What Patients want from IVF Doctors - IVF Treatments

IVF can be an emotionally taxing treatment.

Not only is it very expensive, there is a lot riding on the outcome. Patients know that the success rate depends on how good the doctor is, which is why they have very high expectations from their doctor.
They will spend a lot of time hunting for Dr Right - an IVF expert who is approachable and affordable; who will design their treatment plan and personalize it specifically for them; and who will be available to answer their questions.

IVF Clinic in Mumbai - Parakh Hospital

When they go the clinic for their scans and monitoring, they want to be able to talk to their doctor, so he can check their treatment is progressing as expected, and that there are no unexpected surprises. They want a doctor who knows their name; who cares for them; and who is available to hold their hand and provide a shoulder to cry on when things don't go well.

It's very frustrating for patients to find that the doctor is never accessible. He is either travelling; or giving a lecture; or is away at a conference; or is treating patients at another clinic.  

Even when he is in the clinic, he is so busy doing consultations with new patients, that he is not free to answer queries. When the patient is not sure if things are going well, or why the doctor has made a change to the protocol, they are forced to direct their queries either to the nurses or the assistants. The juniors are often clueless as to what is going on, because they are inexperienced or have been told that all patient's questions have to be answered only by the "Doctor" - they just have to carry out his orders ! 

When patients don't get a chance to get their queries clarified, they feel upset and abandoned.

This lack of information and transparency can become a major sore point for the patient. This is especially true when the cycle fails, and at this point the patient feels cheated. She is very likely to complain that she did not get good medical care, because the Doctor was not available.

Not only do patients need a lot of handholding - they expect their treatment to be personalized. When their care gets fragmented between the sonographer, the nurses, and the andrologist , they are understandably upset - especially when it seems that the left hand has no clue as to what the right hand is doing ! 

When the patient needs clarifications, the standard answer is - we are doing what the doctor has advised. Only he can answer your questions.

They would much rather have one person whom they could talk to - one person who was responsible for coordinating their care - and obviously they want this person to their doctor ! They want the doctor to be available to carry out all their procedures for them - including the scans, the egg collection and the embryo transfer. It's very frustrating when they find that they have to deal with a new doctor everytime they come to the clinic - someone who knows nothing about them and someone with whom they have no personal relationship.

They are always unsure if the new doctor knows what's happening - and it's very difficult to establish a rapport every time with a new doctor who happens to be on duty on that particular day. While these may seem to be relatively minor issues from a doctors point of view (because doctors are focused on providing high quality medical care), the fact still remains that IVF treatment is very highly emotionally charged, and IVF patients require a lot more attention and pampering as compared to the average patient !

Successful IVF clinics will develop processes to ensure sure that the patient's personal doctor is always available to take care of his patient throughout their entire IVF cycle. Not only does this ensure that the medical treatment is being carried out properly , it also allows him to provide the patient with continuity and emotional support. 

He can provide a shoulder to cry on - or serve as a trusted sounding board , when patients are not sure what the next step should be, or if the cycle needs to be cancelled.

Patients also want documentation and openness about how the cycle is progressing. They need to know whether the follicles are growing well ; and if their treatment is progressing according to plan. When the protocol is changed, they need to know why this change was made - and what they can expect. 

It's very frustrating for them when they have to wait for hours before they get a chance to talk to the Doctor.

The doctor should be accessible, so he can answer queries by email - or will ensure that calls are returned promptly by the end of the day. Patients want photos of their ultrasound scans and their embryos, so they have documentation that the treatment was carried our properly.

Before starting treatment, they need clarity about what the IVF treatment plan is going to ; how often they will need to visit the clinic; and how much it is going to cost them. They also need to know when they need to make payments - and what is included in the treatment cost, and what is not.

If there is an emergency or complication, they need to know whom to contact - and need to be sure there doctor is available to take care of them. 

