Infertility- What's the probability

Not all things are understood ...

The purpose of science is to analyze the reasons for what is happening in nature. Medicine also follows the same. But the difference between medicine and the other branches of science, is its limited knowledge. The knowledge of medicine is continuously enriched. The study which was taken the right thing yesterday, may prove totally wrong tomorrow. Similarly, what we reject today as something incorrect, may become the right treatment tomorrow.

Another problem with medicine is that it only talks about possibilities. That means probability. That may be right for you, or may not be. For example, suppose after an operation there is 40% chance that you may be cured of your disease. That is, if we have 100 people like you having the operation, 40 will be alright. No one can tell you what will happen exactly. You may be in the group of 40 lucky people, or may be one of the 60 people in the group of unfortunate people. The answer will be known only after the operation.

In total, medical science does not give "guarantee". A person with a perfect health can suddenly die from heart attack. In this case doctors can only provide medical treatment, not guarantee.

INFERTILITY is another area of Probability. We can just say how likely you can become mother and what is its chance with different treatment; nothing more than this.

There are fewer couples whom we say, the you cannot have naturally, just like those who have no sperm, whose ovaries or uterus have been removed. We only say the possibility to the rest of the couples.

If there is no much problem, we say try for a few months. For every 100 attempts, 15 children of one month comes, that is, success rate or success rate is 15%. Many people said, "When will it come, how long will it take, Doctor?" We do not know the answer. Many people hope to get a reply. But we can only say, how likely it is. We can not give guarantee.

When someone is called drug, OVULATION INDUCTION, then this is the story of one of the possibilities. No one can guarantee how long it will take, whether it will come at all. If someone says that I have been guaranteed in such a place, then it is unscientific. Because the success rate is also 16-17%. That is, if someone says just by guessing, in this month you will get pregnant, the probability of getting the prediction correct is 16-17%. However, if you take medicines within 6-7 months but cannot conceive, there is less chance of having a baby by this method. So it is better to go to another treatment. Many people say, "Can't I conceive with medicine only". We say, that "There are fewer couples whom we say, the you cannot have naturally". That means after more than 6-7 months of medicine intake, this method is unlikely to be successful, but its never nil (ZERO).

Then comes, when it is called IUI (Intrauterine Insemination): there also lies the role of possibilities. And here the success rate is 18-20%. It is not advisable to do IUI more than 4-6 times. If ovulation induction or IUI does not give results within certain months, it is less likely to succeed if continued but the chance is never zero.

Now, coming to IVF (In Vitro fertilization). Chance of success is 40%. But remember it is the probability only. No one can tell what happens to you. If your pregnancy comes, the success rate is 100% for you, and the success rate for those who are not conceiving, is zero. Here are some uncertainties. If you take medication or injection, there is no certainty that follicles (the sac that contains the eggs) will form. That's why, after taking the injection, TVS (a type of ultrasound) is done. That is, there is no guarantee that the injection will work. Then when ovum pickup is done in OT, nobody knows if all the follicles will contain the eggs.Even if the eggs are obtained, there is no guarantee that all these eggs will be mature. It is only possible to test all these in the laboratory, these cannot be predicted before. Again all these mature eggs may not be of good quality.

It is difficult to understand the quality of sperms beforehand. Especially if men have sperm problems and sperms are collected from the testicles using the TESA method, it can not be accurately told beforehand, how much good sperm can be found.

Even with good quality, but how much sperm will form the embryo, after meeting the egg, it is also uncertain. Even we do not know whether the ICSI will be able to form the embryo.

Even if the embryo is created, it is possible to check its quality only in the laboratory. Again, freezing or blastocyst culture cannot predict the fate of the embryo. After overcoming all these hurdles, when the best quality of embryo is transferred inside the uterus, the possibility of pregnancy is 40% and take home baby rate 30%. That means 100 people are doing IVF and pregnancy can happen in 40 people and 30 peope can go home with their baby.

It may seem that the story depicts the frustration only, or the treatment is only discouraged. Most of the time, even if the first cycle fails, there is good chance that you can get pregnant with the next cycle. Even after IVF fails, ithere is good chance that you can get pregnant thereafter.

But before spending all your hard earned money, you have to understand all the things and if you have a realistic expectation then you can get the right result.

The thing is like crossing the roads. Suppose you think you can cross the road and buy sweets from the shop and go home. But is there any guarantee that you can return home? Still we do not stop expecting.

The treatment of infertility is exactly the same. You are not fighting alone. It's right, you're going through social issues, discomfort, medical problems, costs etc, but the real fight is fought by you and your doctor. Often there is friendship built between the doctors and the patients who have been under the treatment for a long time. So when the treatment fails, doctors also feel pain and they feel determined, "This couple is so much dependent on me, I have to do something for them". But everyone knows that there is a limitations of medical treatment, but it does not matter. The doctor has to prepare himself before the fight. You have to play the game and with a very clever opponent, that is the "PROBABILITY" Your doctor will act as your coach there. If you win, he will win and your defeat means his defeat You just need to know and understand that the win and loss is a possibility, what can not be predicted. But once you play, you have to play well.

Thank you. A request has been sent to Dr. Sujoy Dasgupta to set up the service.