When patients come to me as an IVF doctor, many expect me to decide for them.
They assume that because I am the medical expert, I should simply tell them what to do. And yes, it’s true that I know far more about IVF and infertility than they do. That’s my job. But there’s a very important reality both doctors and patients need to understand.
I am not a mind reader.
I do not live in my patients’ shoes. I do not know their emotional priorities, their financial constraints, their family pressures, their risk tolerance, or what matters most to them personally. Because of this, I cannot honestly tell them what the “right” decision is for them.
And I try very hard not to.
What I can do, and what I believe a good doctor should do, is explain the situation clearly and give patients a process they can use to make the right decision for themselves.
By the time many patients come to us, they are already thoroughly confused. They’ve visited ten different websites, each of which says something different. They’ve met five different doctors and received twenty different opinions. Their heads are spinning, and they no longer know what to believe.
This is not surprising.
Medicine is full of shades of grey. There are very few black-and-white answers. Patients often want certainty, but certainty is often an illusion. This is true even for something as basic as a semen analysis.
For example, if a man has zero sperm in his semen, we can confidently say that he cannot get his wife pregnant naturally. But if sperm are present, we still cannot fully test their functional competence. We cannot always predict whether those sperm will fertilise an egg, create healthy embryos, or lead to a baby.
Tests have limitations.
This is something both doctors and patients need to acknowledge with humility. Modern medicine is powerful, but it is not magical. Many IVF patients overestimate what tests can tell them, and many doctors are reluctant to admit uncertainty because they fear it will make them look less authoritative. In fact, the opposite is true. Honest doctors are the ones who openly acknowledge the limits of medical knowledge.
It is equally important to understand that every doctor has biases.
There is nothing unusual or shameful about this. We are all human. Every doctor’s advice is shaped by personal experience, training, expertise, incentives, and worldview. A surgeon may be more likely to recommend surgery. An IVF specialist may be more likely to recommend IVF. A conservative doctor may prefer waiting, while an aggressive doctor may push intervention sooner.
Bias is inevitable.
What matters is not whether bias exists. What matters is whether the doctor is willing to discuss it openly rather than pretending it does not exist.
This is where the conversation often becomes uncomfortable.
For example, it is very common to see IVF doctors advise IVF not necessarily because it is in the patient’s best interest, but because they want to do more IVF cycles. After all, IVF is what they are trained to do, and it is also how they earn money.
This is the elephant in the room.
Patients are often too intimidated to raise this issue, and doctors are often too defensive to address it proactively. But pretending this bias does not exist helps no one. In fact, it only makes patients more anxious and suspicious.
I believe it is far better for doctors to discuss these issues openly. Good doctors are not threatened by thoughtful questions. Good patients should feel free to ask them.
And if a doctor gets offended when you ask reasonable questions, that is a red flag.
A doctor who becomes defensive when questioned is telling you something important about himself. He may want obedience rather than partnership. He may be more invested in protecting his authority than in helping you think clearly.
That is not the kind of doctor you want.
You deserve a doctor who understands your concerns, respects your intelligence, and helps you make the right decision for yourself — not one who simply tells you what to do.
My job is not to control my patients.
My job is to educate them, guide them, and empower them. I need to explain the pros and cons of each option, clarify the uncertainties, identify the limitations of the tests, and be transparent about my own biases. Once I do that well, the final decision belongs where it should always belong — with the patient.
After all, it is their body, their money, their future, and their family.
Not mine.
That is why I don’t tell my IVF patients what to do.
I help them learn how to decide for themselves.
That’s harder than giving orders. But it’s also far more honest. And in the long run, it leads to better decisions, better relationships, and better care.
Please get your doubts resolved free using our chatbot which is powered by AI based on Dr Malpani’s 40 years of clinical expertise and experience at https://www.drmalpani.com/chat-w-chatbot/index.html. This will ensure you’re on the right path and potentially save significant costs in the long run.