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I always tell me patients to prepare for the fact that their IVF cycle may fail. Many patients dislike this. They feel I am being too negative - and are secretly worried that such negative thoughts are a jinx which will jeopardise the outcome. Most patients want a cheerful optimistic doctor who will promise them a baby.

Intelligent patients appreciate my honesty and frankness - they prefer a doctor who will tell them the unvarnished truth. Others who cannot handle the truth will usually move on to another doctor who is willing to promise them the moon - and who is happy to tell them what they want to hear !

It's very easy to smile; be optimistic - and make false promises. Everyone wants to think positive - and if you believe the book The Secret, then positive thoughts attract success !

While I am personally very optimistic by nature, I feel it's not correct for a doctor to overpromise success ! Patients are emotionally very vulnerable and it's easy to take them for a ride - something which many unscrupulous IVF doctors do all the time, by quoting inflated success rates and promising the moon !

When I tell patients to prepare for the worst , this does not mean that I not hopeful or that I am a defeatist. I am not being negative or being a pessimist - I am just trying to be a realist !

Being prepared does not mean that you are expecting a bad outcome or that your negative thoughts will attract failure - it's just that you are preparing for it. This is something you do in daily life all the time , so why shouldn't you do it during your IVF treatment as well ?

It's always easier to mentally prepare when you do not need to !

Let's assume to decide to be positive, optimistic and upbeat and prepare only for a good outcome. If you do get pregnant, you'll be pleased and happy - and life will move on. However, if you do not get pregnant , you will go to pieces. Bouncing back will be much harder - and you'll find coping with the emotional roller coaster ride much more difficult.

However , if your prepare for a bad outcome and get pregnant, you get double the joy ! And even if you do not get pregnant, while your heart will still break, your mind will help you heal faster because you were mentally prepared for this.

It's harder to deal with a negative outcome when you are not ready for it ! IVF is a scary emotional roller coaster ride and mental preparation gives you some stability.

The trick is to find the right balance - to look for the middle path - what Buddha called the golden mean ! It can be helpful if both partners have different world views because they can balance each other !

However, if the husband is optimistic and the wife is pessimistic, and the cycle fails, he may end up blaming her for the failure because " you are always negative" ! Victim blaming is very common when patients adopt a pessimistic approach in order to protect themselves from heartbreak - and this is just adding insult to injury !

Hi, We are from Canada and this is our short story that we would like to share as noted below:

First of all, would like to extend our warm gratitude to Dr.Aniruddha & Dr.Anjali Malpani, and your staff making our IVF treatment a SUCCESS !!!
I am on the eleventh week of pregnancy now and hoping and always pray it will be a SUCCESS until the baby is born.

Planning/deciding to undergo IVF is not a joke/easy. There are a lot of things to consider.

1. Financial - IVF involves a huge amount of money like travelling expenses, hotel,food,medicine and might affect the job as well
2. Stress - Need to manage your stress - IVF involves a lot of stress.
3. Taking the risk

a. Job - Ready to quit the job to have full rest if required according to case to case basis before and after the treatment until the baby is born
b. Effort - Regardless how much effort you exerted expect that sometimes it doesn't succeed at one time treatment only.
c. Time - Ready to accept that in first/second try did not go thru.
d. Budget - It might be very tight at times especially if income is limited.

4. Health - It is very important to remain healthy like balance diet, avoiding caffeine,/alcohol/smoking and have a daily exercise with the doctor's guidance according to health conditions.

I am now in my first pregnancy which is my third IVF treatment with Dr.Malpani coming from Canada to India 3 times. It was really hard to travel and adjustments to another country and lot of stress and finance involved. We cannot fight with God's creations or the nature but the doctors can help to make it happen.

We are really lucky to find the right clinic with experienced doctors who are always there to help, and taking extra steps to make the IVF treatment a success and its so fantastic to have a doctor who responding to all our inquiries promptly all the time additionally his staffs are all helpful and very co-operative treating us like a family and clinic has an excellent facilities everything is done in the clinic itself no need to go somewhere else which is very convenient for us, being a patient for 3 times there we know everything. and enjoyed as well. There are lots of good things to tell but there is no words to express...

However, just to let you know that there are still lot of trauma during my pregnancy on 6th to seventh week had 3 times heavy bleeding but this did not lost our hope I have to deal with and relax thank god did not happen again and very soon I am going to finish my first trimester by April 16,2011.

Thank God !!! There is really nothing impossible. First of all trust in God, trust your doctors, trust yourselves, take a risk and go for it!!!

crpp1@hotmail.com

For many patients, the emotional stress of going through an IVF cycle is far more than the physical stress ! The overriding fear is that of failure – what will I do if the cycle fails ? Will life be worth living ? They understand that IVF is the one treatment option which maximizes their chances of having a baby and have pinned all their hopes and dreams on the cycle succeeding. They dread to entertain the possibility of failure , as a result of which they are emotionally very vulnerable.

Even before starting the IVF cycle, they spend a lot of time and energy doing their homework. Some will do their research and become an expert on IVF; others will doctor shop; while some will go to a temple to make sure God is on their side !

