LEARN INSURANCE

We normally do a blood test for HCG 2 weeks after the embryo transfer to find out if the embryos have implanted and if the cycle has been successful or not.

This can be a very long 2 weeks , and many women will start doing pregnancy tests 5 days after the embryo transfer.

The problem is that even if the embryo has implanted and you are pregnant, the embryo produce such small quantities of HCG for the first few days after it implants ( remember that it's just a microscopic ball of about hundreds of cells or so at this time), that it's not possible to detect this HCG in the blood . To be able to detect the HCG in the urine will take even more time, which is why you need to be patient.

Of course, many patients will cheat :) - and this is an email I got from a patient today. A picture is worth a 1000 words, and this image clearly shows how her pregnancy tests have now become strongly positive ( C stands for Control and T stands for Test). The stripe on C means you have done the test properly. Once the stripe on T shows up ( is positive) , this means you are
pregnant !

She's now ready to start her baby album !

In our quest of paternity, we made some treatments in our home country, Spain, but we got no success. After a period to find an alternative, we chose to go to Mumbai, India, and in fact Malpani Infertility Clinic. We had more contact with other clinics in India, through e-mail, forums, testimonials of patients who were with them, etc., but finally we opted for Malpani Infertility Clinic for many reasons that during the treatment were confirmed. In the talks held by e-mail us seemed honest, ethicals, professionals and they offered us a good humane treatment.

Our experience began in summer 2010, and we decided to begin the pre-treatment that Dr. Malpani suggested us by e-mail while we were in Spain before treatment in Mumbai. He explained to me everything that had to do: medicine, testing, planning, guidance and even where to stay in Mumbai. The day that we arrived at the clinic we were surprised by the number of couples who were there, and by their different nationalities.

That day, Dr. Aniruddha Malpani welcomed us into his office and he discussed our case with the evidence and history that we send, and he explained us the steps of treatment and medicines that provided us for the following days. Our stay in Mumbai was not easy, because it is a chaotic and noisy city that never sleeps, but our goal and dream of having a child gave us the strength to withstand all.

Dr. Anjali Malpani, is the wife of Dr. Aniruddha Malpani, she is the one responsible for making the scans, egg collection and check the status of the uterus. She is a woman of easy-going and very understanding. The day of the transfer and before transferring the embryos, she informed me that we could to go to the lab to see it. Saiprasad Gundeti is the biologist and laboratory technician responsible for the selection of embryos, which showed us the embryos which were transferred me.

The day of transfer I went to the clinic and I was there waiting for my turn, I was taken to the operating theater where two nurses were cleaning and talking to me, the truth is that Indian people is very kind people in general. Dr. Aniruddha Malpani came to the operating theater and never stopped talking to me during the transfer process that was a few time, at the end, he literally asked, "How do you feel?" I replied, "Happy" but he said: “not happy, you must to feel pregnant.”

After embryo transfer, Dr. Aniruddha Malpani recommended I rest for 2 days, and then we went to say goodbye to them all, included clinic nurses and staff. At the end, we were in Mumbai about 24 days and we returned to our home to our normal life. Them they spent 14 days, I went to make hormone beta HCG analysis and the result was positive, I'm pregnant!!! I made 3 blood tests to see increased levels of the hormone beta HCG and they informed me that is a multiple pregnancy. I sent results to Dr. Aniruddha Malpani for his information and assessment. After doing some vaginal sonography, my gynecologist confirmed me that I have triplets. Today I am 21 weeks pregnant and I feel great. What concerns us now
is to be born healthy. Our experience was successful with Dr. Malpani.

Dr. Malpani and his wife showed great respect and proper treatment during our stay, although some days of consultation, the waits were long but no problem. They encouraged us and empathize with us. Communication with staff maybe could be most appropriate, because of language, but we asked many times to avoid doubt. They treated us well to know everything about treatment.

