The basic questions are really quite simple and include how old you are ; how old your husband is ; how long you been married ; and how long you have been actively trying to have a baby . This is called “trying time”. I think sometimes patients forget that human reproduction is not very efficient and that it takes even fertile couples time to make a baby . It’s only in a Hindi film that everyone gets pregnant the first night they have sex, whereas in reality it can easily take up to one year for a completely healthy fertile couple to get pregnant even if they have been having sex on a regular basis . You need to remember that the definition of infertility is the inability to get pregnant even after having regular intercourse for over a year . However, if you are more than 35 , then we will accelerate the process and we will not wait for a year to go by . Similarly , if you have an abnormal medical history such as irregular periods , or sexual difficulty , then we will have to focus on that in order to resolve your problem. I know sometimes this can be a touchy and sensitive issue, and patients are very reluctant to discuss these matters openly with their doctor , and which is why they often hide the truth . But unless you tell us the truth , it’s very hard for us to be able to find the right solution for you . For example, especially in working couples who have hectic careers , it is very common to find that the only time they manage to have sex is once every month when they happen to be in the same city, and that too only on the weekend , which means they are not really infertile , but their childlessness is a social problem , because they just not been having enough intercourse.
If you have been having regular intercourse for over one year and still have not got pregnant , then we need to do a basic work up in order to find out what the problem is. The good news is it’s quite easy to do this and takes less than 15 days, because you really only require 4 things in order to get pregnant – normal sperm, normal uterus, normal fallopian tubes, and good quality eggs. These are the areas which we need to evaluate . The first test which you do is a semen analysis for your husband , because that’s a simple and cheap test . It’s important that you go to good reliable laboratory to get this done because a lot of labs don’t do this test very well . Once we can confirm that the semen analysis is normal , as I expect it will be , because we are doing it just to reassure you that everything is fine , we will then move on to evaluating your fertility . The day your period starts is called day one of your cycle. This basically involves doing a simple blood test to check the status of your reproductive hormones, prolactin, TSH and AMH. This can be done on any day of the cycle; an ultrasound scan to check your ovarian reserve or antral follicle count on the 3rd day of your cycle , a HSG or hysterosalpingogram , which is an X ray of your uterus and tubes to confirm that your fallopian tubes and uterine cavity are normal on day 7 or 8 of your cycle , and finally an other ultrasound scan on the 10th day of your cycle to check that your uterus lining is normal.
Once you get your test reports ,we will analyse and interpret them but it is also important that you try to understand what the levels mean for yourself. The good news is it’s quite easy to do this because we have a lot of information on our website at www.drmalpani.com , which is designed to help you make sense of your own results. You can also scan in your results and upload them to my digital avatar, and I will help you make sense of this . This sense of control will give you much more clarity as to what the next steps are , and will reduce your stress and anxiety levels , because knowledge is power , and the more you know , the easier the journey will be for you . Pease don’t get scared or intimidated by a lot of unfamiliar terms , because it is true that doctors do use a lot of medical jargon , but none of this is very complicated , and the more you understand about what is happening to you , the easier it will be for you to know what the next steps are . Please remember that doctors are not mind readers and we want you to be an active participant in your journey , because we are trying to help you to achieve your goals, and you need to define them clearly.
One of the elephants in the room is that it can be very hard for couples to talk with each other about the problem of infertility. This is because infertility is not something that affects just the man or the woman—it affects both partners. However, because it is such a touchy and sensitive issue, it’s often hard to bring it up. The common tendency is to sweep it under the carpet and avoid discussing it. Unfortunately, this kind of denial does not help achieve resolution. It’s important to discuss what you want to do together so you can make the right decisions for yourselves.
One of the problems with infertility is that it’s not just a medical issue; it also involves psychological, emotional, and social challenges. Often, it induces an inferiority complex because couples think they can’t even accomplish something as “simple” as having a baby. In India especially, everyone is eager to give unsolicited advice on how to get pregnant, assuming that just because they’ve had a baby, they are now fertility experts. This can get quite irritating. However, always remember that you are in charge of your own destiny. Being well-informed will help you make the right decisions for yourself, without being influenced by what others say.
At the end of the day, please don’t make a bad situation worse by blaming yourself for your infertility. Do remember that it is a medical problem for which medical solutions exist. While we may not always be able to identify the exact reason for the problem—such as why your tubes are blocked or why the sperm count is low—we are quite good at bypassing the problem. That’s the beauty of IVF. It allows us to replace your fallopian tube with a test tube, enabling us to replicate in the laboratory what isn’t happening naturally in your bedroom. The success rates of IVF have improved significantly over time, and there’s really no reason to be anxious about the procedure, especially when done in a good clinic.
The babies born as a result of IVF are completely normal because we are simply replicating in the laboratory what would naturally happen in the bedroom. The hormones we use to help you grow multiple eggs are natural hormones that are excreted by the body. They do not increase your risk of breast cancer or cause you to run out of eggs. You don’t need to worry about these concerns. Part of the problem is that there are so many myths and misconceptions surrounding IVF that patients often feel unnecessarily anxious. The best way to immunize yourself against these fears is by arming yourself with information. This helps you understand the truth and prevents you from being misled by old wives’ tales.
It’s important to have realistic expectations so you understand what is in your hands, what is in the doctor’s hands, and finally, what is in God’s hands. The reality is that the outcome will always have an element of uncertainty, but the process itself should be positive and reassuring. This will give you peace of mind, knowing you did your best. It’s crucial to keep an open mind and explore all your options.
While there are no significant medical risks with IVF, there are financial and emotional risks. IVF is expensive, and the expense can be open-ended because you don’t know how many cycles it will take to achieve a pregnancy. The emotional risk comes from the hope that every couple has when starting IVF—that the first cycle will be the only one needed. When a cycle fails, it can break your heart and force you to start all over again, which is extremely difficult.
The good news is that at our clinic, an IVF cycle is both pain-free and stress-free. We don’t subject you to unnecessary injections, and we provide you with information therapy so you know exactly what to expect. This ensures you are much more in control of your cycles and don’t feel blindsided by the process. This sense of control is incredibly valuable because we believe in being partners in your IVF journey.
I understand that an IVF journey can be stressful, but actually, IVF should reduce your stress and anxiety levels. We always tell patients that if you come to us, please come with a smile because IVF gives you the best chance of having a baby.
You also need to remember that there are no right or wrong decisions—there is only the decision that is right for both of you. This is something you both need to decide together. You cannot outsource this decision to your parents or your doctor because it will affect the rest of your life, and you need to take ownership of it. Yes, it can be hard, but it’s important to make the right decision for yourselves. If you’re confused about what to do next, we are happy to guide and counsel you. However, you need to make that decision for yourself. We can only serve as coaches and guides; we can’t tell you what to do.
You should also keep an open mind and explore additional options, including non-medical ones such as child-free living or adoption. Remember, these options are not mutually exclusive—they are complementary. If you prefer, we will be happy to help you explore these options as well. At the end of the day, what matters most is that you have peace of mind knowing you made the right decision for yourself.
One of the most common questions patients ask is, “What is the success rate of IVF?” Unfortunately, while the question is simple, the answer is quite complex because there are so many variables, some of which we only learn after starting the IVF cycle. Remember, an IVF cycle is not just a treatment—it also provides invaluable diagnostic and prognostic information. Based on what went well and what didn’t, we can continue to refine and improve the process for you.
Coping with the stress of an IVF cycle can be difficult because of all the uncertainty involved , but the more you know the easier the journey will be.
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