Finally, they expect a caring doctor, who will followup after the cycle, when the beta HCG test negative, so they know what their next action steps are, and don't feel abandoned just because they cycle failed.

All this requires a lot of coordination and care on the part of the doctor and a good IVF clinic will make sure that the doctor, who is the face of the clinic as far as the patient is concerned, is always available for his patient, when the patient wants and needs him.

We at Parakh Hospital have a team of approachable IVF Doctors in Mumbai for all your Infertility treatments like - Female Infertility treatments, Male Infertility Treatments, IVF Treatments, ICSI Treatment, Surgery for Infertility, IUI treatment - Artificial Insemination, Egg Donation and Surrogacy India.

Connect with Parakh Hospital at - 

PARAKH HOSPITAL

Khokhani Lane,
Opp. Ghatkopar Rly. Stn.,
Ghatkopar (E), Mumbai - 400 077 Phone: 022 - 67827000 / 7004 / 7005 Fax: 022 - 6782 7007 Emergency: 9821125519 / 9821237708 Email: info@fertilityfirst.in

Stress And Infertility

Stress could be the cause of infertility, and infertility could cause stress. Understanding the connection between the two is therefore very important in dealing with infertility.

What is the relationship between stress and infertility ?

Stress has become a buzzword today. It is one of the most over used words in our vocabulary - and one of the most poorly understood ones as well. Stress is defined as any event that a person perceives as threatening, and in order to protect itself, the body responds to stressors with a classic "fight or flight" response, which nature designed to allow survival. In response to stress, the hypothalamus produces a hormone called corticotropin releasing factor ( CRF) which activates the hypothalamic-pituitary-adrenal (HPA) system, causing it to releases neurotransmitters (chemical messengers) called catecholamines, as well as cortisol, the primary stress hormone.

The relationship between stress and infertility is still poorly understood today. While there is little doubt that infertility causes considerable stress, the question whether stress can cause infertility, and whether stress reduction can enhance pregnancy rates in infertile couples, is still very controversial.

Can stress cause infertility?

Historically, infertility, particularly "functional" infertility, was attributed to abnormal psychological functioning on the part of one or both members of the couple. Preliminary works in the 1940s and 1950s considered "psychogenic infertility" as the major cause of failure to conceive in as many as 50% of cases. As recently as the late 1960s, it was commonly believed that reproductive failure was the result of psychological and emotional factors. Psychogenic infertility was supposed to occur because of unconscious anxiety about sexual feelings, ambivalence toward motherhood, unresolved Oedipal conflict, or conflicts of gender identity. Fortunately, advances in reproductive endocrinology and medical technology as well as in psychological research have de-emphasized the significance of psychopathology as the basis of infertility, and modern research shows that there is little evidence to support a role for personality factors or conflicts as a cause of infertility. This perspective unburdens the couple by relieving them of the additional guilt of thinking that it is their mental stress that may be responsible for their infertility.

Biologically, since the hypothalamus regulates both stress responses as well as the sex hormones, it's easy to see how stress could cause infertility in some women. Excessive stress may even lead to complete suppression of the menstrual cycle, and this is often seen in female marathon runners, who develop " runner's amenorrhea". In less severe cases, it could cause anovulation or irregular menstrual cycles. When activated by stress, the pituitary gland also produces increased amounts of prolactin, and elevated levels of prolactin could cause irregular ovulation. Since the female reproductive tract contains catecholamine receptors catecholamines produced in response to stress may potentially affect fertility, for example, by interfering with the transport of gametes through the Fallopian tube or by altering uterine blood flow.

However, more complex mechanisms may be at play, and researchers still don't completely understand how stress interacts with the reproductive system. This is a story which is still unfolding, and during the last 20 years, the new field of pychoneuroimmunology has emerged, which focuses on how your mind can affect your body. Research has shown that the brain produces special molecules called neuropeptides, in response to emotions, and these peptides can interact with every cell of the body, including those of the immune system. In this view, the mind and the body are not only connected, but inseparable, so that it is hardly surprising that stress can have a negative influence on fertility.

