A doctor is supposed to know. That is what they are paid for. They
have supposedly spent precious decades of their lives learning all about
the maladies that afflict the body and mind. And so they should know
why the disease occurred, how bad/advanced it is and how to treat it.
And of course they should be able to tell us when it will get better and
how.
Everyday I encounter patients in my OPD who at the end of the consultation bend forward in their seats and ask me only one question, Doctor will I have a baby? and to be honest, I don’t know. I don’t know when they will conceive, I often don’t know why they can’t conceive and sometimes I even don’t know whether they will ever conceive at all.
Welcome to the world of infertility, where even the best doctor and the best clinic can most times give you only an estimate of your chances to conceive.
This is baffling for most of us. But look at it this way, infertility is not a disease. Conception, the meeting of an egg and sperm and subsequent implantation and growth in the uterus is just a coincidence. There are many things that could go wrong with the meeting of the sperm and the egg. The sperm may not turn up while the egg waits for it in the fallopian tube. Or there is no way the twain can meet as the passage ( the tube) is blocked. and there are hundreds of other things that could go wrong and result in another period..
The chances that a couple could conceive in a month ( when there is nothing wrong with the tubes/egg/sperm/uterus) is only 25%. If there is something wrong with either or both of them, the chances dwindle.
When the estimated chances for a couple are less than 5% when they try naturally, we advise them to go for In Vitro Fertilization. Couples who agree for an IVF cycle are in for some more surprises. Their treating doctor does not know for sure how many eggs would be produced, how many would be fertilized and how many embryos would be formed. And the biggest surprise, the doctor doesn’t know if they will fall pregnant this cycle.
We throw figures and estimates and percentages at every question ( ‘we expect 8 to 10 eggs’, ‘usually 70% of the eggs retrieved fertilize’ and ‘you have a 40% chance of conceiving this month’). A worse situation is a patients coming after a failed IVF cycle for a repeat cycle with the same question and getting the same answer, ‘I don’t know if you will conceive this time around’.
I once told a share broker who came for IVF that IVF is a lot like the stock market. There are experts who study, analyze and opine about the likely way in which the market will turn. But their opinions, based on a lot of study and analysis remain conjectures or educated guesses and no one for sure can predict which way the stocks will go. That doesn’t diminish the importance of the market gurus though.
In IVF too, an experienced and qualified doctor will tell you an estimate of your chances on the basis of your clinical profile. But because infertility is not a disease, it is difficult to know when exactly it will be ‘cured’. We are out to create a new life and with all our technology, experience and skill we can not tell you if that pregnancy test will be positive this month. We are the doctors who don’t know. The doctors of desire.
But we know one thing, if you try the right way, the right place and the right time with the right doctor, the answer to the question ” Can I conceive?” is “YES”
Everyday I encounter patients in my OPD who at the end of the consultation bend forward in their seats and ask me only one question, Doctor will I have a baby? and to be honest, I don’t know. I don’t know when they will conceive, I often don’t know why they can’t conceive and sometimes I even don’t know whether they will ever conceive at all.
Welcome to the world of infertility, where even the best doctor and the best clinic can most times give you only an estimate of your chances to conceive.
This is baffling for most of us. But look at it this way, infertility is not a disease. Conception, the meeting of an egg and sperm and subsequent implantation and growth in the uterus is just a coincidence. There are many things that could go wrong with the meeting of the sperm and the egg. The sperm may not turn up while the egg waits for it in the fallopian tube. Or there is no way the twain can meet as the passage ( the tube) is blocked. and there are hundreds of other things that could go wrong and result in another period..
The chances that a couple could conceive in a month ( when there is nothing wrong with the tubes/egg/sperm/uterus) is only 25%. If there is something wrong with either or both of them, the chances dwindle.
When the estimated chances for a couple are less than 5% when they try naturally, we advise them to go for In Vitro Fertilization. Couples who agree for an IVF cycle are in for some more surprises. Their treating doctor does not know for sure how many eggs would be produced, how many would be fertilized and how many embryos would be formed. And the biggest surprise, the doctor doesn’t know if they will fall pregnant this cycle.
We throw figures and estimates and percentages at every question ( ‘we expect 8 to 10 eggs’, ‘usually 70% of the eggs retrieved fertilize’ and ‘you have a 40% chance of conceiving this month’). A worse situation is a patients coming after a failed IVF cycle for a repeat cycle with the same question and getting the same answer, ‘I don’t know if you will conceive this time around’.
I once told a share broker who came for IVF that IVF is a lot like the stock market. There are experts who study, analyze and opine about the likely way in which the market will turn. But their opinions, based on a lot of study and analysis remain conjectures or educated guesses and no one for sure can predict which way the stocks will go. That doesn’t diminish the importance of the market gurus though.
In IVF too, an experienced and qualified doctor will tell you an estimate of your chances on the basis of your clinical profile. But because infertility is not a disease, it is difficult to know when exactly it will be ‘cured’. We are out to create a new life and with all our technology, experience and skill we can not tell you if that pregnancy test will be positive this month. We are the doctors who don’t know. The doctors of desire.
But we know one thing, if you try the right way, the right place and the right time with the right doctor, the answer to the question ” Can I conceive?” is “YES”
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