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Medical errors are a leading cause of preventable deaths. When a patient dies because of perceived medical negligence, hospitals get burnt down and doctors get beaten up. However, not all deaths are because of negligence - and not all errors can be prevented. In order to learn about what we can do to make sure that medical errors are minimised , India's first Patient Safety Workshop is being organised in Mumbai. This is the first conference in India which focuses on this key issue, which is usually misunderstood; and often ignored.

I am especially excited about the fact that this workshop will be involving patients as well, as I deeply believe that well-informed patients can play a very important role in preventing medical errors !

We've got some great speakers - please do come and join us ! You can get more details by emailing qcimumbai@yahoo.com !

NB Nrip, thanks for pointing out that there is an error in the conference announcement - it is on 24 April . Just shows how easy it is to make errors :)

The website for the conference is at http://thepatient.in/safety/

This is an email a patient from Nigeria sent me today.

" I have set aside this morning to commend you and your beautiful wife on the good work you are doing for humanity. You give hope to the hopeless, healing our wounds of years by showing commitment and concern, even when the situation looks gloomy. You are ready to even pray for mercy and help for your patients! I am impressed.

I have discovered that IVF is a journey. The travellers are the patients, but all of us will have to travel by different means of transportation, The luckiest by air, some by sea, others by road. It means there will be travellers by jet, speedboat, canoe, ships, cars, bikes, rail or even trucks and cartwheels! I am happy you guys are the drivers and my prayer is that the Almighty Creator will always grant you the wisdom to choose the right means of transportation, and the patience/perseverance to convey your travellers to their desired destination.

Please keep up the good work. I love you both and appreciate you."

I just received this thoughtful questionnaire from a patient.

We are looking for “gestational surrogacy” in India. There are many clinics offering these services and before moving forward in this decision, we want to have more information about your clinic and some steps of the process. Here are our questions and concerns.


1. How many years of experiences in fertility and surrogacy does your clinic have?

20 years

2. What are the main steps and what is the time table of the whole process
a. Steps

The process is described in details at www.indiansurrogates.in

b. Timeframe

20 days

3. What is the delay from first contact to start of surrogacy?

3-4 months

4. What are the legal concerns with surrogacy?

Our legal consultant will take you through these

5. What are the legal procedures we have to go through?

Our legal consultant will draft the contract which you and the surrogate will have to sign before we start your treatment

6. What is the selection process for the surrogates?

We select the surrogate for you. We screen them for their health; and to rule out infectious diseases; and counsel them as well


7. What facilities do you provide and what control do you then have with surrogates?

The surrogate’s pregnancy is monitored by our obstetric consultant

8. What is the cost and what does it include?

US $ 25000

9. What other expenses / costs (not included) that are at my charge?

Travel

10. How much goes to the surrogate and how much goes to the clinic?

Described at www.indiansurrogates.in

11. What is the probability of success/failure?

Our pregnancy rate is 56% when we transfer 3 Grade A embryos

12. Has there ever been health related issues when the new born is taken back to the parents’ country?

No

13. Do you have a blog webpage where parents can share their experience with your clinic?

You can talk to some of our patients by email at www.drmalpani.com/ivfsuccessstories.htm

14. Why should we select your clinic more than another?

You can read about how we pamper our patients at http://www.drmalpani.com/ivf-treatment-at-malpani-ivf-clinic.htm

I am the classic case of a woman who postponed starting a family to focus on her career while never believing that one day she would be facing infertility issues. I even believed that I could choose the month I wanted to get pregnant! I was almost 34 years old by the time my husband and I were out of school and settled enough in our jobs to start our family. I guess that is not really so old if there are no fertility issues, but if there are then time is definitely not on your side. By the time I turned 35 years old, we were living in Europe and began seeing a infertility specialist. In the middle of all the standard infertility tests, I managed to fall pregnant naturally. Our joy did not last long because at 8 weeks pregnant all that could be seen on the ultrasound were two empty gestational sacs. Nonetheless, the doctors felt that I had a good chance of getting pregnant naturally. I even had a laparoscopy done which showed that nothing was wrong. The doctors believed we had a good shot at IUI so we did 3 unsuccessful cycles before moving onto IVF.

I was 36.5 years old (tick tick tick) by the time we did our first IVF cycle. I always responded well to the medicines so we were confident that IVF would work for us. Our first cycle failed and our second cycle resulted in a chemical pregnancy. Frustrated after our third unsuccessful cycle, we changed clinics and found a doctor that would take a more aggressive approach. After two failed cycles, we changed clinics once again. The next cycle at the new clinic ended like all the others. in which I had 3 decent looking embryos transferred on day 3 but none of them implanted. The obvious conclusion was that there was a problem with my eggs. At this point, after 6 failed fresh cycles, I felt I had enough and could not endure another cycle. Above all, I did not think I could get pregnant with my own eggs. One of the worst things about infertility is that it slowly damages your self-esteem. No matter how much you know in your head that it is not your fault, you can not help but feeling like a failure. And as if that isn't bad enough, I would like myself even less because of all the feelings of anger and jealousy I had. But above all, I could not imagine living the rest of my life without children.