Stress can reduce sperm counts as well. Thus, testicular biopsies obtained from prisoners awaiting execution, who were obviously under extreme stress, revealed complete spermatogenetic arrest in all cases. Researchers have also showed significantly lower semen volume and sperm concentration in a group of chronically stressed marmoset monkey, and these changes were attributed to lower concentrations of LH and testosterone (which were reduced in the stressed group). However, how relevant these research findings are in clinical practise is still to be determined.

In addition to these direct effects, stress can also suppress libido, cause erectile dysfunction, and result in a reduction in the frequency of intercourse, which in turn could also reduce fertility. Also, many women start overeating in response to the stress of infertility. The increased fat cells then disrupt the hormonal balance, making a bad situation even worse.

While studies have shown that infertile couples do show psychologic dysfunction and even psychiatric abnormalities ( such as depression or anxiety), this is actually a chicken and egg problem, and in reality the response of the infertile couple is a perfectly "normal" response to their abnormal situation, which is designed to help them to cope with the difficult circumstances they find themselves in. However, many people start blaming the couple, and many couples themselves start believing that it is the stress which they are under which is causing them to be infertile.

Victim blaming is popular - especially where fertility and women are concerned, and instead of providing them with support, couples receive completely gratuitous and unwanted advise. Ironically, victim blaming has become more prevalent today because of the fashionable "holistic health" belief about the influence of the mind on the body, which holds that even patients with cancer can cure themselves by the power of positive thinking. Many IVF couples too may subscribe to the belief that success is practically guaranteed if the patient remain optimistic and relaxed. Thus, if the attempt fails, it was because the patient was "too tense" or " too stressed out".

This myth has been perpetuated by anecdotes of friends or relatives who have conceived while on holiday, and stories of couples conceiving after many years of infertility after they have adopted a baby are a part of today's "urban myths".

Stress and infertility often have a circular relationship, and they can aggravate each other, setting up a vicious cycle. Infertile couples, who are under stress because of their infertility, start blaming themselves for their infertility. This increases their stress levels and further aggravates the problem! As one mind-body expert has said, "Stress causes illness causes more stress which causes more illness."

How does infertility cause stress ?

Infertility Causing Stress
Research has shown that women undergoing treatment for infertility have a similar, and often higher, level of "stress" as women dealing with life-threatening illnesses such as cancer and heart disease. Infertile couples experience chronic ( long-term) stress each month, first hoping that they will conceive and then dealing with the disappointment if they do not.

It is helpful to differentiate between external stress and internal stress; as well as stressors you can control and those which you cannot. Internal stress arises when you are not able to achieve the goals you set yourself while external stress is created by relatives, friends, and work pressures. Some stressors you can do nothing about - for example, the frustration you feel when your period starts. However, there are many others which you can control. As an example, many patients get upset when they are forced to wait in the doctor's clinic. Waiting can be stressful, so do carry a book to read -while you cannot control the stressor, you can modify your response to it, and this helps to decrease your distress.

Why is infertility stressful ?

When diagnosed with infertility, many couples feel helpless and no longer in control of their bodies or their life plan. Infertility can be a major crisis because the important life goal of parenthood is threatened. Most couples are accustomed to planning their lives and experience has shown them that if they work hard at something, they can achieve it. With infertility, this may not be the case!

However, not all stress faced by infertile couples is emotional or psychological - infertility treatment can be physically stressful as well! Blood tests; injections; hysterosalpingograms, inseminations and surgery can be painful, awkward, and embarrassing.

There is considerable financial stress too and this is especially acute for poor patients. Infertility treatment is expensive, and this represents a major hurdle. Many patients drop out of treatment because they cannot afford it, and this can be very hard to come to terms with, especially when they know they could have got pregnant, if only they could have afforded the treatment.

