Engineers , business analysts and computer programmers find it very hard to understand why perfect IVF cycles fail. After all, didnt the doctor transfer a Grade A blastocyst into a beautiful endometrium ? Why didnt the embryo become a baby isnt that what embryos are supposed to do ?

What went wrong ? Given their educational background, they demand a logical and rational explanation for why the cycle failed - a root cause analysis.

When doctors tell them the truth and say, "We cannot provide an accurate answer," they get very upset, because they're so used to mathematical precision and certainty . They forget that biological systems are very messy. Not only is there a lot of variability from cycle to cycle, there's also lot of variability from patient to patient, which is why IVF cycles are neither repeatable or predictable.

Finally, remember that a lot of what we do in medicine is based on anecdotal successes as well as personal prejudices. Since the numbers are small, probability estimates are unreliable, which is why it's very hard to be precise.

It's important that patients not have unrealistic expectations about some of the answers which we can give them. It's not as if we are trying to fudge, but the truth is that it's very hard to be accurate when dealing with biological systems.

However, rather than take the time and trouble to explain the complexity to patients, many IVF doctors will take shortcuts by coming up with fanciful explanations many of which are sprinkled with meaningless biological jargon ( such as failed implantation) in order to placate their patients. Sadly, these answers are rubbish but patients are very impressed. The irony is that the doctor can earn a lot more money by doing expensive and pointless tests, such as the ERA ( endometrial receptivity assay ) , even though these tests are a waste of time and money. Read more at https://www.drmalpani.com/knowledge-center/articles/why-the-new-expensive-endometrial-receptivity-tests-are-useless



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