While there are quite a few ups and downs during the moments of truth during an IVF cycle, the fact that there is so much action ( are the follicles growing ? do we have enough eggs ? are the embryos of good quality ?) , the mind is extremely hard to manage during the 2ww , and plays havoc during this time.

While your head knows you should be detached, and that the final outcome is now out of your hands, your heart finds it hard to do this ! You look for omens and signs all the time ! Everyone ( especially your husband ) tells you not to “ stress “ , but how can you possibly not stress about this – after all, so much rides on this ! While your friends are sympathetic and caring, they just cannot understand what you are going through. Every minute seems to take an hour to pass – and you are never sure whether to be hopeful ( because you’ve read somewhere that being positive increases the chances of success ?); or to be prepared for failure ( so that it’s easy to deal with the emotional roller coaster ride). Unfortunately, many doctors make a bad situation worse by forcing their patients on “bed rest” after the embryo transfer. When you lying in bed all day long, it’s hard to stop your mind from imagining the worst !

Unfortunately, there are no reliable symptoms or signs which can predict what the outcome will be. The symptoms are exactly the same, whether or not you are pregnant or not. This is hardly surprising, given the fact that the symptoms of PMS are exactly the same as those of early pregnancy – and that all the hormones you are taking for luteal phase support are the same hormones your body produces during pregnancy !

You need to find ways to cope constructively ! Think of this as a learning opportunity which can test your emotional resilience. Tap into your inner strengths and remember you have dealt with waiting in the past as well – waiting for exam results; or waiting for your boyfriend to call ! The waiting game is exactly the same and learning mind management skills such as yoga and meditation can help ! Keeping yourself gainfully occupied and continuing to work is very useful – this keeps you distracted and allows you to channel your energies constructively !

Everyone loves advising infertile couples ! ( After all, if they've had a baby in their bedroom and proven their fertility , this makes them fertility experts, right ? )

The commonest advise is - Just relax ! Do not stress - do not take any tension ! This advise is even more pronounced during an IVF treatment cycle. If you want your IVF to succeed and the embryos to stick, you've got to "go with the flow" and not stress out. If you get too stressed out, your uterus will reject the embryos and they will not implant !

This is very unhelpful advise ! Of course there's a lot of stress in an IVF cycle - after all, no one wants to come to Dr Malpani to have a baby ! All my IVF patients are stressed out - and even the hyper ones do get pregnant ! It's true that patients need to learn constructive ways of dealing with this stress but to pretend that there's no tension involved is just being unrealistic.

The worry is that this kind of advise leads to blaming the victim. " You did not get pregnant because you were too stressed out ! Your IVF cycle failed ( what a cruel word) because you did do not relax enough !" This is hogwash. Don't forget that even a woman who gets raped ( whose stress levels must be through the roof) can get pregnant !

IVF patients understand the importance of optimism. However, many of them are very scared of getting their hopes up . They have been let down too many times in the past so far; and they are worried that if they become too optimistic, the crash down to reality will be much more painful if the cycle fails. This is why many patients keep their expectations low - so that they are better able to cope with failure .

Personally, I find a balanced approach the best option.

I request my patients to remember the Serenity Prayer -
God grant me the serenity to accept the things I cannot change;
the courage to change the things I can;
and the wisdom to know the difference.

Having a Plan B ready even before starting the IVF cycle can help you better cope with the IVF emotional roller coaster ride !

Being infertile is stressful and going through an IVF cycle can be even more so because so much is riding on the outcome of the treatment. An IVF treatment cycle is much more than just a medical procedure, because there are so many hopes, dreams and desires wrapped up in the treatment.

However, the biggest emotion is often that of fear ! What will I do if the IVF cycle fails ? Is there any hope of my ever having my own baby if even IVF fails ?

I feel it's the unrealistic expectations which cause the most stress . Most patients who start an IVF cycle refuse to even consider the possibility that the treatment may not work. They have been brainwashed into " thinking positive" , so they refuse to remember that the chances of the IVF failing for a given patient in any cycle are more than the chances of success !

Most of them keep on repeating the mantra - It's got to work ! It will work ! There are lots of family-members and friends who are hoping and praying for success as well, so everyone is on an emotional high during the treatment cycle, because they need to keep each other's hopes up. The truth is that no one would ever start an IVF cycle if they did not feel in their heart of hearts that it was going to work for them.

This is why patients arm themselves with prayers and lucky charms before and during the IVF treatment. While the IVF process is straightforward - grow eggs; make embryos; and then transfer these into the uterus , the outcome is always uncertain. This is because implantation - whether the transferred embryo will become a baby or not - is a biological process which no one can influence. Along with medical expertise and good protoplasm, it also requires a large dose of luck - the one intangible no one can control !

The truth is that no one can ever be sure of the outcome of the IVF cycle, which is why you need to keep your expectations realistic ! While you cannot control the final outcome, if you have peace of mind you did your best, you will find it much easier to manage your stress levels during your IVF treatment !

Please remember the Serenity Prayer
God grant me the serenity to accept the things I cannot change;
the courage to change the things I can;
and the wisdom to know the difference.