Some of the hormonal medications you may need to take can also cause mood swings and emotional upsets, making it harder for you to cope with the stress.

Don't forget the impact of being stressed on your personal relations. Being stressed out can add to marital distress and disrupt sexual intimacy as well, making a bad situation even worse. It can also alienate you from your friends, cutting off sources of support. Also, if you are always irritable, tense, and angry, it's going to be hard to build a rapport with your doctor or his clinic staff. You may get a reputation as being a " difficult " patient, and this may make it harder for you to get good medical care.

There are certain times which are especially stressful:

• Having to time sex when trying at home
• Waiting for the menses. The suspense can be killing each month - and is even worse when the period is delayed for any reason
• Having to answer questions from family-members and friends. Many of these questions are insensitive and hurtful.
• Having to juggle infertility treatment with work pressures
• Making a decision to see the doctor
• Deciding which medical treatment to take
• Waiting for results -Is the sperm count normal? have the eggs fertilized?

Many of these stresses are amplified considerably during IVF treatment. Many couples start IVF focused anxiously on one primary concern: failure of the procedure. To compound this anxiety, couples are aware that they have little control over the final outcome - and this helplessness can make the situation even worse.

The inconvenience of daily injections and blood tests, the perception of low success rates, the wait for results, and financial pressures only add to the travails. Often, IVF is their last hope after many years of trying, and they feel that their entire future rides on the outcome of the cycle.

While it is true that couples cannot control the outcome, they can be helped to control their responses to the various phrases of the process and to the overall outcome.

It has been suggested that patients who are better able to cope with stress have higher pregnancy rates, although there have been relatively few studies in this area. Interestingly, we find that patients coming for the second IVF treatment in Mumbai cycle are much more relaxed and in control, so that they are less "stressed out".

What can you do to reduce your stress ?

Perhaps the best general approach for treating stress can be found in the Serenity Prayer by Reinhold Niebuhr, " God, Grant me the serenity to accept the things I cannot change, the courage to change the things I can change, and the wisdom to know the difference." Remember that no single method is uniformly successful: a combination of approaches is generally most effective. Also, what works for one person does not necessarily work for someone else.

There are a number of very useful books which deal with stress management techniques in great detail. A special bonus is that these tools will help you cope with stress for the rest of your life as well! Some of these tools, which you need to learn how to use, so that you can deal better with the ups and downs of your infertility include: imagery, visualization, hypnosis, auto-suggestion, meditation, positive thinking, progressive muscular relaxation, deep breathing, biofeedback, and massage.

To know more about Infertility Treatment in Mumbai Visit:

http://www.fertilityfirst.in

Contact us at:

PARAKH HOSPITAL

Khokhani Lane, Opp. Ghatkopar Rly. Stn., 

Ghatkopar (E), Mumbai - 400 077

Phone: 022 - 67827000 / 7004 / 7005

Fax: 022 - 6782 7007

Emergency: 9821125519/9821237708

Email: info@fertilityfirst.in

How to tackle the infertility blues?

