Patient: Dr. Malpani, I’ve heard about some unethical practices in IVF clinics. Can you explain more about these?
Dr. Malpani: Absolutely, one particularly despicable trick that many doctors seem to use is giving patients HCG injections after the embryo transfer to get a positive pregnancy test. This is cruel on multiple levels, but first, let me explain why this works.
Patient: Why would HCG injections affect the pregnancy test?
Dr. Malpani: When we are testing for pregnancy, we check for the presence of HCG either in the urine with a urine pregnancy test or by doing a blood test, which is the gold standard. This HCG molecule is produced by the extraembryonic cells which form the future placenta and is specific to pregnancy. This means it is found present only when a woman is pregnant, and a positive test result is diagnostic of pregnancy.
Patient: So, how do these injections interfere?
Dr. Malpani: We also give the same HCG injection during IVF treatment as an HCG trigger at the time of egg collection. However, some doctors continue giving HCG injections after the transfer, justifying it as “luteal phase support” to improve the chances of embryo implantation. The problem is that the same HCG will remain in the bloodstream and spill over into the urine. As a result, the patient will get a positive pregnancy test – but this is a false positive! She will be over the moon, thinking her doctor was excellent and she got pregnant after the IVF treatment.
Patient: That sounds awful. What happens when the HCG levels decline?
Dr. Malpani: When this HCG level declines, the doctor tells her, “Oh, I’m so sorry, this was a chemical pregnancy or a miscarriage. But the fact that you got pregnant means my treatment worked. Therefore, we need to either repeat the treatment or perhaps do some additional tests or treatments, such as the ERA test or PGD.”
Patient: How can patients protect themselves from such practices?
Dr. Malpani: It’s easy for crooked doctors to take patients for a ride because they are so poorly informed. They believe, “Hey, I did get pregnant in my first cycle, so obviously this is a good doctor. Therefore, my chances of getting pregnant in the second cycle are even better, and I should trust him and go ahead.” Please don’t allow doctors to take you for a ride. The only way to protect yourself from bad doctors is by investing in information therapy and making sure that they are following global best practices, rather than doing whatever suits them and taking advantage of your ignorance and gullibility.
Patient: Thank you, Dr. Malpani. I’ll make sure to stay informed and ask the right questions.
Dr. Malpani: You’re welcome. I’m here to help you navigate this journey with as much information and support as possible.
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