Our experience tells us that we must be relaxed, be positive and be communicative to get confidence and no doubts. You need to have patience with several unknown things and to trust in the possibilities. Note that there is no 100% chance and to have no despair.

Dr. Anjali Malpani and Dr Aniruddha Malpani have over 10 years experience in fertility and their nurses and staff also has much experience. We hope our experience will serve to encourage couples to clear up their doubts and encourage them to use this opportunity to be assisted, helped and loved by Dr. Malpani.

casamaria2010@gmail.com

Saiprasad Gundeti, Senior Embryologist, Malpani Infertility Clinic

There are multiple variables which need to be considered while deciding how many embryos to transfer.
When we decide about the number of embryos to transfer , our aim is to :

1. Select Top Quality Embryo(s) for transfer
2. Maximise the chances of pregnancy.
3. Minimise the risk of failure.
4. Minimise the risk of multiple pregnancy.

Each country has its own policies depending upon their patient population, their healthcare system and their laws.
In Scandinavian countries , not more than one embryo is allowed to be transferred.
In such countries, doing a Day 5 transfer is ideal.

Top Quality Day 5 Embryo

That’s not the case in India where we can transfer multiple embryos. However, we need to individualise this decision for each patient ! More is not always better – and transferring too many embryos increases the risk of a high order multiple pregnancy.

We need to be flexible !

For example, when doing a Day 3 Embryo Transfer for a young patient who is doing her first IVF cycle, we need to consider transferring only 2 embryos, as there are high chances of a pregnancy even with 2 embryos.

2 Top Quality Day 3 Embryos

At Malpani Infertility Clinic, we use the following guidelines. These are rules of thumb – the patient needs to make the final decision ! While the present fashion seems to be to push for a SET ( single embryo transfer) for all patients, this is a complex decision – especially when patients are paying large amounts of money for their IVF treatment. And for many IVF patients, twins are a welcome bonus as they represent their chance to create an instant family !

While it’s quite easy to make decisions when we have good quality embryos, it’s much harder to do so when the embryos are of poor quality. While it’s not necessarily true that transferring more embryos increases the chances of success when the embryos are of poor quality, patients are understandably reluctant to throw away their embryos ! This is especially true when patients have failed multiple IVF cycles in the past . Their logic is – even if the embryo has a poor chance of becoming a baby after transfer, at least it’s better than the zero chance if I do not transfer it. This can be a difficult call to
make !

DAY	Criteria	Age <>	Age > 38	Previous Failures
Day 2	Good Embryo Quality For e.g. 4 x 4-Cell Grade A	3 Embryos	4 Embryos	4 Embryos + 1 Embryo
	Slow Growing embryos. For e.g. 2 Cell Grade A 3 Cell Grade A	4 Embryos	5 Embryos	5 Embryos + 1 Embryo
	Poor Embryo Grade For e.g. 4-Cell Grade C	5 Embryos	6 Embryos	5 Embryos + 1 Embryo
Day 3	Good Embryo Quality For e.g. 8-Cell Grade A 6-Cell Grade A	3 Embryos 3x 8-Cell Grade A	4 Embryos	4 Embryos + 1 Embryo
	Slow Growing embryos. For e.g. 4 Cell Grade A 3 Cell Grade A	4 Embryos	5 Embryos	5 Embryos + 1 Embryo
	Poor Embryo Grade For e.g. 8-Cell Grade C	4 Embryos	5 Embryos	5 Embryos + 1 Embryo
Day 5/6	Good Embryo Quality For e.g. Grade A Blastocyst	2 Embryos	3 Embryos	3 Embryos + 1 Embryo
	Slow Growing embryos. For e.g. Morulae	2-3 Embryos	4 Embryos	3 Embryos + 1 Embryo
	Poor Embryo Grade For e.g. Grade C Blastocyst	3-4 Embryos	4 Embryos	3 Embryos + 1 Embryo

Note : The number of embryos to transfer :
1) may be increased if the endometrial thickness is poor
2) may be reduced if the patient is young