Patient: Dr. Malpani, I’ve been hearing a lot about the use of donor eggs in IVF. A few of my friends who’ve been through IVF told me that they were pushed into using donor eggs by their doctors, even when their ovarian reserve seemed fine. This worries me—why would a doctor suggest donor eggs if a patient still has viable eggs?
Dr. Malpani: I’m glad you brought this up. Unfortunately, it’s true that some doctors do push patients toward using donor eggs, often prematurely. This is especially concerning because it disregards the patient’s autonomy and the possibility of using their own eggs.
Let me explain why this happens. The most common excuse given by some doctors is that they fear the possibility of “empty follicles,” where they might not retrieve any eggs during the egg collection process. They may tell patients that there’s a chance of finding no eggs in the follicles, and this possibility is used as a rationale to recommend donor eggs, even when the patient’s ovarian reserve is adequate.
Patient: But isn’t it a doctor’s duty to try everything possible with the patient’s own eggs first? What’s the point of IVF if they’re going to skip straight to donor eggs?
Dr. Malpani: Exactly. IVF is a process that’s meant to help you conceive with your own eggs, if at all possible. The decision to move to donor eggs should only be made after thorough discussions and when there’s clear evidence that using your own eggs won’t be successful. However, in some cases, the pressure to use donor eggs can be financially motivated.
Patient: Financially motivated? Do you mean the doctors are doing this just to make more money?
Dr. Malpani: Sadly, yes. Using donor eggs can be more profitable for some clinics. It’s a straightforward process with a higher success rate, and the costs involved are higher. This can tempt some less ethical practitioners to push patients in that direction prematurely. But let’s be clear—this is not how ethical medicine should be practiced.
A responsible doctor should first exhaust all options with your own eggs. The decision to use donor eggs should be based on medical necessity, not financial gain. The tragedy is that many patients, especially in India, are easy targets for this kind of exploitation because they trust their doctors implicitly.
Patient: That’s so disheartening. How can patients protect themselves from falling into this trap?
Dr. Malpani: The key is to be well-informed and to ask the right questions. You need to understand your own fertility, including your antral follicle count (AFC) and Anti-Müllerian Hormone (AMH) levels. If these are within the normal range, there’s generally no reason to jump straight to donor eggs without first attempting IVF with your own eggs.
Always ask your doctor why they are recommending donor eggs. Request to see your ultrasound scans and hormone levels, and get a second opinion if you’re unsure. If a doctor is quick to suggest donor eggs without trying with your own eggs first, that’s a red flag.
Patient: So, if my AFC and AMH levels are good, there’s a reasonable chance I can conceive with my own eggs, right?
Dr. Malpani: Absolutely. High AFC and normal AMH levels generally indicate a good ovarian reserve. This means your ovaries have a good number of eggs left, and there’s every reason to attempt IVF with your own eggs first. Remember, IVF isn’t a guarantee, but it gives you a fighting chance with your own biology.
Patient: What if the doctor insists that my follicles might be empty? Is that a valid concern?
Dr. Malpani: Empty follicle syndrome is a rare condition where no eggs are retrieved despite normal follicle development. However, it’s not something that should be assumed lightly. The decision to use donor eggs should be based on actual findings, not on fear or speculation.
If your doctor is insisting on donor eggs due to empty follicles, it’s important to ask for a detailed explanation and proof. Demand to see your hormone levels, follicle scans, and previous cycle results. If they’re unwilling to provide this information or if their reasoning doesn’t add up, it’s time to seek a second opinion.
Patient: This is really eye-opening. I never realized how much I needed to advocate for myself. What should I do if I feel like I’m being pushed into something I’m not comfortable with?
Dr. Malpani: Trust your instincts. If you feel uncomfortable or pressured, it’s crucial to take a step back and re-evaluate your options. Don’t rush into any decisions. IVF is an emotional and financial investment, and you deserve to have all the information and time you need to make the right choice for yourself.
Consider seeking a second opinion from a doctor who values your autonomy and is willing to explore all options with your own eggs first. Don’t hesitate to question your doctor and ask for clear, evidence-based explanations for their recommendations.
Patient: Thank you, Dr. Malpani. This has been really helpful. I feel much more empowered to make informed decisions about my treatment.
Dr. Malpani: I’m glad to hear that. Remember, your body, your choice. It’s important to find a doctor who respects that and who will work with you to achieve the best possible outcome using the least invasive and most natural means first.
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