Infertile couples often find themselves feeling sorry for themselves. They feel that life is unfair and that the Gods are conspiring against them ! What can you do to cope with these down days ? Here's a very thoughtful article on what to do when you are feeling sorry for yourself. I wish I had written this - but I cannot claim authorship . This was sent to me by a patient, who chooses to remain anonymous. It's full of wise advise ! 1) Kill your self-pity Self-pity is a good emotional lubricant when facing any adverse event in life. It helps to cry your eyes out. We all get some comfort after a nice crying spell. But on the long run it ruins your ability to fight-back the crisis. If you dwell on self-pity your development comes to a halt. 'Why me?' is the first question you ask yourself when you realize that your baby-making machinery has a defect. Once you come out of the 'why me?' stage and start thinking clearly you can find so many solutions which will help you to deal with your infertility effectively. So kill your self-pity in order to get a better view of the infertility crisis and to tackle it in a better way! 2) Knowledge is power! Educate yourself about your condition. It will help you to come out of self-pity and see your infertility in a rational way. More you know about your condition lesser will be your pains. Remember, no one cares about you as much as you do, not even your doctor. In the field of infertility Treatment clinics in Mumbai there are a wide variety of treatment options and each doctor will have his/her own style of approaching a problem. Only when you educate yourself you can actively participate in the decision making processes of your treatment which will give you immense satisfaction and will also spare you from unnecessary infertility tests and therapies. This means you can save more money and time which in turn might help you to reach your target (baby!) quicker.There is so much information about infertility on net. Infertility bulletin boards are full of knowledgeable ladies who can offer you emotional as well as intellectual support. Read blogs which are written by infertility specialists which will give you authentic information. 3) Remove 'The God Factor' from your infertility Just like flu, just like heart problem, just like cancer, infertility is also a medical condition. God doesn't make you infertile. God doesn't want you to be infertile. Infertility is not God's curse. Please realize that praying to God and not taking proper medical treatment will not give you a baby; which you crave for! I have seen people going form temple to temple instead of going to a doctor. In infertility time is also one of the most important factors. Go to temple but also find a good doctor. After all, God can help you only when you help yourself. When you think 'why God did this to me' then it is also a source of major unhappiness. Again it will make you go into the self-pity mode. Remember that 'The God Factor' is a soothing medicine for your mind which in turn can help you feel better physically. When I say remove "The God Factor", I am not asking you to be nihilistic, I just ask you to be moderate and rational! Spirituality is not a cure for your infertility but it will help you to remain sane even if your attempts of conceiving a baby doesn't work as expected! 4) Socialize Do not retract into your shell. Be with the company of good friends who will understand you and offer emotional support. When you socialize you will realize that people come in all different varieties and colours. Some might hurt you, some might offer their sympathy, some will empathize with you, some don't care and few people can inspire you too! What people think of your infertility is their problem and not yours. As Bertrand Russell said, 'A dog will bark more loudly and bite more readily when people are afraid of him than when they treat him with contempt, and the human herd has something of this same characteristic. If you show that you are afraid of them, you give promise of good hunting, whereas if you show indifference, they begin to doubt their own power and therefore tend to let you alone'. Do not give undue importance to people's comments or thinking. Be bold to face the world and try to imbibe inspiration from the people you meet. Ultimately you will realize that everyone has their own journey filled with hope and desperation. You are never alone! 5) Try not to hide your infertility You do not have to tell everyone about your infertility history. But be honest when your friends and relatives ask 'aren't you ready for kids yet?' Tell them that you have problem with your 'fertility apparatus' and hopefully it will be mended soon . I have personally experienced that this kind of frank answers make people behave themselves. This also stops them from pestering you with further questions so that you do not have to panic each and every time you meet them. 6) Forgive unreasonable people People are often unreasonable. Forgive them anyway. This will not teach them anything but will help you to safe-guard your happiness and peace of mind. Forgiving doesn't mean that you have to be docile all the time. If their words and actions hurt you never be afraid to tell them to mind their own business. Anger not expressed at the right time can cause damage too! 7) Stay way from superstition (and also from superstitious people!) Fear is the major causative factor for superstitious beliefs and such beliefs will in turn keep you in fear's grip all the time. Never get caught in that cycle. I find people's attitude is infectious too. Avoid people with low self-esteem and superstitious beliefs. Not only they can reduce your confidence levels but can hurt you too. To tackle infertility you need lots of self-confidence. Never loose it to superstitious beliefs! 8) Count your fortunes Some people undergo much more horrible suffering in this world than you can imagine. Infertility hurts but it is not going to kill you anyway. What doesn't kill you; will only make you stronger! Be thankful for your blessings. Try to help people who are not as fortunate as you are. It will keep you happy and appreciate who you are! 9) Get out of abusive relationships It is impossible to fight infertility alone. When your spouse does not support you and is abusive then there is no point in going through this exhaustive journey. Your partner must provide you with an emotional cocoon where you can get all the support from. He has to also safe guard you from spiteful in-laws (if you are not fortunate enough!). If he is abusive himself the only way to escape from mental stress is to quit the relationship. It is good for both your physical and emotional health. 10) Be selfish and pamper yourself You are the person who is undergoing lots of stress physically and mentally. Love and pamper yourself. Never carry others problem in your mind. Your mother or mother-in-law's problem of not being able to have a grandchild is something which they have to deal with. Be selfish to the core! Sometimes it is wise to be selfish. I think if infertile couples follow this they can be rational enough to take good decisions! To know more Infertility Treatment in Mumbai, Contact us at: PARAKH HOSPITAL Khokhani Lane, Opp. Ghatkopar Rly. Stn., Ghatkopar (E), Mumbai - 400 077 Phone: 022 - 67827000 / 7004 / 7005 Fax: 022 - 6782 7007 Emergency: 9821125519/9821237708 Email: info@fertilityfirst.in

