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Rational IVF

The other day, my wife asked why I don’t shorten my stories. I explained to her that these entries were more than stories of inspiration and hope; these stories are also meant to explain and educate.

When patients come to me after failing at other centers, I sometimes find myself having difficulty following the logic of prior treatments. At times, I am stunned at the lack of thought placed in creating differential diagnoses and treatment options. “If at first you don’t succeed, try, try again” and (fortunately and unfortunately) there is literature that supports this: If the first IVF treatment fails, subsequent treatments will result in a higher rate of success. In my gut, this doesn’t feel right, this “doing the same thing over and over again and expecting a different result.” IVF is too emotionally, physically and financially expensive to thoughtlessly do the same thing and HOPE things work out the second or third time around.

If you fail, instead of blindly blaming “bad eggs” and repeating the same treatment again, think about why you may have failed. See what you can learn from your failure.

Can you truly blame the egg and how did you come to this conclusion?

Could it be the sperm even though traditional testing is all normal?

Did you attempt to grow the embryo to blastocyst and possibly even test it?

Did the embryo implant? Have you ever been pregnant?

If not, could this be a uterine issue? Did you try preparing the endometrium in anyway even though all traditional testing was all normal?

If you did implant, could your body be rejecting the embryo? Did you do any testing for rejection issues? Did you try any therapies anyway since immunological testing is far from conclusive?

In the end, you may be repeating the same treatment again, but at least you have thought it through and made an educated decision going forward.

This is what I call “Rational IVF”