We searched the internet for egg donor options. In most European countries, it is illegal to pay egg donors so there are very few and the wait list is quite long. In the U.S., egg donors cost a fortune. We came across Dr Malpani's website. I was impressed by how much information was on the website, but most of all I was impressed with how well the emotional aspects of infertility were addressed. I began emailing Dr Malpani and he was always quick and thorough in answering all my questions. In fact, he was so quick in replying to my emails that I thought there must be something wrong! At one of the clinics we had been treated at we could not even talk directly with our doctor without making an appointment a few weeks to months in advance. After answering many of my emails, we felt that this was the right choice for us, but even so I was still a little unsure about going to a clinic in India and never having been there before or met Dr Malpani in person.

Dr Malpani found us an egg donor and 2 months later we were in Mumbai. I was still unsure about what to expect, but all my fears were laid to rest when we went to the clinic and were waiting with many other couples from around the world. Then after meeting Dr. Malpani and Dr Anjali Malpani I knew we made the right decision. We spent about a week and a half in Mumbai which was like a holiday for us. Everything was very smooth and easy.

After I got back, Dr Malpani continued to answer all my emails and ease my mind whenever I started to obsess negatively until I took my pregnancy test and got a positive result! We were so excited but still cautious until finally we saw and heard a beautiful little heartbeat at 6 weeks. Now I am experiencing all the joys of being pregnant, including the dreaded nausea!

Many gynecologists have started offering IVF services and at last count, there were over 45 IVF clinics in Mumbai ! The reason is because IVF is seen to be remunerative and profitable ! After all, why send the patient away to an IVF clinic and lose all that income ? Never mind that these gynecologists have never been trained in doing IVF or have never done a single IVF cycle in their life - after all, how hard can doing IVF be for a MD gynecologist ? Plus, there are now many companies which are happy to offer a 1-week workshop which certifies doctors as being IVF trained !

This is why we are seeing a huge number of " part time IVF doctors" in India. They spend most of their time seeing OB patients and gynec patients - but rather than refer their infertile patients to IVF specialists, they hold on to them and promise to do IVF for them. They will either take the patient to an IVF clinic and do the procedure there ( because they do not have the equipment or the expertise to do the IVF themselves); or they will invite a "travelling" IVF specialist to come to their clinic to do IVF on their patients, which they batch once a month.

This means that you are being treated by a doctor who is a jack of all trades and master of none. These doctors simply do not give their IVF patients the time and energy they need. Infertile couples are treated along with other OB patients and there is no acknowledgment of the fact that their needs are special . It can be very hard for an infertile woman to sit in a clinic full of pregnant women !

Since many of these doctors are gynecologists, they do not have the technical expertise or experience to provide IVF services. They have to depend upon imported IVF specialists who come from other cities. This means the care becomes fragmented, resulting in reduced success rates.

The sad truth is that beggars can't be choosers - and this is a useful service for infertile couples who do not want to ( or cannot afford to ) travel - after all, some service is better than no service at all ! However, if you want the best possible treatment, it's best to go to a full time IVF clinic. While this may initally appear to be more expensive, it may actually be far more cost effective because full-time dedicated IVF clinics have a higher success rates ! They are busier; more experienced; and have more expertise !

We live in the US and I was diagnosed with Polycystic Ovarian Syndrome in 2003. We had been to an obgyn in the US and she had recommended 3 cycles of clomid treatment. Since this did not work for us, she had asked us to go for higher infertility treatments like Artificial Insemination or IVF. At that point we did not have proper information regarding these treatments and hence were not mentally prepared to proceed further.

Later we started research on the Internet regarding various infertility treatment options for us. It was at this time that we came across this amazing website. Dr.Malpani's website is an excellent source of information for infertility related issues. This was a panacea for all our questions. We then started interacting with Dr.Malpani through his website. We submitted the second opinion form with all the relevant information. Dr.Malpani graciously replied to all our queries. He was very prompt and patient with our questions. After 2 months of interaction with him, we finally decided that we should travel to Mumbai to start our infertility treatment at the Malpani clinic.

We stay at Hyderabad. However, Dr. Malpani was very flexible and had given us a treatment plan in advance so that we can plan out our trip and stay in Mumbai. We stayed at the accomodation at Janaki Nursing home. It was very cost effective and homely.

Our treatment started on Jan 7th 2010. We were advised to undergo IVF treatment. The IVF comic book on the website was very helpful to understand the various steps in the IVF treatment. On our first visit we were very impressed. There was not much waiting time. It was well organized and the staff was very friendly.

Dr.Mr& Mrs Aniruddha Malpani are well experienced and knowledgeable couple. Our treatment went exactly as planned per the steps in the IVF calendar on the website. It was on Jan 21st that 3 embryos were implanted. I requested for anesthesia during implantation since I was nervous. We were asked to see the embryos first. The embryologist walked us through the process of development before the implantation.

Later after 2 days of rest, we flew back to Hyderabad. I took a week's rest at home and flew to the US on Jan30 th. On Feb 4th, I did a home pregnancy test and by god's grace and Dr.Malpani's guidance and support I was pregnant. We were blessed with a healthy baby boy on Oct 1st 2010. What we once thought was very difficult turned out to be so easy at the Malpani clinic.

We would definitely recommend anyone looking for infertility treatment options to pursue treatment at Malpani infertility clinic.

HELP is the world's largest free patient education library, located in Mumbai.

We are looking for Patient Information Officers, to help promote Information Therapy in India.

You will help to empower patients with information.

If you are interested in this exciting job which please email your resume to: malpani@vsnl.com !