How to Stop Feeling Miserable - Coping with Infertiliy

Being infertile is bad enough - but unfortunately many infertile couples compound their misery by adding to it !

He calls these traps misery maximizers, and by avoiding them, you will be able to decrease your suffering dramatically. Not only does he describe the traps, he also suggests clever ways of getting out of them. Below is a short course on what NOT TO DO.

1. Put yourself down for being infertile. The trap-buster he suggests is that you get a paper and pen, and make a list of the negative or self-critical things you've said or thought in the last 24 hours. Next, pretend that a close friend is also infertile, and has said those things you've written down. Now, for each item, ask yourself what you might say to him or her to cheer her up. What advice would you give your friend when she begins to feel so low, and so self-critical? Be your own good friend, and say these things to yourself !
2. Lose control over your treatment and your life. Retaining a sense of control is one of the essential ingredients of emotional well being. The more control you are able to exercise in your lives (even if it is for something as simple as to what clothes to wear) the happier and emotionally healthier you'll become.
3. Don't feel grateful to anyone for anything. Gratitude improves emotional and physical health. Saying "thanks" keeps us human, and helps keep us happy and healthy.
4. Don't have a sense of humor. A sense of humor and an appreciation for the absurdities of are valuable resources to use to help you cope. Check out our infertility cartoons for a quick chuckle !
5. Don't take time for yourself. Many women are so used to putting others first, that they often end up neglecting themselves. However, if you don't take care of yourself, you'll never be able to take care of anyone else ! And you don't score any brownie points for being a martyr either ! DO ONE SMALL THING A DAY TO MAKE YOURSELF FEEL BETTER - you are worth it !
6. Don't take responsibility for your medical care. Obviously if you don't get good medical care you're reducing your chance of starting your family even further ! Unfortunately, many patients still hold their doctors in awe, with the result that they often settle for poor quality treatment and even worse service in the clinic . Don't fall into this trap - there are lots of good specialist around - find the one who is right for you.
7. Dwell on your infertility day and night. This is one of the easiest ways to get reduced into misery. Remember that there is more to life than having a baby - don't underestimate your contribution to making others happier; or minimize your success in the other areas of your life.
8. Isolate yourself. Isolating yourself makes it much easier to forget that no matter how serious your problem is, there are always people who have it much worse. While knowing that won't make your infertility better, it will help put it in perspective.

To know more about Infertility Treatment, contact us at:

PARAKH HOSPITAL

Khokhani Lane, Opp. Ghatkopar Rly. Stn.,

Ghatkopar (E), Mumbai - 400 077

Phone: 022 - 67827000 / 7004 / 7005

Fax: 022 - 6782 7007

Emergency: 9821125519/9821237708

Email: info@fertilityfirst.in