in their bedroom. Very few of them will know the exact date they ovulated , which is why we use the menstrual age in clinical practise. This does not change just because you have had an IVF pregnancy - the clinical rules remain the same !This creates a lot of confusion in patient's mi... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4636491 Sat, 26 Mar 2011 03:47:00 +0100 4636491 http://www.medworm.com/index.php?rid=4636495&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fblog.drmalpani.com%2F2011%2F03%2Finfertility-mans-perspective-ivf.html We were a happy carefree couple, enjoying our freedom to do things that we liked, for the first four years of our marriage. And then when we finally thought of starting a family…. It didn’t happen for another year and we were happy childfree couple. Couldn’t figure out initially what can go wrong, but when we decided to do a reality check, we landed up at a neighborhood Obs&G’s clinic. She ran a few preliminary tests which didn’t point to anything in particular, prescribed few medicines for me. Six months later, the same tests were repeated again, and again. And then I was referred to a urologist for surgery for a suspected varicocele. That’s when it dawned upon us that may be we are knocking on the wrong door!After a couple of months & a million clicks on the net, we d... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4636495 Thu, 24 Mar 2011 03:21:00 +0100 4636495 http://www.medworm.com/index.php?rid=4636505&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fblog.drmalpani.com%2F2011%2F03%2Fsperm-dna-fragmentation-assessment-is_17.html All infertile couples know that the sperm plays a vitally important role in fertility. However, there's still a lot of confusion ! If we need only one sperm to fertilise an egg during ICSI, does the sperm count and motility really matter ? And if it does, how and why ?The fact that the WHO has kept on changing the definition of what a normal sperm count just testifies to the fact that experts are as confused as patients are. This is especially true when we consider 3 contentious areas. While it's true that the sperm provides 50% of the child's DNA, can it be responsible for:failed fertilisation after ICSI ?poor qualty embryos ?miscarriages ?In order to drill down further into when the sperm can be responsible for reproductive problems, researchers have developed sophisticated tests to anal... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4636505 Thu, 17 Mar 2011 03:46:00 +0100 4636505 http://www.medworm.com/index.php?rid=4636513&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fblog.drmalpani.com%2F2011%2F03%2Fhow-couples-reduce-their-own-fertility.html Infertile couples are often willing to move heaven and earth in order to have a baby. However, I find to my dismay that a lot of them do things which actually end up reducing their fertility !1. They use lubricants while having sex which kill the sperm . Having "baby making sex" on demand is not much fun for either husband or wife - and it's quite common to have to use lubricants in order to be able to achieve intravaginal penetration. However, many couples will use lubricants such as K-Y jelly or saliva - both of which can kill the sperm ! If you do need to use a lubricant, please use a sperm friendly lubricant. The easiest one to buy ( and the cheapest one) is liquid paraffin. It' easy available OTC at a chemist - just look under the laxatives !2. Timing sex. Most couples know that the w... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4636513 Sun, 13 Mar 2011 13:58:00 +0100 4636513 http://www.medworm.com/index.php?rid=4636514&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fblog.drmalpani.com%2F2011%2F03%2Fthanks-dr-malpani.html This is an email a patient from Nigeria sent me today." I have set aside this morning to commend you and your beautiful wife on the good work you are doing for humanity. You give hope to the hopeless, healing our wounds of years by showing commitment and concern, even when the situation looks gloomy. You are ready to even pray for mercy and help for your patients! I am impressed.I have discovered that IVF is a journey. The travellers are the patients, but all of us will have to travel by different means of transportation, The luckiest by air, some by sea, others by road. It means there will be travellers by jet, speedboat, canoe, ships, cars, bikes, rail or even trucks and cartwheels! I am happy you guys are the drivers and my prayer is that the Almighty Creator will always grant you the w... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4636514 Sun, 13 Mar 2011 13:41:00 +0100 4636514 http://www.medworm.com/index.php?rid=4636515&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fblog.drmalpani.com%2F2011%2F03%2Fmoments-of-truth-in-ivf-cycle.html An IVF cycle is full of uncertainty and suspense , like any other biological system. However, being prepared for these can help you cope better !Think of an IVF cycle as being a series of hurdles - and you need to cross all these to reach the finish line ! While most patients will cross these hurdles with ease in a good IVF clinic, each of these is a " moment of truth ".You should grow many folliclesThese follicles should matureYour uterine lining should also mature in synch with your folliclesOvulation should not occur before the eggs can be collectedMature eggs must be retrieved by the doctor during the "pick-up"Your sperm must fertilize the eggs ( with IVF or ICSI)The embryos must divide and grow healthily in the IVF labYour embryos should be transferred by the doctor smoothly into your... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4636515 Sat, 12 Mar 2011 03:35:00 +0100 4636515 http://www.medworm.com/index.php?rid=4575111&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F03%2Fwhy-should-i-select-malpani-infertility.html I just received this thoughtful questionnaire from a patient.We are looking for “gestational surrogacy” in India. There are many clinics offering these services and before moving forward in this decision, we want to have more information about your clinic and some steps of the process. Here are our questions and concerns.1. How many years of experiences in fertility and surrogacy does your clinic have? 20 years2. What are the main steps and what is the time table of the whole process a. Steps The process is described in details at www.indiansurrogates.in b. Timeframe 20 days3. What is the delay from first contact to start of surrogacy? 3-4 months4. What are the legal concerns with surrogacy? Our legal consultant will take you through these5. What are the legal p... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4575111 Fri, 11 Mar 2011 10:36:00 +0100 4575111 http://www.medworm.com/index.php?rid=4570602&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F03%2Fwhy-we-offer-guaranteed-pregnancy.html Everyone knows IVF has a limited success rate and that there are no guarantees in medicine. If that's the case, then why do we offer an IVF guaranteed pregnancy program ?Is this just a marketing gimmick ?No ! There are lots of benefits to this option, both for our patients and for us.For one thing, this option bolsters the patient's confidence levels ! Patients who have failed IVF cycles elsewhere have lost confidence in doctors - and in themselves. Before starting the IVF cycle, most clinics promise the moon. However, when the cycle fails, the patient becomes a leper and the doctor becomes inaccessible ! Finding a doctor who is is willing to put his money where his mouth is helps them to rebuild confidence in the medical system !This option also helps patients to have realistic expectatio... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4570602 Fri, 11 Mar 2011 03:56:00 +0100 4570602 http://www.medworm.com/index.php?rid=4570603&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F03%2Fspringtime-in-mumbai-ivf-success-story.html My husband and I have been married for seven years, and are now 11 weeks pregnant! Even with the euphoria of this moment I don’t want to forget the journey of three years that brought us here, and Dr. Malpani and his team have been like a guiding light in this.The ‘TTC’ CoupleWe wanted the first few years of our marriage for ourselves and made the most of them by traveling all we wanted, my establishing myself in my career and having time with each other. After the fourth year we started trying for a baby, once the initial 7-8 months were over we started to think that we should get a medical opinion so that we can eliminate the possibility of a problem or rectify it if there’s one. We met our OB&G and she suggested a few basic tests, based on these she started some medication f... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4570603 Thu, 10 Mar 2011 09:10:00 +0100 4570603 http://www.medworm.com/index.php?rid=4566165&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F03%2Fis-doctor-professional-or-technician.html I just saw a patient who was 40 years old; she had had 2 miscarriages; and she wanted me to do surrogacy for her. I spent a long time explaining to her why I did not think this was her best choice. Surrogacy is an expensive and complex treatment option, which is best reserved forwomen without a uterus. Research shows that the reason for failed implantation is much more likely to be genetically abnormal embryos ( because of poor quality eggs), rather than a uterine problem.Her reasoning was completely different. The fact I got pregnant means my eggs are OK ! The fact I miscarried means my uterus is defective because it could not hold the baby. This means that if use a surrogate uterus, I will have a baby !The reality is completely different. The fact that she conceived means her uterus is f... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4566165 Thu, 10 Mar 2011 04:26:00 +0100 4566165 http://www.medworm.com/index.php?rid=4566169&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F03%2Fatlas-of-ivf-embryos-dr-sai-senior.html Unfortunately, most patients doing IVF treatment are quite clueless about the most important end-result of the IVF cycle - the embryos ! This atlas will help you understand what your eggs and embryos should look like, so you have a better understanding of what happens in the IVF lab !DAY 0 ( the day of egg collection)MATURE OOCYTE CUMULUS COMPLEXESTHESE ARE MATURE OOCYTE CUMULUS COMPLEXES, IDENTIFIED IN THE FOLLICULAR FLUID ASPIRATED DURING EGG COLLECTION.POST MATURE OCCYTE CUMULUS COMPLEXSTRIPPED EGGSMATURE EGGS :THIS IS A MATURE EGG (SURROUNDING CUMULUS CELLS HAVE BEEN STRIPPED OFF)POLAR BODY AT 12 O CLOCK POSITION INDICATES THAT THIS IS A MATURE EGG AT METAPHASE IISTRIPPING IS MANDATORY FOR PERFORMING ICSI ON THEM.CUMULUS NEED NOT BE STRIPPED FOR CONVENTIONAL IVF.THIS EGG IS NOT A MATUR... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4566169 Wed, 09 Mar 2011 06:44:00 +0100 4566169 http://www.medworm.com/index.php?rid=4560371&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F03%2Fwhy-do-women-who-miscarry-feel-they.html All doctors know that the commonest reason for a miscarriage is a genetic abnormality in the fetus, and this is Nature's defense mechanism, to prevent the birth of an abnormal baby. While these defects are often random, they are commoner in older women. This is because the eggs of older women have more genetically abnormalities, because they have "aged" and have genetic defects, which cannot be screened for. This means that the usual reason for a miscarriage is a problem with the embryo - and most women who miscarry have a completely normal and healthy uterus !However, a patient who had early recurrent pregnancy losses has a completely different world view ! She feels that the fact that she got pregnant in her bedroom means her eggs must be fine. She usually has regular cycles , and since ... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4560371 Tue, 08 Mar 2011 04:31:00 +0100 4560371 http://www.medworm.com/index.php?rid=4560400&cid=t_99549_113_f&fid=38494&url=http%3A%2F%2Fcuretogether.com%2Fblog%2F2011%2F03%2F07%2Finfertility-asthma-link-confirmed%2F It’s time to start repeating some of our earlier studies to see if they hold up with the larger dataset we’ve now gathered in collaboration with our nearly 25,000 marvelous members. The very first discovery we announced, back in September 2009, was an association between Infertility and Asthma. The 2009 finding was based on an analysis of 324 members, and revealed that members with Infertility were 1.9x more likely to report Asthma. We just re-ran the analysis (15 months later), with data from 3,735 members (11.5x larger sample!) and we discovered that… the association still holds.     The gritty details: within the 253 people reporting infertility, 51 (20%) reported having asthma (the remaining 202 out of 253 specifically said they did NOT have asthma). Wi... The Collective Well blogs http://www.medworm.com/rss/comments.php?id=4560400 Mon, 07 Mar 2011 22:21:07 +0100 4560400 http://www.medworm.com/index.php?rid=4554662&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F03%2Ftry-and-try-till-you-succeed-success.html Try and try till you succeed....i think this mantra holds not only in your professional life but personal too....After two years of trying for baby and undergoing two laproscopies ,two iuis and one failed ivf we were devastated....we thought we can never have a child of our own....but then by God's grace we came across the web site of Dr Malpani..Oh it was so informative! i posted my history and there came a very positive reply..there was a ray of hope...we made up our minds to give ourselves one more chance so that we don't repent later.We visited Dr Malpani clinic in May 2009 for the first time and i must say there is something in his clinic..i think its God's blessing to them...the environment is so positive and cordial and Dr Malpani is so very approachable and positive too that we imm... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4554662 Sun, 06 Mar 2011 11:45:00 +0100 4554662 http://www.medworm.com/index.php?rid=4549791&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F03%2Fwhat-can-i-do-to-improve-chances-of-my.html This is one of the commonest questions patients ask me. A good IVF clinic is quite good at making good embryos in the lab. However, once they are transferred into the uterus, then whether they will implant to not is a biological process which is not in anyone's control ! It can be quite scary to think that the fate of your embryos is in your hands - and that if you make a false move, you may lose the embryos !The actual IVF treatment, leading upto the egg collection is full of action ! You are taking injections every day and the doctor monitors you closely. It's fun watching your follicles grow on the ultrasound screen and actually seeing your embryos can be a very emotional moment in your life ! However, after the embryos are transferred, you are pretty much on your own. You have no idea ... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4549791 Sat, 05 Mar 2011 05:16:00 +0100 4549791 http://www.medworm.com/index.php?rid=4545024&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F03%2Fovertested-and-overtreated.html Infertile patients can be desperate for a diagnosis. They naively feel that once they know what the problem is, we'll be able to find the solution !This leads to testing - which has now become an epidemic of overtesting.Let's see why. Patients still have unrealistic expectations from IVF treatment. Doctors often do not bother to counsel them. They are so focused on "grabbing patients" to do one IVF cycle, that they overpromise success. They make tall claims during the IVF cycle to keep the patient's hopes high - everything is going very well- you will definitely get pregnant ! Then, when the cycle fails, the doctor becomes inaccessible ! Patients get disillusioned and hunt for a new doctor. The new doctor needs to do something more - something different - as compared to the old one - after... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4545024 Fri, 04 Mar 2011 04:49:00 +0100 4545024 http://www.medworm.com/index.php?rid=4540601&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F03%2Fwhat-is-minimum-number-of-follicles-you.html We deal with a number of difficult patients who have failed multiple IVF cycles elsewhere. Many of these are poor ovarian responders and a common question is - How many follicles do you need to go ahead with the treatment ? Is there a number in your clinic below which you will cancel the cycle ?These patients suffer from a lot of anxiety and apprehension during the superovulation, because they know they are not likely to grow many eggs. They have already had many of their cycles cancelled in the past - and this can be quite a cruel thing to do , because these are eggs which they have produced with a lot of effort ! Their eggs are precious - and represent their best chance of their having a baby with their own genes. This is why when the doctor cancels the cycle because they have not produc... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4540601 Thu, 03 Mar 2011 03:26:00 +0100 4540601 http://www.medworm.com/index.php?rid=4536150&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F03%2Fdonor-embryos-and-embryo-adoption.html Donor Embryos: Biologically , embryo adoption is exactly the same as a traditional adoption , in that the child and the parents have no genetic linkage. However , here the resemblance ends. Whereas with traditional adoption it is a child who is adopted after birth, in embryo adoption the infertile couple adopts an embryo before pregnancy.However , the sad tragedy is that there are just not enough babies available for adoption. Not only is the demand for adopting babies increasing day by day as infertility becomes more prevalent , the supply of unwanted babies being put up for adoption by the mother has become drastically reduced.It is ironic that while the technology of contraception and abortion has reduced the availability of adoptable children, assisted reproductive technology now offer... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4536150 Wed, 02 Mar 2011 05:00:00 +0100 4536150 http://www.medworm.com/index.php?rid=4532590&cid=t_99549_177_f&fid=38137&url=http%3A%2F%2Fmissionimpossibleinfertile.wordpress.com%2F2011%2F03%2F01%2Foffline%2F Do forgive me, I’ve kind of been offline. I can’t say that I precisely recall at what point I ceased whining incessantly about howling misery, divided-in-two cramps, an unmistakable and rather painful everything-is-going-all-prolapse-y sensation of, well, one cervix becoming rather lax and products of conception UN-concepting in the usual messy fashion and the like EXCEPT that I may have not got to that point on accounts of I was busy moving house, home, losing my marbles in the process and, yes, working. I still love a good case of run-on sentence abuse, even with near-terminal anaemia. It’s not very nice at all to flush lumps of gore down the loo in the middle of a ten hour cover shift, but at the rate I keep losing pregnancies it’s either that or join the dol... Mission: Impossible (or adventures in infertility, pregnancy....parenting?) blogs http://www.medworm.com/rss/comments.php?id=4532590 Tue, 01 Mar 2011 10:08:28 +0100 4532590 http://www.medworm.com/index.php?rid=4532274&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F02%2Fhappy-patient-from-europe-who-did-donor.html I am the classic case of a woman who postponed starting a family to focus on her career while never believing that one day she would be facing infertility issues. I even believed that I could choose the month I wanted to get pregnant! I was almost 34 years old by the time my husband and I were out of school and settled enough in our jobs to start our family. I guess that is not really so old if there are no fertility issues, but if there are then time is definitely not on your side. By the time I turned 35 years old, we were living in Europe and began seeing a infertility specialist. In the middle of all the standard infertility tests, I managed to fall pregnant naturally. Our joy did not last long because at 8 weeks pregnant all that could be seen on the ultrasound were two empty gesta... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4532274 Mon, 28 Feb 2011 13:11:00 +0100 4532274 http://www.medworm.com/index.php?rid=4527782&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F02%2Fwhy-follicular-studies-ovulation.html Many gynecologists advise ovulation tracking as the first line of "treatment" for infertile couples.This seems to be sensible advise. You just have to go for vaginal ultrasound scans which help you time precisely when you ovulate. You have sex at this time, and since eggs plus sperm = baby, you get pregnant in the first cycle itself ! How can this fail - especially if you are young and all your test results are normal ?Actually, the tragedy is that patients have very unrealistic expectations from follicle tracking ! The success rate , even in a perfect cycle , is only about 10 % ! Remember that human reproduction is not very efficient, and just timing sex does not help ( unless you've never had sex at the right time earlier !)Doctors often forget the downside of ordering follicular studies... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4527782 Mon, 28 Feb 2011 04:47:00 +0100 4527782 http://www.medworm.com/index.php?rid=4525061&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F02%2Fdoes-it-matter-how-many-ivf-cycles-you.html We see many patients who have failed multiple IVF treatment cycles in other clinics. Most of them are quite depressed and frustrated. They are not sure whether it's worth trying another IVF cycle with us, or whether they should explore alternative options .The key question in their mind is - What can you do differently from the other IVF clinics ? What makes you better ?I enjoy treating these patients . For one, they are a challenge, and if our treatment works where other clinics have failed, this is a feather in our cap ( doctors can be very competitive !)Also, because they have done IVF earlier, they understand the basics of the treatment, so I can have an intelligent conversation with them and explain what we are going to differently. Because we are a full-service clinic, we can offer a... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4525061 Sat, 26 Feb 2011 04:47:00 +0100 4525061 http://www.medworm.com/index.php?rid=4522160&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F02%2Fmaking-sense-of-your-ivf-superovulation.html One of my patients recently asked me - Which protocol is better for IVF - the Letrozole Antagonist Protocol vs the Estrogen Priming Protocol ?( In passing, I'd like to point out how impressive it is that patients are so well informed about medical minutiae ! Most gynecologists are quite unaware of all these finer details !)Actually, the principles of any superovulation protocol for IVF are extremely simple. Superovulation forms the heart of modern IVF. We use medications to help you grow more eggs. Every month you start to grow about 30-40 follicles, but in a natural cycle, most of these undergo atresia (die), so that only one matures every month, in the normal course of events. With the help of medications, we are able to rescue follicles which would otherwise have died, so that we can he... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4522160 Fri, 25 Feb 2011 04:41:00 +0100 4522160 http://www.medworm.com/index.php?rid=4512446&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F02%2Fwhy-do-my-sperm-counts-vary-so-much.html One of the most frustrating problems for infertile men is the fact that their sperm counts seem to vary all the time. On some days it is 5 million per ml; on others it drops to 2 million per ml; while on good days it goes upto 10 million per ml ! It's like the Sensex; as volatile; as hard to predict ; impossible to control; and variations in the sperm count cause as much stress as dips in the Sensex !Remember that the testes are sperm production factories which produce billions of sperm daily. The efficiency of this factory is affected by many variables, many of which we still cannot identify ! Even in a normal healthy fertile man, sperm counts fluctuate all the time - and can vary all the way from 10 million per ml to 80 million per ml !What makes a bad situation worse is the fact that ma... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4512446 Thu, 24 Feb 2011 03:23:00 +0100 4512446 http://www.medworm.com/index.php?rid=4501648&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F02%2Fis-advise-just-be-positive-useful-for.html Everyone loves advising infertile couples ! ( After all, if they've had a baby in their bedroom and proven their fertility , this makes them fertility experts, right ? )The commonest advise is - Just relax ! Do not stress - do not take any tension ! This advise is even more pronounced during an IVF treatment cycle. If you want your IVF to succeed and the embryos to stick, you've got to "go with the flow" and not stress out. If you get too stressed out, your uterus will reject the embryos and they will not implant !This is very unhelpful advise ! Of course there's a lot of stress in an IVF cycle - after all, no one wants to come to Dr Malpani to have a baby ! All my IVF patients are stressed out - and even the hyper ones do get pregnant ! It's true that patients need to learn constructive w... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4501648 Mon, 21 Feb 2011 03:07:00 +0100 4501648 http://www.medworm.com/index.php?rid=4498303&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F02%2Fwhy-dont-you-have-copy-of-your-ivf.html I see patients who have done IVF cycles in other clinics all the time. How they responded in the earlier IVF treatment cycle provides me with valuable information, based on which I can tailor a better treatment protocol for them.One of the basic questions I ask them is - Please tell me more details about your earlier IVF cycles . What were the meds which were used for superovulation ? What was the dose used ? How many follicles did you grow ? How many eggs were collected ? What was the E2 ( estradiol) level in the blood ? How many embryos were transferred ? What was the embryo quality ? DO YOU HAVE PHOTOS OF YOUR EMBRYOS ? What was the endometrial thickness ?Can you please show me the printed treatment summary from your IVF clinic ?Many of them look at me blankly. ( I am sure some of them ... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4498303 Sun, 20 Feb 2011 03:01:00 +0100 4498303 http://www.medworm.com/index.php?rid=4495256&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F02%2Fday-in-life-of-embryologist.html This is a guest post by Saiprasad Gundeti, Senior Embryologist, Malpani Infertility Clinic.As an embryologist, I help in making the dreams of infertile couples come true ! Most couples do not know what happens in an IVF lab, so I am happy to describe a day in my life !This is the daily routine we follow at our centre :First thing in the morning –Cleaning Cleanliness is a very important factor in IVF Lab. We need to make sure everything is sterile ! Because I work alone in our lab, it's much easier for me to ensure that everything is clean !Hood and bench work surfaces (including microscope working areas, heat baths, petridish warmer) are cleaned and wiped down with 6% Hydrogen Peroxide.Once a week centrifuge rotors and carriers as well as outside area of the centrifuge are cleaned and di... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4495256 Sat, 19 Feb 2011 04:43:00 +0100 4495256 http://www.medworm.com/index.php?rid=4495257&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F02%2Fwhy-i-want-my-patients-to-become-ivf.html I want all my IVF patients to become an expert on IVF , which is why we spend a lot of time and energy in educating them; and in creating unique online educational tools to help them to learn more about IVF.Now, I am not trying to teach my patients how to do IVF in their bedroom ! The reason we want them to know as much about their treatment as possible is because this is the best way of explaining to them why we are so good at what we do - and what makes us better than other IVF clinics . The outcome of any IVF treatment is always uncertain, and no matter how good I am , there is no certainty that the IVF cycle will be successful. Also, it's a very competitive field, and there are over 40 IVF clinics in Bombay itself ! Sadly, most patients are quite clueless, and do not have the ability t... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4495257 Fri, 18 Feb 2011 13:26:00 +0100 4495257 http://www.medworm.com/index.php?rid=4482842&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F02%2Fhappy-infertile-couple-from-spain-at.html In our quest of paternity, we made some treatments in our home country, Spain, but we got no success. After a period to find an alternative, we chose to go to Mumbai, India, and in fact Malpani Infertility Clinic. We had more contact with other clinics in India, through e-mail, forums, testimonials of patients who were with them, etc., but finally we opted for Malpani Infertility Clinic for many reasons that during the treatment were confirmed. In the talks held by e-mail us seemed honest, ethicals, professionals and they offered us a good humane treatment.Our experience began in summer 2010, and we decided to begin the pre-treatment that Dr. Malpani suggested us by e-mail while we were in Spain before treatment in Mumbai. He explained to me everything that had to do: medicine, testing, pl... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4482842 Wed, 16 Feb 2011 14:11:00 +0100 4482842 http://www.medworm.com/index.php?rid=4477836&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F02%2Fone-womans-quest-for-egg-donor.html I was watching TV late one night , into the wee hours of the morning…I was so tired & bored that I started channel-surfing and I stopped on this program called “70&Pregnant” on the Discovery/TLC Cable Channel. Boy! Did it wake me up? Mark & I have tried for years to get pregnant and we realized about 15 years ago that because of my premature ovarian failure, only a donor egg would work for us. So needless to say when I saw this program, I perked up immediately…. On this program, they featured an Indian doctor who helped a 70 year old Indian lady get pregnant and have child with a donor egg. The donor came from a nearby Indian village & the cost was cheap by U.S.A. Standards for IVF.During the program, the doctor discussed the cost of IVF in Indian and immediately, s... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4477836 Mon, 14 Feb 2011 15:51:00 +0100 4477836 http://www.medworm.com/index.php?rid=4460017&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F02%2Fwhy-are-men-so-reluctant-to-get-their.html Most men are very reluctant to get their sperm tested. For one, most men hate going to a doctor - and they need to be dragged to the clinic for any medical testing - whether it's a X-ray or a sperm test. Secondly, most men still believe that having a baby is their wife's job, so it's the wife who should get tested. For another, they expect that their sperm count must be fine , so why bother to get it tested ? " Hey - I can have sex as often as I want, and if my virility is fine, I am sure my fertility will be superb too ! Why waste time and money getting it tested ? " Finally, it can be quite humiliating to have to go to a lab to produce a semen sample - and this is an experience most men are quite happy to bypass.The problem is much worse for men who know that they have a low sperm count.... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4460017 Fri, 11 Feb 2011 02:34:00 +0100 4460017 http://www.medworm.com/index.php?rid=4455317&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F02%2Fsurrogacy-versus-embryo-adoption.html One of the major problems with surrogacy today is that it is overused and misused.This is especially true when surrogacy is advised for patients who have failed multiple IVF cyclesor had multiple miscarriages. These patients are very depressed and have very low self esteem. They often end up believing that it's their uterus which is defective; and they therefore believe that surrogacy would be their best treatment option. They often approach IVF clinics asking for surrogacy treatment - and many doctors are happy to oblige, because this is a very profitable treatment option !In reality, surrogacy is an expensive and complex treatment option, which is best reserved forwomen without a uterus. Research shows that the reason for failed implantation is much more likely to be genetically abnormal... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4455317 Thu, 10 Feb 2011 02:48:00 +0100 4455317 http://www.medworm.com/index.php?rid=4450344&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F02%2Fi-have-failed-five-ivf-cycles-dr.html My patient was at her wit's end and was sobbing her heart out. I have done 5 IVF cycles all over the world, Dr Malpani - and they've all failed. What do I do next ?This is always a complex question - and there's no easy answer. You need to be analytical and logical, so we know what to do next. The trick is not to waste time looking for problems, but rather to focus on solutions which will allow us to bypass the problems !We need to ask ourselves - what have we learned from these failures ? What can we do differently the next time ? What can we change to increase the chances of success ?If you do need to change something, remember that there are only 5 things we can change in any IVF treatment1. The IVF treatment protocol2. The clinic3. The sperm4. The eggs5. The uterusLet's think through t... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4450344 Tue, 08 Feb 2011 04:12:00 +0100 4450344 http://www.medworm.com/index.php?rid=4445864&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F02%2Fwhat-i-want-from-my-webmaster-for-my.html Our website is the global face of our clinic. I take it very seriously, because we treat patients from all over the world and our website is the first point of contact for all our patients. It’s crucial to our success and our webmaster plays a key role in our business ! I need a webmaster who understands the importance of a website in our business – someone who does not see himself as just a web designer, but rather as a business partner who can help us to grow. Here’s my wish list for a perfect web designer/ webmaster. His competence and efficiency is taken for granted – but I am a premium client, and want to be treated as one. I am willing to pay the additional premium, and I want someone who understands the importance of keeping me happy !I want someone who will extend my horizo... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4445864 Mon, 07 Feb 2011 04:58:00 +0100 4445864 http://www.medworm.com/index.php?rid=4441993&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F02%2Fevery-complaint-is-gift-dr-malpanis.html Most doctors get put off by patients who complain and most doctors will either ignore these patients – or fire them ! While I’d rather have smiling and happy patients as well , I also believe that every complaint is a gift – it’s a chance to learn and improve. In fact, we actively encourage our patients to provide us with feedback – and both compliments and complaints are welcome . Compliments give us a high and tell us we are doing a good job. Complaints remind us that we can do better !As a doctor, I am focused on providing high quality medical care to my patients. However, I also run a clinic, and I may not see some basic problems ( which are easy to fix) unless someone takes the trouble to point them out to me !Most patients are quite reluctant to complain to their doctor. Fo... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4441993 Sun, 06 Feb 2011 05:03:00 +0100 4441993 http://www.medworm.com/index.php?rid=4436810&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F02%2Fanother-malpani-infertility-clinic-baby.html (Source: The Patient's Doctor) The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4436810 Sat, 05 Feb 2011 02:49:00 +0100 4436810 http://www.medworm.com/index.php?rid=4436811&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F02%2Fdr-malpani-tells-you-why-you-must.html The failure of an IVF cycle always causes major heartburn. The next question is - Why did the IVF cycle fail ? What should I do next ? Did I get good quality medical care ? Or should I change my doctor ?This is always a hard question to answer, because even if the quality of medical care provided is excellent, the IVF cycle can still fail. How is the patient to judge the quality of technical competence of the IVF clinic ? Did the cycle fail because the clinic was bad ? Or was it just bad luck ? You cannot rely on a doctor's bed side manner to judge his clinical skills - you need more tangible evidence - but what should you be looking for ?Fortunately, the answer is very easy - you should ask for photos of your embryos ! The core competence of a good IVF clinic is to produce high quality em... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4436811 Fri, 04 Feb 2011 13:22:00 +0100 4436811 http://www.medworm.com/index.php?rid=4433147&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F02%2Fhow-we-deal-with-patient-complaints-at.html As a boutique IVF clinic which provides highly personalized care to infertile couples in a comfortable setting, we take great pride in our customer service. We pamper our patients and do our best to keep them happy. While the outcome of any IVF cycle is always uncertain, we do our best to make sure the process is as stress-free as possible. We do this by listening carefully to our patients and involving them actively in their treatment by educating them and sharing information with them.However, there will always be some patients who are unhappy with us and who have complaints about us. I guess this is inevitable when we do over 400 IVF cycles every year. Not all IVF cycles are going to be successful – and patients who have failed IVF cycles are often likely to be unhappy and discontente... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4433147 Thu, 03 Feb 2011 14:31:00 +0100 4433147 http://www.medworm.com/index.php?rid=4429072&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F02%2Fdr-malpani-why-did-my-ivf-cycle-fail.html This is one of the commonest questions patients ask me. Doctor, I did an IVF cycle at this other clinic and it failed - can you please tell me why ?Obviously, the next thing I need to do is to drill deeper to find out more details about the medical treatment provided, so I can provide an intelligent answer.I ask patients for more details about their IVF cycle. What were the meds which were used forsuperovulation ? What was the dose used ? How many follicles did you grow ? How many eggs were collected ? What was the E2 ( estradiol) level in the blood ? How many embryos were transferred ? What was the embryo quality ? What was the endometrial thickness ?Most patients look completely blank when I ask them these basic questions - and some even think I am crazy for expecting them to know the an... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4429072 Wed, 02 Feb 2011 04:14:00 +0100 4429072 http://www.medworm.com/index.php?rid=4419230&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F02%2Fdr-malpani-tells-you-what-to-do-if-your.html There's always a lot of anxiety when you have to go a doctor - and this is especially true when you have to do your tests to find out if you are fertile or not.When your test results come back as abnormal, this is often your like your worst nightmare coming true ! The first response is often one of disbelief - maybe the lab mixed up my sample ?Then start the mind games ! Oh God - does this mean I will never be able to have a baby ? Will we ever be able to fix this problem ? Will my spouse leave me if I cannot have a baby ?Rule number one - please do not panic ! Remember that every problem has a solution - even if it may not be a very palatable one initially !Please look at the silver lining - you are actually better off , because now at least we know what the problem is . The known enemy c... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4419230 Tue, 01 Feb 2011 02:40:00 +0100 4419230 http://www.medworm.com/index.php?rid=4419231&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F01%2Fpart-time-versus-full-time-ivf-doctors.html Many gynecologists have started offering IVF services and at last count, there were over 45 IVF clinics in Mumbai ! The reason is because IVF is seen to be remunerative and profitable ! After all, why send the patient away to an IVF clinic and lose all that income ? Never mind that these gynecologists have never been trained in doing IVF or have never done a single IVF cycle in their life - after all, how hard can doing IVF be for a MD gynecologist ? Plus, there are now many companies which are happy to offer a 1-week workshop which certifies doctors as being IVF trained !This is why we are seeing a huge number of " part time IVF doctors" in India. They spend most of their time seeing OB patients and gynec patients - but rather than refer their infertile patients to IVF specialists, they h... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4419231 Mon, 31 Jan 2011 02:32:00 +0100 4419231 http://www.medworm.com/index.php?rid=4411574&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F01%2Flearning-from-my-patients.html I am always amazed by how smart my patients are ! It's fun learning from them and they keep me on my toes. Here's a first person guest post from one of my patients ( who is a PhD and knows more about fertility than most gynecologists do !). She has done all her learning "on the job" - and this is an excellent example of what a highly motivated intelligent patient can do to help herself, when she sets her mind to it.She has carried out a clinic trial on herself and done an extremely good job of it as well. In fact, based on her experience, I am now going to start studying the effect of Vit D3 supplementation on women with low AMH levels. If Vit D helps to improve their low AMH levels ( and thus their ovarian reserve ) this will be a big step forward in the treatment of these women !) It's t... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4411574 Fri, 28 Jan 2011 04:37:00 +0100 4411574 http://www.medworm.com/index.php?rid=4405844&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F01%2Fsuccess-story-from-netherlands-baby.html This is a story about perseverance, courage but most of all a good understanding between a doctor and a patient.After some difficult years including infertility treatments, despair and discouragement by infertility doctors (!), my husband and I decided we should take a sabbatical and rest for a while from all the disappointments of the past. We decided to travel to Asia and visit some wonderful countries.After a few months however, my child wish was very strong again and we decided we should try one more time an IVF treatment.The question was where? we had all these possibilities in all of these countries.I decided to do a little research and I wrote to a dozen clinics in Thailand, Singapore, Malaysia and India.Some clinics did not respond at all (!) other were very short in their informat... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4405844 Thu, 27 Jan 2011 04:32:00 +0100 4405844 http://www.medworm.com/index.php?rid=4394545&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F01%2Fwhy-i-love-talking-to-my-patients.html I had just finished seeing a patient who came to me from Bangalore for IVF treatment , and before leaving the room, he turned around and said - " Thank you so much for taking the time to listen to us so patiently ! "I was flummoxed ! After all, isn't listening to a patient a part of the doctor's job description ? Why was he thanking me for doing something which is so routine and mundane ?When I asked my next patient why I was being thanked, he said - That's because you are so different from most other doctors, doc ! Most doctors just rush like automatons through a long line of patients. It's like they are just processing an assembly line of people - and they have 7 minutes in which to listen to you . They are always rushed and harassed - and it's very hard to have a decent convesration wit... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4394545 Tue, 25 Jan 2011 07:11:00 +0100 4394545 http://www.medworm.com/index.php?rid=4382756&cid=t_99549_87_f&fid=36941&url=http%3A%2F%2Fwww.mazecordblood.com%2Fblog%2F%3Fp%3D1074 Folic acid, in combination with vitamin B-12 and vitamin C, is considered essential by health care providers for women that are planning pregnancy.  Being on a healthy diet and adding a daily dose of 400 micrograms of folic acid in a multivitamin along with folic acid rich foods is highly recommended by researchers and midwives. A lack of dietary folic acid leads to folate deficiency  (FD). This can result in many health problems, the most notable one being neural tube defects in developing embryo. Read here for more information on how much folic acid you need for a healthy pregnancy. (Source: Cord Blood News) Cord Blood News blogs http://www.medworm.com/rss/comments.php?id=4382756 Sat, 22 Jan 2011 02:17:40 +0100 4382756 http://www.medworm.com/index.php?rid=4361085&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F01%2Fpatient-education-in-india-times-of.html (Source: The Patient's Doctor) The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4361085 Mon, 17 Jan 2011 13:33:00 +0100 4361085 http://www.medworm.com/index.php?rid=4349552&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F01%2Fdoes-your-ivf-doctor-travel-lot.html Many IVF doctors in India travel extensively. They have many clinics all over the city ( and in some cases, all over the country). Naive patients get impressed by such doctors - wow - he is so busy and so much in demand that he needs to travel all over the place. In fact, some doctors even go to Dubai and Africa ! While this seems very impressive, in reality this means that the quality of care they provide to their patients leaves a lot to be desired. Let me explain.The personal goal for these doctors seems to be to maximise the number of patients they treat, so they can maximise their throughput and their revenue. While it's very good for an IVF clinic to be busy, it's also important that the quality of care provided to their patients not be compromised in the quest for quantity !How do t... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4349552 Fri, 14 Jan 2011 09:02:00 +0100 4349552 http://www.medworm.com/index.php?rid=4337922&cid=t_99549_87_f&fid=36941&url=http%3A%2F%2Fwww.mazecordblood.com%2Fblog%2F%3Fp%3D1047 A simultaneously sad and funny/happy blog about fertility and its trials and tribulations. Our friends at www.mothering.com have compiled a list of 6 word stories a la Ernest Hemingway. Read here for more (Source: Cord Blood News) Cord Blood News blogs http://www.medworm.com/rss/comments.php?id=4337922 Wed, 12 Jan 2011 19:56:20 +0100 4337922 http://www.medworm.com/index.php?rid=4338047&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F01%2Fhow-your-doctor-can-reduce-your.html Infertile patients expect that their doctors will provide them with treatment to improve their chances of having a baby. Tragically, some medical procedures can actually end up reducing your fertility !Here's a list of the top ten procedures which can actually harm you, rather than help you ! If your doctor advises any of these, please get a second opinion before agreeing !1. D&C ( dilatation and curettage) . This is a "minor" surgical procedure in which the doctor dilates the mouth of the uterus ( the cervix) and scrapes the uterine lining using a curette( curettage). This endometrial tissue is then sent for pathological examination. In the past, when doctors had very little to offer to their patients, this used to be the mainstay of the treatment of an infertile couple. In fact, even... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4338047 Wed, 12 Jan 2011 02:38:00 +0100 4338047 http://www.medworm.com/index.php?rid=4326939&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F01%2Fchocolate-cysts-how-we-manage-them-at.html A chocolate cyst of the ovary ( also known as an endometrioma, endometrioid cyst, or endometrial cyst) is found in some infertile women who have endometriosis. In this disease, the inner lining of the uterus ( called the endometrium ) grows in various abnormal locations within the pelvis . One of the commonest sites this aberrant endometrial tissue can be found in is the ovary. With every menstrual period, this tissue grows, enlarges , bleeds, and sloughs off . Here it forms a cyst; and because the contents of this cyst are black, tarry and thick, they resemble dark chocolate , hence the name ! ( I feel that sometimes doctors can have a perverse sense of humor . For most women, the word chocolate produces happy feelings, because chocolates are a woman’s favourite treat. To label a diseas... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4326939 Mon, 10 Jan 2011 02:52:00 +0100 4326939 http://www.medworm.com/index.php?rid=4324823&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F01%2Fpatients-with-poor-ovarian-reserve_08.html For many IVF clinics, the patients which cause the most distress are the ones who are poor ovarian responders. These are patients who have poor ovarian reserve - and are often heartsink patients, because no matter what we do , it's very difficult to get them pregnant !It is possible to get them to grow eggs and make embryos - and this actually makes the matter even more complex. This often creates false hopes - if I can make eggs and embryos, of course I can get pregnant ! All I need to do is to get the embryo to stick !Unfortunately, there is no easy answer, and every patient needs to look into their own heart to resolve this personal quandary for themselves. While we are very happy to aggressively superovulate these patients, I feel using expensive and unproven treatments ( suc... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4324823 Sat, 08 Jan 2011 04:37:00 +0100 4324823 http://www.medworm.com/index.php?rid=4318382&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F01%2Ftop-10-myths-about-infertility.html Probably one of the most enjoyable books I've read on infertility is: A Few Good Eggs: Two Chicks Dish on Overcoming the Insanity of Infertility by Julie Vargo and Maureen Regan. This guide is actually targeted to infertile women residing in the US, and it is designed in the currently fashionable "chick-lit" style. It's amusingly put together; and it is certainly a breath of healthy air, if you are the type of individual who discovers a sense of humor can help you deal much better with infertility.This book is loaded with lots of Top-10 lists, and here is their valuable listing of Top 10 Myths Regarding Infertility:10 Mis(sed)-Conceptions Regarding Infertility1. Infertility will not happen to me.2. I cannot be infertile. I already have got a child!3. I can easily conceive, therefore i do n... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4318382 Fri, 07 Jan 2011 02:32:00 +0100 4318382 http://www.medworm.com/index.php?rid=4318383&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F01%2Fget-more-patients-by-treating-them-as.html How to get more patients by treating them as VIPs - Dr MalpaniView more presentations from malpani. (Source: The Patient's Doctor) The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4318383 Thu, 06 Jan 2011 12:08:00 +0100 4318383 http://www.medworm.com/index.php?rid=4318384&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F01%2Fquality-certification-for-primary.html " On Sunday, the quasi-governmental organization, Quality Control of India, will introduce the accreditation process with the first stop of healthcare for most consumers: neighbourhood doctors. “Once the government passes the Clinical Establishments Act, it will be binding on all healthcare providers to seek accreditation,’’ said QCI secretary general Dr Giridhar Gyani. How will Cliniq 21st help patients ? It will mean that a doctor with the brand has been attending continued medical education (CME) lectures, he or she will provide health checkups for his/her staff and the clinic will have minimum required emergency care equipment and the place will be fumigated once a week. “Once patients or their relatives see this Cliniq 21st board outside a doctor’s chamber or a clinic, they ... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4318384 Thu, 06 Jan 2011 11:02:00 +0100 4318384 http://www.medworm.com/index.php?rid=4314072&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F01%2Fwhat-are-my-chances-of-getting-pregnant.html The commonest question patients will ask before starting an IVF cycle is - what are my chances of getting pregnant ?While it's true that the chances of success do depend upon how good your IVF clinic is, it's also true that the chances do depend upon biological factors which are outside your control - the most important one of which is your age !You can now use the Free IVF Predictor to estimate how good your chances of success are ! While you cannot do much about your age, you can improve your chances of success by choosing a world class IVF clinic ! (Source: The Patient's Doctor) The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4314072 Thu, 06 Jan 2011 05:12:00 +0100 4314072 http://www.medworm.com/index.php?rid=4314074&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F01%2Ftesting-for-pregnancy-after-embryo.html While all IVF patients understand with their heads that not every IVF cycle results in success, in their heart of hearts, every patient expects to get pregnant every time they do IVF ! This is why the 2ww after the embryo transfer can be so nerve-wracking ! Am I pregnant or not ? Have the embryos implanted or not ? The suspense during the 2ww can be even worse than the pain of the IVF injections !Most patients would love to have a test which will allow them to find out if they are pregnant immediately after the embryo transfer ! Have the embryos stuck or not ? Why can’t we do a pregnancy test and find out right now ? Even if I am not pregnant, at least it’s better to know than to be unsure.To understand why patients ( and their doctors ) still have to suffer through a 2 week wait to fi... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4314074 Thu, 06 Jan 2011 03:04:00 +0100 4314074 http://www.medworm.com/index.php?rid=4314075&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F01%2Findias-first-free-phone-service-for.html Malpani Infertility Clinic have just launched India's first free phone service to educate infertile couples about infertility.This innovative IVR ( interactive voice response) service called FertilityFactsFoneLine, powered by BolTell, walks patients through their treatment options, and helps to dispel many myths and misconceptions.Best of all, it's free !Try it out by dialling 08042658370 ! (Source: The Patient's Doctor) The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4314075 Wed, 05 Jan 2011 11:11:00 +0100 4314075 http://www.medworm.com/index.php?rid=4314076&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F01%2Fmedical-profession-is-conspiracy.html I am a full-time practising doctor and yet sometimes I believe that the medical profession is not always completely honest with patients.Now, I am not talking about the rubbish which alternative medicine practitioners are selling about how the medical establishment is out to rip patients off with unnecessary surgery and exorbitantly priced drugs. And neither is it true that doctors will gang up on patients and refuse to testify against other doctors when a medical mishap occurs. I believe that most doctors are honest professionals who are doing their best to try to help their patients to get better.The truth is far worse. Sadly, most doctors do not realise the harm they often end up inflicting on their patients. They mean well, but because they become arrogant and brainwashed as they get o... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4314076 Wed, 05 Jan 2011 09:03:00 +0100 4314076 http://www.medworm.com/index.php?rid=4309686&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F01%2Finterview-with-dr-malpani-ivf.html You can now read the transcript of the interview below the video ! (Source: The Patient's Doctor) The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4309686 Tue, 04 Jan 2011 17:18:00 +0100 4309686 http://www.medworm.com/index.php?rid=4309687&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F01%2Fwhy-do-i-have-to-wait-2-weeks-to-do.html Most patients find that one of the most difficult things to manage during an IVF cycle is the dreaded 2 week wait ( 2ww) after the embryo transfer. Time seems to come to a halt and you live in a state of suspended animation - a bit like Schroedinger's cat ! Am I pregnant ? Am I not pregnant ? Every ache and twinge sends you scurrying to the bathroom to check if your periods have started - and you over-interpret every signal your body sends you. Am I feeling nauseous ? Is this a good sign ? Do my breasts feel fuller than usual ? Is this just PMS ? You try to prevent your mind from playing games with you, but this is surprisingly hard to do. Every hour seems to stretch on like a day ! You obsessively compare notes with all your online IVF friends - and drive your husband batty with your inte... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4309687 Tue, 04 Jan 2011 03:28:00 +0100 4309687 http://www.medworm.com/index.php?rid=4304942&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F01%2Fnew-cartoon-video-older-woman-and.html Along with watching the video, you can now also read the transcript - it's just below the video ! (Source: The Patient's Doctor) The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4304942 Mon, 03 Jan 2011 14:09:00 +0100 4304942 http://www.medworm.com/index.php?rid=4304943&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F01%2Fpatient-educational-dvds-now-being.html By passing the Clinical Establishment Act, the Indian government is planning to make accreditation compulsory for clinics, to ensure that patients get good quality medical care from doctors, because they will be forced to meet basic standards.I am thrilled to observe that one of the requirements for accreditation is that doctors provide patient educational materials in their clinics.The good news is that innovative companies like PEAS ( in which I am an angel investor) are producing patient educational DVDs in Indian languages, customised for Indian patients !Information Therapy will hopefully become an integral part of Indian medical practise ! (Source: The Patient's Doctor) The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4304943 Mon, 03 Jan 2011 10:53:00 +0100 4304943 http://www.medworm.com/index.php?rid=4304944&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F01%2Fbehaviour-nurture-not-nature-says-ivf.html A long-term study following 1,000 families with children born using IVF between 1994 and 2002 in the UK and US has shown the importance of parenting in the outcome of a child's behaviour. In the study, which investigated the mental wellbeing of both the parents and children, some of the children were biologically related to their parents, while others were unrelated and conceived using either donor sperm or eggs, or both. This gave the researchers a unique opportunity to compare the role of nature (genes) and nurture (the environment) in the development of a child's behaviour.This is why patients who use donor gametes for IVF after counselling and forethought are usually very happy with their kids ! (Source: The Patient's Doctor) The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4304944 Mon, 03 Jan 2011 05:41:00 +0100 4304944 http://www.medworm.com/index.php?rid=4304945&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F01%2Fwhy-hcg-blood-test-is-better-than-home.html Blood tests for checking the beta HCG level are better than home urine pregnancy tests for the following reasons.1. They are more accurate , sensitive and reliable. A negative test ( HCG level of less than 10 mIU/ml) can reliably rule out a pregnancy with 100% accuracy. Urine tests are not as reliable or accurate. This is because they can have false negatives. A false negative is the situation when a woman is pregnant, but the urine pregnancy test comes back as negative. This can be because her HCG levels are low, so that they cannot be picked up by the urine test ( which becomes positive only after the blood HCG levels cross more than about 30-50 mIU/ml). Other reasons the urine test can be incorrectly negative is when it’s not done properly by the patient ( who is not an expert, after... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4304945 Mon, 03 Jan 2011 03:57:00 +0100 4304945 http://www.medworm.com/index.php?rid=4304946&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F01%2Finfertility-edutainment-to-help.html Infertile couples need to learn about IVF - but it's boring to read pages and pages of text. The good news is that we've made learning about IVF fun ! You can actually learn all about infertility while playing solitaire ! (Source: The Patient's Doctor) The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4304946 Sun, 02 Jan 2011 15:20:00 +0100 4304946 http://www.medworm.com/index.php?rid=4302898&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F01%2Fcreating-something-out-of-nothing.html Society takes great pride in depicting business barons as being role models of success. They are revered as "wealth creators" and admired in a capitalistic society.However, in reality, many of these businessmen are just traders . They do not actually create anything - they just accumulate money. While it's great to be rich, all they have done is merely transfer assets from others into their pocket, without creating anything new.The real creators are the creative artists, who actually produce something out of nothing. However, while it's true that a work of music is a piece of art, this is a luxury which only affluential societies can afford to indulge in !The true creators are the farmers ! Unfortunately, most of us have never been to a farm, so it's hard to remember what a miracle growing... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4302898 Sun, 02 Jan 2011 03:33:00 +0100 4302898 http://www.medworm.com/index.php?rid=4302899&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2011%2F01%2Ffred-trotter-blog-archive-patient.html : "Eventually, the IHE-based Health Internet will support patients as equals on the Health Internet. Eventually, the routing between different IHE nodes will be more direct, and then the benefits of IHE might begin to outweigh the benefits of the simple Direct Exchange.But for now, the Direct model empowers the patient in ways the IHE model could never hope to."New models will allow patients to share their medical records with other doctors - and with other expert patients as well - many of whom can give excellent advice, since they've "been there , done that " ! (Source: The Patient's Doctor) The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4302899 Sat, 01 Jan 2011 15:11:00 +0100 4302899 http://www.medworm.com/index.php?rid=4298683&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2010%2F12%2Fwho-should-you-go-to-gynecologist-or.html Infertile couples are often confused whom they should visit when they need medical assistance. Even though infertility always affects a couple , it's usually the woman who takes the initiative in seeking medical care . Most will bypass their family physician , but are unsure whether to go to a gynecologist or an infertility specialist. Both options have advantages and disadvantages , and it's worth examining these.The gynecologist is a logical first choice. Most women have a long-standing relationship with their gynecologist , and are comfortable with him. Since gynecologists are specialists in tackling women's health problems , most can competently diagnose the cause of infertility ; and provide basic medical treatment. They are usually quite conservative; and would be the first choice fo... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4298683 Thu, 30 Dec 2010 05:05:00 +0100 4298683 http://www.medworm.com/index.php?rid=4298827&cid=t_99549_177_f&fid=38137&url=http%3A%2F%2Fmissionimpossibleinfertile.wordpress.com%2F2010%2F12%2F29%2Fseven%2F Apologies for the dull tone around the blog, it’s just that I’m on the pill and no matter what any clinic nurse will tell you about the why’s and wherefore’s of aforementioned little hormonal tablets, it’s pretty damn hard to get pregnant on the pill. Actually, since I haven’t been on it since 2004 it’s actually about as hard for me to get in the family way OFF the pill, but that’s a whole ‘nother seven IVF’s, six clomid cycles, lethal anomoly, miscarriage and a partridge in a pear tree. Ergo, I am dull at the moment. I am full of newfound sixties sexual freedom (ha!) but oh-so-reproductively dull. On the plus side- at least I am the kind of dull that doesn’t have to whine on about my horrid hypoestrogenic brain splittin... Mission: Impossible (or adventures in infertility, pregnancy....parenting?) blogs http://www.medworm.com/rss/comments.php?id=4298827 Wed, 29 Dec 2010 10:08:22 +0100 4298827 http://www.medworm.com/index.php?rid=4294742&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2010%2F12%2Ftop-ten-tips-for-facing-infertility.html One of the most amusing books I have read on infertility is: A Few Good Eggs : Two Chicks Dish on Overcoming the Insanity of Infertility by Julie Vargo and Maureen Regan. The book is targetted towards infertile women living in the US, and is written in the currently fashionable "chick-lit" style. It's amusingly written; and is a breath of fresh air , if you are the sort of person who finds a sense of humour helps you cope better with infertility. The book has lots of Top-10 lists, and here's their list of Top Ten Tips for Facing Infertility. # 10 Tips for Facing Infertility1. Keep reminding yourself that you are not alone.2. Realize that dealing with infertility is an all-consuming process.3. Stay calm.4. Remind yourself you are not a failure if a procedure doesn't work.5. Have a sense of ... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4294742 Wed, 29 Dec 2010 05:02:00 +0100 4294742 http://www.medworm.com/index.php?rid=4288580&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2010%2F12%2Fhow-do-infections-cause-male.html The most common cause of azoospermia in India was previously smallpox. This infection injured the epididymis, leading to ductal obstruction. Fortunately, this particular disease is now of historical importance only, as it has been wiped out. Tuberculosis also harms the epididymis, causing azoospermia. Nevertheless, making the correct medical diagnosis of tuberculous epididymitis can be quite difficult, since it is often a silent as well as indolent disease. Gonorrhea, chlamydia, syphilis along with other STDs ( sexually transmitted diseases) might also create chaos with the man's genital system; leading to irreparable injury to its epithelium (inner lining).Mumps may also cause orchitis (inflammation of the testis) - particularly when this impacts younger males. This may result in signific... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4288580 Sun, 26 Dec 2010 04:39:00 +0100 4288580 http://www.medworm.com/index.php?rid=4288581&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2010%2F12%2Fhow-can-you-be-sure-your-ivf-clinic-is.html One of the major decisions infertile patients have to make is - How to pick a really good IVF clinic? The majority of IVF treatment centers appear to be identical on paper, and their websites are quite similar (because some unethical doctors will unashamedly copy and paste content from our website!). Many have happy patients - and most IVF specialists talk the identical talk - all of them quote high success rates and claim they are the finest! Exactly how is a poor patient supposed to separate the wheat from the chaff and assure himself that the IVF clinic he's going to is efficient? After all, while it is easy for patients to evaluate a doctor's bedside manner, it's difficult for them to make a call concerning his medical and technical proficiency.Simply because the IVF cycle fails doesn'... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4288581 Sat, 25 Dec 2010 04:31:00 +0100 4288581 http://www.medworm.com/index.php?rid=4281363&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2010%2F12%2Fquality-of-doctors-answers-depend-upon.html Recently I witnessed an infertile couple who had over three heavy files bulging along with medical tests and reviews. They may have visited more than ten infertility experts who tried every single possible examination under the sun to attempt to discover what their issue was. The lady had been examined for antisperm antibodies, NK cells , hostile cervical mucus, tuberculosis, chlamydia, sperm DNA fragmentation… you name it, and she had had the examination done. Every single gynaecologist had repeated test after test, however every result had been normal. They were at their wit’s end. “Why can’t I get pregnant , doctor , if things are all normal ?” was her plaintive cry.I was surprised about how little she had learned after going to numerous doctors. Rather than understanding from... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4281363 Thu, 23 Dec 2010 04:57:00 +0100 4281363 http://www.medworm.com/index.php?rid=4266312&cid=t_99549_177_f&fid=38137&url=http%3A%2F%2Fmissionimpossibleinfertile.wordpress.com%2F2010%2F12%2F18%2Fstill-negative%2F Officially calling it and weirdly for an eternal pessimist this is the first time I find myself unexpectedly hurt by another early morning face-slapping negative. I have no earthly idea why I expected this cycle to work when so many others haven’t, perhaps it was the magical thinking of returning to old protocol plus some even more magical thinking around it being my third transfer for this pregnancy attempt (and Saag and Naan were my third transfer, too) but I am stung. Sails deflated. I really REALLY did not want to be in this place I find myself, failing three fresh transfers (allegedly my best odds) along with the frozen ones. I really REALLY can’t explain how much it kicks me in the gut to have to suck it up and go have dinner with a bunch of friendly pregnant women ton... Mission: Impossible (or adventures in infertility, pregnancy....parenting?) blogs http://www.medworm.com/rss/comments.php?id=4266312 Sat, 18 Dec 2010 02:38:04 +0100 4266312 http://www.medworm.com/index.php?rid=4266314&cid=t_99549_177_f&fid=38137&url=http%3A%2F%2Fmissionimpossibleinfertile.wordpress.com%2F2010%2F12%2F16%2Fnegative%2F Lily-white pregnancy test, 1. Geohde, 0. Also sore boobs, 0, and late OHSS distinctly absent. I could really stop there, but then I would be missing the chance to bruise my virtual fists thumping a virtual wall because this shite just isn’t funny any more. I’ve always been told that fresh odds are best and in not one of my three fresh transfers have I managed to have a shred of hCG in my system. I’m two for three on frozens, though, if you count chemical gestations. I think I need to count the misery of snot and blood simply to keep my increasingly woeful stats up. Seriously, if it wasn’t for Saag and Naan (and even with them, bless their supermarket ‘YOU’VE GOT A SORE BUM!’ shouting at utter strangers), my batting average would get me kicked righ... Mission: Impossible (or adventures in infertility, pregnancy....parenting?) blogs http://www.medworm.com/rss/comments.php?id=4266314 Thu, 16 Dec 2010 09:55:05 +0100 4266314 http://www.medworm.com/index.php?rid=4259235&cid=t_99549_177_f&fid=38137&url=http%3A%2F%2Fmissionimpossibleinfertile.wordpress.com%2F2010%2F12%2F14%2Fbarfly%2F I guess that those of you who know me on other online pastures are already aware that because I work in healthcare and nobody wants a fresh serving of gastroenteritis with their hospital admission, I have to be well, chipper, and not in any way exploding from either end before I can return to work. In other words, I have been paid to take two days off this week, two days in which I feel completely well although I am now a weight I haven’t been since I was about fourteen years old. Gastroenteritis is an astonishingly fast, albeit brutal, weight loss technique but I really don’t recommend you try it at home. Funny how a few tiny not-strictly alive in themselves particles can bring one to one’s knees,  repeatedly, except really there wasn’t anything funny about it.... Mission: Impossible (or adventures in infertility, pregnancy....parenting?) blogs http://www.medworm.com/rss/comments.php?id=4259235 Tue, 14 Dec 2010 01:48:29 +0100 4259235 http://www.medworm.com/index.php?rid=4251159&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2010%2F12%2Fhappy-nri-patient-from-usa.html We live in the US and I was diagnosed with Polycystic Ovarian Syndrome in 2003. We had been to an obgyn in the US and she had recommended 3 cycles of clomid treatment. Since this did not work for us, she had asked us to go for higher infertility treatments like Artificial Insemination or IVF. At that point we did not have proper information regarding these treatments and hence were not mentally prepared to proceed further.Later we started research on the Internet regarding various infertility treatment options for us. It was at this time that we came across this amazing website. Dr.Malpani's website is an excellent source of information for infertility related issues. This was a panacea for all our questions. We then started interacting with Dr.Malpani through his website. We submitted the... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4251159 Sat, 11 Dec 2010 15:15:00 +0100 4251159 http://www.medworm.com/index.php?rid=4207352&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2010%2F11%2Fcanadian-couple-success-story.html We have been married for 7 years now. We tried to get pregnant after the first year of marriage with no success. We then tried IVF clinics in Canada the first Doctor we went to we did IVF it was a positive result only to find out that it was a chemical pregnancy. We took that very hard because we wanted to have a baby and we wanted to start our family right away. This Doctor told us that because of age that we had to use a donor’s egg we despised that thought we did not accept it so we decided to go to another Doctor. We were with this Doctor for 2 years trying all kinds of treatment, firstly , IUIs with no success, we then decided to try IVF again but every cycle my eggs got lesser and lesser and not developing the way they should for a successful IVF procedure so I we would be detour t... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4207352 Sun, 28 Nov 2010 17:18:00 +0100 4207352 http://www.medworm.com/index.php?rid=4168215&cid=t_99549_151_f&fid=35818&url=http%3A%2F%2Frecoveryissexy.com%2Finfertility-treatment-in-recovery%2F This article is based on the book, "Pregnancy Miracle" by Lisa Olson. Lisa is an author, researcher, nutritionist and health consultant who dedicated her life to creating the ultimate pregnancy solution guaranteed to permanently reverse the root of infertility, help you get pregnant quickly and naturally and dramatically improve the overall quality of your life,  without the use of prescription medication and without any surgical procedures. Learn more by visiting her website: Infertility Treatment  Click Here! Share, print or e-mail this articleRandom ArticlesSex is Good for your HealthLife Cycle of a PenisGood-Enough SexSymptoms of Co-dependenceRecovery Self-awareness (Source: Recovery Is Sexy.com) Recovery Is Sexy.com blogs http://www.medworm.com/rss/comments.php?id=4168215 Mon, 15 Nov 2010 15:42:00 +0100 4168215 http://www.medworm.com/index.php?rid=4159275&cid=t_99549_107_f&fid=36672&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSciencebaseScienceBlog%2F%7E3%2FjTS2f09T_Fw%2Fcanned-heavy-metal-and-more.html My latest science news updates on SpectroscopyNOW – a sneak preview just for you ahead of their going live on 15th November, covering heavy metals in sardines, enzyme inhibitors for pain relief and sleep problems, the possibility of oral insulin without a Trojan horse carrier, and a spectroscopic test for male infertility that could explain the issue problem. Canned heavy metal – Samples of tinned sardines, originating from six countries have been analyzed for total arsenic, cadmium, lead and mercury content using spectroscopy. The analysis provides a useful baseline for a foodstuff – small pelagic fish – that could become increasingly important in a possible sustainable future and shows that arsenic rather than mercury could be the main concern in eating such smal... Sciencebase Science Blog blogs http://www.medworm.com/rss/comments.php?id=4159275 Fri, 12 Nov 2010 15:00:27 +0100 4159275 http://www.medworm.com/index.php?rid=4155415&cid=t_99549_177_f&fid=38137&url=http%3A%2F%2Fmissionimpossibleinfertile.wordpress.com%2F2010%2F11%2F11%2Fby-inches%2F Sometimes it’s kind of hard to know how to break the silence. After all, the drama of the whole ‘will I ever have a happy ending?’ is about two years and counting gone. By all standards of infertility blogs, I did get my happy ever after. I do have two rudely healthy children. I’m even kind of attached the the little buggers although I do wish Naan would cease widdling on my carpets with such unnerving accuracy and that Saag would not ringlead BOTH of the silly creatures into what has become a Traditional Evening (fortunately temperate climate) Pre-Bath Nudey Streak right down the side of the house  to show the entire street what twin girls are REALLY made of. Hint, it sure as hell isn’t sugar and spice. Also, I probably shouldn’t have tau... Mission: Impossible (or adventures in infertility, pregnancy....parenting?) blogs http://www.medworm.com/rss/comments.php?id=4155415 Thu, 11 Nov 2010 09:56:49 +0100 4155415 http://www.medworm.com/index.php?rid=4151921&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2010%2F11%2Fhow-can-i-be-sure-my-ivf-doctor-is.html One of the major worries most IVF patients have is about the competence of their IVF doctor. While most patients select an IVF clinic based on its reputation, the sad truth is that there is not much correlation with the actual quality of the medical treatment they receive and the brand name of the clinic. Many "big name" clinics are very impersonal and are run like assembly lines. The patient rarely gets to meet the doctor and most of the care is provided either by the nurses of the assistants. Patients feel they are helpless and passively put up with poor quality care, because they do not know what else they can do.A much bigger problem is the lack of transparency and documentation . Most IVF clinics do not even bother to provide patients with a simple treatment summary ! Patients are clu... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4151921 Wed, 10 Nov 2010 05:46:00 +0100 4151921 http://www.medworm.com/index.php?rid=4139219&cid=t_99549_87_f&fid=36941&url=http%3A%2F%2Fwww.mazecordblood.com%2Fblog%2F%3Fp%3D811 If you are thinking about becoming pregnant, or if you are having difficulties getting pregnant, this website is an amazing resource.  From pre conception to ‘normal’ pregnancy to high risk pregnancies, there are blog posts, resources and wonderful success stories to answer your unique questions.  You can find women and men who are going through very similar experiences; get their thoughts and ideas on many different issues and perhaps give some advice to others. There are resources on infertility, moms to be, pharmacy guides and cord blood banking.  Make your way over there, it will be worth the trip!! http://tinyurl.com/28kxqgd (Source: Cord Blood News) Cord Blood News blogs http://www.medworm.com/rss/comments.php?id=4139219 Fri, 05 Nov 2010 20:42:44 +0100 4139219 http://www.medworm.com/index.php?rid=4133877&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2010%2F11%2Fhow-to-manage-your-pcod-guide-for.html PCOD ( polycystic ovarian disease) is one of the commoner causes of infertility. It's a chronic disease, which patients need to learn to manage themselves. Sadly, lots of patients with PCOD are very confused. They seem to understand very little about their own problem and I think this is partly because their doctors are very confused themselves and do not take the time and trouble to teach patients about their disease.Patients with PCOD have irregular periods ; and they know that their irregular periods also means that they will be infertile. How the irregular periods cause infertility is something they are not clear about . They also know that they have a "hormonal imbalance" - but are clueless about which hormones are not in balance.Because they miss their periods every month, many of th... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4133877 Tue, 02 Nov 2010 14:35:00 +0100 4133877 http://www.medworm.com/index.php?rid=4105787&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2010%2F10%2Funexplained-infertility-vs-incompletely.html Many patients are diagnosed with having unexplained infertility. This means that all their fertility tests - semen analysis; hormonal blood tests ( FSH,LH,PRL,TSH and AMH) for egg quality; HSG ( hysterosalpingogram) for tubal patency; and ultrasound scanning for ovulation monitoring are normal.This can be a very frustrating diagnosis for patients. " But doctor, if everything is normal, then why aren't I getting pregnant ? " Patients are never happy with doctors who honestly answer - We do not know ! Patients expect a scientific definitive answer from their doctor who is meant to be an expert - and if a doctor cannot provide this, then be mustn't be very competent at his job is the natural conclusion many of them jump to . The truth is that our technology for identifying problems is still v... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4105787 Mon, 25 Oct 2010 02:19:00 +0100 4105787 http://www.medworm.com/index.php?rid=4098097&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2010%2F10%2Fmaking-sense-of-your-infertility.html I just saw an infertile 42 year old woman who said - Doctor, my husband has a low sperm count. Can you please prescribe some medicines so we can improve it and have a baby. "It always amazes me that even in this day and age so many infertile couples do so little to try to make sense of their treatment options.Many find it very hard to decipher the medical terms their doctor uses. They do all the tests the doctor asks for - and are often completely lost when he then explains to them what the next action steps are.Unfortunately, many doctors also "complexify" matters rather than simplifying them. They take a perverse pride in doing so, because it allows them to position themselves as experts in a difficult subject which the poor patient will never be able to understand !I think they just mak... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4098097 Sat, 23 Oct 2010 01:42:00 +0100 4098097 http://www.medworm.com/index.php?rid=4082151&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2010%2F10%2Fwhy-do-doctors-advise-bed-rest-after.html When an infertile patient gets pregnant after IVF , they are on top of the world. All that hard work and effort has finally paid off - and you can now look forward to cradling your baby in your arms soon !However, there are still 8 months to go before your baby is born - and the pregnancy can be packed with anxiety and suspense. Will everything go well ? Will the baby be normal ? Every ache and twinge causes worry because you are scared you may miscarry. This is a "precious pregnancy" - and you do your best to take things easy and be as careful as you can, so you can nurture your baby.This is one of the reasons why many doctors advise bed rest during an IVF pregnancy. In fact, some patients will voluntarily place themselves under house arrest, because they do not want to take the slightest... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4082151 Tue, 19 Oct 2010 03:02:00 +0100 4082151 http://www.medworm.com/index.php?rid=4077351&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2010%2F10%2Fabuse-and-misuse-of-surrogacy.html Surrogacy in India gets a lot of press - and often for all the wrong reasons.There's a lot of talk about how rich Westerners are coming to India for surrogacy and exploiting poor women by using their uterus to have a baby.Actually, it is true that there is a lot of exploitation occurring - but it's not just the poor women who are being exploited.In my opinion, a lot of the exploitation is by the IVF clinics - but not of the poor women, but of the rich infertile couples who come to them for treatment !Many infertile couples are quite desperate to have a baby and are willing to clutch at straws. They've read a lot about how India has become the surrogacy capital of the world - and how it is much less expensive to do surrogacy in India than in other parts of the world. Because so many of them... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4077351 Mon, 18 Oct 2010 12:40:00 +0100 4077351 http://www.medworm.com/index.php?rid=4077354&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2010%2F10%2Ftaking-infertile-patients-for-ride.html I got an email from a patient whose fallopian tubes were blocked at the fimbrial end. I explained to her that her best option would be IVF.She was very concerned about how expensive IVF was; and wanted to explore alternative options. She sent me a link to this website - Blocked Fallopian Tube Kit (USA & Canada)http://biotanicalhealth.com/products/blocked-fallopian-tube-kit-usa-canada and asked me my opinion as to whether this would be useful.Visiting this site made my blood boil - and also taught me a lot about how people will prey on an infertile patient's desperation and ignorance and take them for a ride. It's also a great example of clever marketing ! The manufacturer has cleverly packaged a few herbs, tampons, books and DVDs ( costing about US $ 50) - and is selling them as a Kit ... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4077354 Sun, 17 Oct 2010 07:23:00 +0100 4077354 http://www.medworm.com/index.php?rid=4074174&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2010%2F10%2Fwhy-i-prefer-email-as-compared-to-phone.html We treat patients from all over the world and many of them want to do a phone consultation with me before coming to our clinic for an IVF treatment.I can understand why they want to do so - after all, going half way across the world to get treated by a doctor you've never seen or met is a major leap of faith - and talking to the doctor can help to reduce some of this anxiety !While it's true that the human touch is very important in providing good medical care, the truth is that it's not humanly possible for me to do so. This is true for many reasons.For one, because of time zone differences, it's quite difficult to find a time slot which suits both the patient and me. We often end up playing phone tag - causing even more frustration ! Also, phone connections in certain countries ( such as... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4074174 Fri, 15 Oct 2010 02:22:00 +0100 4074174 http://www.medworm.com/index.php?rid=4065427&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2010%2F10%2Fare-ivf-injections-painful.html One of the major reasons patients do not want to do IVF is their fear of injections. They know that during IVF they need to take injections for many days - and many patients are understandably reluctant to take these shots because they have been told that these injections are painful !While it's no fun to take injections , the good news is that the injections used for IVF treatment are not painful !Lupron and Anatgon ( which are used for downregulation) and given subcutaneously, just like a diabetic takes insulin injections. these are easy to self-administer and are not painful.The injections which are used for superovulation ( the urinary gonadotropins such as Menogon) used to be given intramuscularly. IM injections are more painful than subcutaneous injections, because a larger volume ne... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4065427 Thu, 14 Oct 2010 02:44:00 +0100 4065427 http://www.medworm.com/index.php?rid=4060910&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2010%2F10%2Ffailed-fertilisation-after-ivf.html Most IVF clinics are very good at making embryos in vitro, which means that for most patients, each IVF cycle results in the formation of embryos which they can admire.( Tip: If you are doing IVF treatment, insist that the clinic give you photos of your embryos. This is the best documentation that you have received good quality medical care. You have a legal right to your medical records - every hospital has to provide them by law ! Please make a request for this in writing ! Poor quality documentation without photos of your embryos suggests you have received poor quality medical care !)However, sometimes there is complete failure of fertilisation, as a result of which no embryos are formed. This can be a rude shock to the patient, and causes major heartburn !Why do the sperm fail to ferti... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4060910 Tue, 12 Oct 2010 03:54:00 +0100 4060910 http://www.medworm.com/index.php?rid=4053364&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2010%2F10%2Ffear-of-ivf.html Many infertile couples are afraid of doing IVF. For some of them, the fear is so overwhelming, that they refuse to even consider this option, thus depriving themselves of their best chance of having a baby !There are many reasons for this fear - it can be a long list !fear of injectionsfear of painfear of side effectsfear of multiple pregnanciesfear of anesthesia ( once I sleep, will I wake up again ?)fear of failurefear of expenseI think it's important for patients to face up to their fears - and the best way of doing this is to reframe your perspective ! Many of these fears are untrue and irrational.Its true that IVF is expensive; and that the outcome is always uncertain; but the only risk is emotional and financial. There is no medical risk and no pain ; and it's important to explode th... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4053364 Sat, 09 Oct 2010 05:37:00 +0100 4053364 http://www.medworm.com/index.php?rid=4040626&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2010%2F10%2Fmanaging-your-anxiety-before-ivf.html While most patients can handle the medical bits and bobs of an IVF treatment cycle quite easily, dealing with the anxiety which an IVF cycle involves can be very challenging.I just saw a 38 year old patient who had a low AMH level. She had been advised IVF, and wanted a second opinion as to whether this was a good option for her.Given her advanced age and her low AMH level, I told her that she had reached the oopause. I agreed that she needed IVF, because time was at a premium for her.When I said this, she because very agitated. I did my best to try to calm her down, but she seemed to get even more anxious." What are you worried about ? Pain ? side effects ? the expense ? "" No, doctor, I am worried that I am now too old. I know that my low AMH level means my eggs are poor quality, and tha... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4040626 Thu, 07 Oct 2010 02:01:00 +0100 4040626 http://www.medworm.com/index.php?rid=4036968&cid=t_99549_177_f&fid=38137&url=http%3A%2F%2Fmissionimpossibleinfertile.wordpress.com%2F2010%2F10%2F06%2F2467%2F I do sincerely apologise for the radio silence around these parts, you know, given that I am actually doing the most relevent thing that the writer of an actual infertility related blog can do, to whit undergo my seven billionth IVF cycle. It’s just that I’ve only had one day off to myself this entire month thus far and I get one more in a week or so. For the entirety of October and no, I am not making that up. I am too tired to bother exagerrating and I have run out of clean knickers, again. Times are hard. Also, my ‘day off’ was technically spent in a delightful turn of phrase known as ‘on call’, meaning that not only could I not do anything remotely useful just in case the outbreak of rampant dysentery on my ward had spread further afield than ho... Mission: Impossible (or adventures in infertility, pregnancy....parenting?) blogs http://www.medworm.com/rss/comments.php?id=4036968 Wed, 06 Oct 2010 09:56:20 +0100 4036968 http://www.medworm.com/index.php?rid=4036744&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2010%2F10%2Fpoor-quality-ivf-medical-treatment.html It breaks my heart when I see how poorly patients are informed about their IVF treatment. It seems to be a conspiracy of silence - and most doctors seem to be extremely stingy about sharing medical details with their patients . I find this very difficult to understand - after all, the patient has a legal right to their medical records.Many IVF clinics provided printed treatment summaries - which conceal more than they reveal.I have attached an image of a " treatment summary" of a patient who had IVF done in a leading IVF clinic in Delhi ( name removed to protect the guilty !).While it seems quite impressive , there is no medical information in it at all ! The doctor does not even specify how many eggs were collected !There are no details about the embryo quality - or even how many embryos ... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4036744 Wed, 06 Oct 2010 02:47:00 +0100 4036744 http://www.medworm.com/index.php?rid=4031324&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2010%2F10%2Fbut-i-am-not-doctor-doctor.html I will often ask my patients for their inputs during their IVF treatment cycle. I feel patients should be well-informed and I see my role as a technical facilitator . My goal is to empower my patients so that they can make the right decisions for themselves and not have to depend upon me.When I ask my patients to decide, many of them look at me as as I was crazy. Most Indian patients are used to dealing with doctors who have a much more paternalistic style, and most are used to being told what to do by their doctor.A common response to my question , What would you like to do ? is - But I am not a doctor ! This has 2 sub-texts - You are the doctor, which means you are the expert, so you should decide. Secondly, because I am not a doctor, I do not understand much about IVF, so do not feel I ... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4031324 Tue, 05 Oct 2010 15:46:00 +0100 4031324 http://www.medworm.com/index.php?rid=3976546&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2010%2F09%2Ftreatment-independent-pregnancies.html Many IVF specialists have seen couples who do not get pregnant in the IVF cycle and then promptly conceive in the next month ! Even couples whom we think have no business getting pregnant do so all the time ( for example, those with very low sperm counts or poor ovarian reserve ) !This is why IVF specialists no longer use the word sterility. We prefer the description, infertility, because this emphasises the fact that fertility is a relative term !So are all these pregnancies miracles ? Not really ! When some patients fail an IVF cycle, they just give up. They believe - " If the IVF cycle failed, this means I am never going to get pregnant on my own , so why bother ? "Others take a completely different approach. " If Dr Malpani can make embryos for me in his lab, I can do so for myself in ... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=3976546 Fri, 17 Sep 2010 03:23:00 +0100 3976546 http://www.medworm.com/index.php?rid=3973133&cid=t_99549_177_f&fid=38137&url=http%3A%2F%2Fmissionimpossibleinfertile.wordpress.com%2F2010%2F09%2F15%2Ftiming%2F I think that, after having just opened letter from my clinic hoping perhaps to have real word of cycle protocol (or failing that a bleeping prescription for the DRUGS since I am a confirmed fertility junkie these days) only to discover instead an ‘oops we forgot to bill you six months ago for those frozen embryos of yours, so’s how abouts you pay us NOW, xoxo hugs and kisses Financial Henchmen’ I can safely observe that timing is critical in these sort of delicate matters. That is if the sender doesn’t actually want aforementioned letter rolled up tight, set alight and shoved firmly up their rectum. Personally, having just had five embryos die in vitro and the last remaining hope die in vivo rather messily, I think I plan to tell Clinic Unmentioned that I high... Mission: Impossible (or adventures in infertility, pregnancy....parenting?) blogs http://www.medworm.com/rss/comments.php?id=3973133 Wed, 15 Sep 2010 11:02:32 +0100 3973133 http://www.medworm.com/index.php?rid=3965725&cid=t_99549_167_f&fid=36994&url=http%3A%2F%2Fnutrition-news.blogspot.com%2F2010%2F09%2Fivf-fertility-treatment-hello-for-rod.html HELLO! Exclusive: Rod + Penny Lancaster Stewart proudly announce they're expecting a second child - hellomagazine.com:The rich and famous are used to getting what they want when they want it. However if it's a new baby you want and fertility that's your problem you don't need to be skipping backwards and forwards over the Atlantic from New York to Los Angeles and then back to Harley Street in London.You may not necessarily need the £1,000's of pounds need per course of IVF and even if you've decided that's your only option you can dramatically increase your chances of success and a healthy baby with or without IVF with nutrition therapy based on findings and research gathered by Foresight the Preconceptual Care charity from Universities and human trials all over the world.Couples followin... Healthy Eating and Nutrition News blogs http://www.medworm.com/rss/comments.php?id=3965725 Mon, 13 Sep 2010 13:48:00 +0100 3965725 http://www.medworm.com/index.php?rid=3942861&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2010%2F09%2Fhow-to-increase-your-stress-levels-when.html Being infertile is stressful and going through an IVF cycle can be even more so because so much is riding on the outcome of the treatment. An IVF treatment cycle is much more than just a medical procedure, because there are so many hopes, dreams and desires wrapped up in the treatment.However, the biggest emotion is often that of fear ! What will I do if the IVF cycle fails ? Is there any hope of my ever having my own baby if even IVF fails ?I feel it's the unrealistic expectations which cause the most stress . Most patients who start an IVF cycle refuse to even consider the possibility that the treatment may not work. They have been brainwashed into " thinking positive" , so they refuse to remember that the chances of the IVF failing for a given patient in any cycle are more than the chan... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=3942861 Wed, 08 Sep 2010 03:34:00 +0100 3942861 http://www.medworm.com/index.php?rid=3938291&cid=t_99549_83_f&fid=34856&url=http%3A%2F%2Finsidesurgery.com%2F2010%2F09%2Fkartageners-syndrome-classic-clinical-triad%2F Situs inversus, infertility, pulmonary infections (Source: Inside Surgery) Inside Surgery blogs http://www.medworm.com/rss/comments.php?id=3938291 Tue, 07 Sep 2010 06:04:44 +0100 3938291 http://www.medworm.com/index.php?rid=3929296&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2010%2F09%2Fwhat-precautions-should-i-take-after.html One of the commonest questions patients ask me is - " Doctor, what are the dos and don'ts after the embryo transfer ? " They are very worried about the risk of failure, and are petrified that they may end up doing something which will cause their embryos to "fall out" of the uterus. Many will often spend the entire 2 week wait obsessing about their diet and physical activity.Some will even put themselves on voluntary house arrest. Even worse, their relatives will often force them to sleep in bed for 14 days after the transfer. And to add insult to injury, many IVF doctors will also "advise" this !Why do we still continue to perpetuate this myth ? I think it's partly doctors who are responsible For one thing, many doctors do not bother to educate their patients that physical activity will n... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=3929296 Fri, 03 Sep 2010 04:32:00 +0100 3929296 http://www.medworm.com/index.php?rid=3924963&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2010%2F09%2Fhow-some-ivf-clinics-lie-to-their.html Many IVF clinics are desperate to get patients. This is especially true for new clinics which have just been started in small towns and cities. Though they have not been able to achieve a single pregnancy, they do their best to attract patients, and often lie in order to do so.Unfortunately, many patients are not sophisticated enough to be able to separate fact from fiction, and will often get taken for a ride.1. " Our pregnancy rates are 45%". This is the commonest lie. Most clinics do not bother to keep data or report their personal pregnancy rates. Most will just "borrow" the highest success rates of the best IVF clinics, and claim to have the same results. This is a lie - but there's no way the patient can find out the truth !2. " Our doctors come from Bombay. " Some IVF clinics pride ... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=3924963 Thu, 02 Sep 2010 04:01:00 +0100 3924963 http://www.medworm.com/index.php?rid=3920924&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2010%2F09%2Finfertile-man-comic-book-on-male.html Open publication - Free publishing - More infertility (Source: The Patient's Doctor) The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=3920924 Wed, 01 Sep 2010 03:20:00 +0100 3920924 http://www.medworm.com/index.php?rid=3920925&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2010%2F08%2Fmaking-use-of-tradtional-remedies-for.html Infertile couples in India will often resort to using traditional medicines . Many will go to temples and take a prasad or tie a holy thread to help them to have a baby. Not only does traditional medicine have a long history in India, it has also helped many couples with unexplained infertility to have a baby, which means it has an established track record of success !However, many modern IVF doctors make fun of these "remedies". They believe these are useless, and will often discourage a patient from adopting these.It's not smart to do this. A good doctor respects a patient's beliefs, and understands that different people have different world views - and there is no one right way of looking at things ! After all, IVF specialists and Western medicine do not have a monopoly on the truth !Th... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=3920925 Tue, 31 Aug 2010 05:55:00 +0100 3920925 http://www.medworm.com/index.php?rid=3914650&cid=t_99549_146_f&fid=38266&url=http%3A%2F%2Fsleepeducation.blogspot.com%2F2010%2F08%2Fcpap-can-reverse-sleep-apnea-related.html (Source: Sleep Education) Sleep Education blogs http://www.medworm.com/rss/comments.php?id=3914650 Sun, 29 Aug 2010 13:15:00 +0100 3914650 http://www.medworm.com/index.php?rid=3903152&cid=t_99549_177_f&fid=38137&url=http%3A%2F%2Fmissionimpossibleinfertile.wordpress.com%2F2010%2F08%2F25%2Fone%2F Only one. Everything else either died at thaw, and I have never lost a single embryo at thaw before, ever, or arrested. One. THIS close to not getting a transfer at all. It’s not an embryonic supermodel either, but I’ll take what I can get. One. Out of six. Urgh. I have to admit one was a big fat letdown. I was hoping for at least three to choose from and re-freeze because now? I have zip in the can. Anyone care to punt which way the dice shall rolleth? (Source: Mission: Impossible (or adventures in infertility, pregnancy....parenting?)) Mission: Impossible (or adventures in infertility, pregnancy....parenting?) blogs http://www.medworm.com/rss/comments.php?id=3903152 Wed, 25 Aug 2010 10:26:03 +0100 3903152 http://www.medworm.com/index.php?rid=3891828&cid=t_99549_167_f&fid=36994&url=http%3A%2F%2Fnutrition-news.blogspot.com%2F2010%2F08%2F1-in-96-chance-of-getting-pregnant-says.html The average couple has sex 96 times to get pregnant a new study has revealed.It takes a woman just six months to conceive her first child, but is having to ‘do the deed’ over four times a week. The poll of 3000 mothers was commissioned by family planning brand First Response which also revealed that two thirds of women conceived much quicker than they expected.One in 10 women have been so eager to get pregnant they have called their husband home from work when they were ovulating. And a further, pushy 10 per cent said they then jumped on their other half as soon as he walked through the door.Despite this, 70 per cent of those polled said they wanted their baby to be conceived during a loving and spontaneous sex session rather than going through the mechanics. In order to woo their othe... Healthy Eating and Nutrition News blogs http://www.medworm.com/rss/comments.php?id=3891828 Mon, 23 Aug 2010 10:04:00 +0100 3891828 http://www.medworm.com/index.php?rid=3865325&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2010%2F08%2Fexpert-patient.html When patients have a medical problem, they come to doctors asking for help . They expect the doctor to provide solutions ; and the traditional model is that the doctor reviews the problems and offers the right treatment. The patient complies with this and gets better, so that everyone is happy.In real life, things are far more complex.What happens when the doctor and patient do not see eye to eye ? What if the patient is not happy with the solution which the doctor offers ? Usually, patients are scared of doctors and are reluctant to express their disagreement openly. Most will nod their heads, pretend to agree - and then walk out and find another doctor ( if they can afford to do so) who provides an alternative solution they are happier with. However, this is not a happy solution, either ... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=3865325 Fri, 13 Aug 2010 13:35:00 +0100 3865325 http://www.medworm.com/index.php?rid=3862207&cid=t_99549_177_f&fid=38137&url=http%3A%2F%2Fmissionimpossibleinfertile.wordpress.com%2F2010%2F08%2F13%2Fsucked%2F Scan sucked. I’d type more, but I’m screaming inside about the bit afterwards where the clinic nurse rang me up presumably to find out what was happening because nobody communicates within that joint, and in responded to my ‘no, nothing is happening’, ‘no, I don’t need bloods because NOTHING is happening’, ‘No, I don’t need another appointment right now because, um, nothing is happening’ with ‘Fabulous!’, ‘Great!’, ‘WONDERFUL’, and (my personal favourite) ‘You have a GREAT weekend!’. Thanks, I think. Hope she actually listened to what I was saying and isn’t thawing embryos as I type since that’s about the only way this cycle could get more painful right now. Another scan ... Mission: Impossible (or adventures in infertility, pregnancy....parenting?) blogs http://www.medworm.com/rss/comments.php?id=3862207 Fri, 13 Aug 2010 06:54:06 +0100 3862207 http://www.medworm.com/index.php?rid=3862075&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2010%2F08%2Fwhy-are-young-fertile-women-doing-ivf.html I saw a 28 year old business executive today , who had an unusual request. " Doctor, I want you to do IVF for me ! I know I am most probably fertile, but my husband and I are both very busy and are finding it hard to find the time to make a baby, because we both travel so much. I want to have a baby quickly and do not want to waste time. IVF is more efficient than natural sex , so I want to do this in this month. Can you do this for me ? I know that natural Human reproduction is a very inefficient enterprise - and the chances of a pregnancy in one month are about 25%. I checked my husband's diary and mine and compared it with the free online fertility calculator . It seems that the only time we will be together during my fertile time is in Nov 2010 and Feb 2011. I don't want to waste time ... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=3862075 Thu, 12 Aug 2010 10:41:00 +0100 3862075 http://www.medworm.com/index.php?rid=3858229&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2010%2F08%2Fpgd-newest-art.html Open publication - Free publishing - More infertility (Source: The Patient's Doctor) The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=3858229 Wed, 11 Aug 2010 17:37:00 +0100 3858229 http://www.medworm.com/index.php?rid=3854785&cid=t_99549_177_f&fid=38137&url=http%3A%2F%2Fmissionimpossibleinfertile.wordpress.com%2F2010%2F08%2F11%2Finspiration%2F Ladies and, well, probably only ladies of the Internet, I pop my virtual head (and ovaries I guess since I am technically stimming and stuff)  up today to tell you two things, namely: 1. I am still barely past baseline but apparently something on my right ovary is possibly thinking about the concept of generally doing something and MAYBE getting designs on leading the show. I have another scan Friday, and if this is indeed the case then you shall all hear the whoops of joy followed by the terrified nail biting of a woman who is risking everything on three year old frozen embryos making it to day five, something my clinic does not often do. I mean, it’s becoming increasingly REAL that I may very well have nothing to transfer and because I am not exactly a genius with words I&#821... Mission: Impossible (or adventures in infertility, pregnancy....parenting?) blogs http://www.medworm.com/rss/comments.php?id=3854785 Wed, 11 Aug 2010 01:37:19 +0100 3854785 http://www.medworm.com/index.php?rid=3854588&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2010%2F08%2Frisks-and-complications-of-ivf.html Open publication - Free publishing - More infertility (Source: The Patient's Doctor) The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=3854588 Tue, 10 Aug 2010 17:34:00 +0100 3854588 http://www.medworm.com/index.php?rid=3845305&cid=t_99549_177_f&fid=38137&url=http%3A%2F%2Fmissionimpossibleinfertile.wordpress.com%2F2010%2F08%2F08%2Fyawn-2%2F I think my clinic’s terror at my newly discovered  AMH of 49, a disturbingly abundant number for an ageing old mare (an age I shan’t be confessing here thank-you-very-muchly) like myself and my own RE’s natural tendency to caution at the best of times have really conspired against me with this cycle. That’s the only rational explanation I have for the farce of driving an hour each way for a monitoring scan on day four of injecting a piddling 33 IU of the good stuff into my locale of current choice, my thighs. My stretched out abdomen keeps bleeding like stink and I am sick of looking like a badly-aimed junkie. Also, it hurts to rest my guts on the bench and fold my head quietly over in misery on nightshift and I have enough troubles with nightshift as it is.... Mission: Impossible (or adventures in infertility, pregnancy....parenting?) blogs http://www.medworm.com/rss/comments.php?id=3845305 Sun, 08 Aug 2010 10:31:24 +0100 3845305 http://www.medworm.com/index.php?rid=3822989&cid=t_99549_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2010%2F08%2Fftr-fallopian-tubal-recanalisation.html In some infertile women, the fallopian tubes are blocked at the uterine ( cornual) end. Recanalization is a minimally invasive procedure used to open the blocked fallopian tubes in these patients. The diagnosis of cornual block or proximal tubal occlusion ( PTO) is made usually by doing a X-ray of the uterus and tubes, called a hysterosalpingogram ( HSG) or a laparoscopy. Fallopian tube recanalization is a relatively new reproductive technique , in which an X-ray of the uterus is performed, using a dye to visualise the uterine cavity and the site of the block, with the help of an advanced X-ray machine called an image intensifier. In patients who demonstrate a tubal block on X-ray, a guide wire or a balloon is passed to the area of tubal blockage & the block is opened up. In women who... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=3822989 Wed, 04 Aug 2010 11:30:00 +0100 3822989