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With increasing numbers of infertility patients no of IVF centers have also increases. Initially these centers were limited to big cities/metro cities and to big names only. But now a day’s almost every city has one or two IVF center and there is mushrooming in bigger cities .Now every gynecologist is infertility specialist as after MD or MS there is no further specialization in this field. In smaller towns and cities all lady doctors practicing medicine from any pathy are gynecologist so they automatically qualify for being infertility specialist too .Today doctors are coming up with IVF centers who have loads of patients or money or who want to feel superior by looking distinguished and different from crowd of fellow doctors .It’s more of a ego trip and superiority issue than devotion and love for the subject these days. IVF is work of fine creativity like painting or music where you need to have knowledge and passion for your work along with compassion and love for people since you are dealing with live sensitive people. It should not be another money making instrument in other wise running hospital. When you work money will definitely follow as a rule but the basic aim should be creating something newer and better to bring happiness in people’s life than to make bigger money.

In smaller cities few enthusiastic doctors have become feeders for the IVF centers of big names/big cities. They gather crowd of patients by organizing camps for IVF consultants and then they investigate and treat them and then these patients are then referred to these IVF centers .These  doctors label themselves as infertility specialist and IVF consultant and misguide the patients.

      Few doctors who have good number of patients they feel their patients need these techniques and money is not a constrain for them. So they put up IVF lab in their hospital . Directly or indirectly,knowingly or unknowingly they pass on the message that IVF is the only treatment for infertility management.Since they are too busy in their routine obstetrics practice, they get freelancers to support and run their lab in their hospital. To support these centers now freelancer embryologist and interventional sonologist or the whole team of doctors and technicians visit the center and does the job on scheduled dates or on call .Market is flooded with such free lancers. On single call 10 people are waiting in line to grab the opportunity. So these doctors work like traffic hawaldar and direct the traffic of infertility patients on the road of IVF center where these patients are clubbed in a batch for certain days when team comes over and do the rest of the work.

   We know, there are good number of infertility specialists and IVF conultants who are working in this field with dedication,passion and with deep knowledge of the subject and we strongly feel that treating infertile patient  is a creative job hence  it should not be just another  money making instrument of other wise running hospital.

     Now a day’s few senior doctors are conducting workshops and training courses for learning IVF/ICSI techniques. Some of them want to setup a satellite IVF center in different cities or create feeder/reffering centers from different areas. To achieve this, they try to find suitable candidates through such workshops. They are definitely creating awareness about advancement in IVF techniques and spread its knowledge among the  fellow doctors, this is really good and auspicious work but at times it doesn’t bring the result which was otherwise desired .Like a seed ,if sown in right soil and nurtured-it grows up to fine tree and bear fruits. In similar way if the seed of knowledge is given to right doctors and nurtured by giving initial backup support then general population will be benefited.

    New IVF center needs support in the beginning. It has to be treated and reared like a toddler who needs support in the beginning while learning to walk, then after some time it starts running on it;s own. If every time you give support then it will be crippled. Do you want to be crippled all your life?

Now very important question arises about patient selection-whom we should advice IVF/ICSI etc. Assisted reproduction techniques are the greatest invention in the field of infertility….no doubt about it.
With the mushrooming of IVF centers we have come across many patients who had been advised/undergone IVF/ICSI cycles when once or twice IUI failure occur or HSG reports shows blocked fallopian tube. Do you think HSG reports are fully reliable ?

And say, even if  tube is blocked,then can’t we open it with medical/surgical method?

If IUI fails once or twice ,then should desperation of patient be the only criteria for doing IVF?

Should ICSI be advised/done for poor  or low economy class azoospermic patient  or severe OAT patients,who has to borrow money or sell his belongings for such costly treatment when donor IUI can be easily afforded?
Our job is to inform them about the different options available and based on our information let them take their own decision.

There are so many questions which every IVF consultants has to sincerely ask themselves before taking decision for doing/advising IVF/ICSI etc. to their patients. In our infertility practice total cumulative pregnancy rates in 6-8 IUI cycles are 75-80% in properly selected and prepared patients. Even the patients who had IVF/ICSI failure in past, have successfully conceived with regular treatment protocol of ours. This must have been experienced by other gynecologists also.

Friends …….Right invention, system or technique in wrong hands leads to disaster by its misuse….. For example - atomic energy, democracy, genetic testing and of course assisted reproduction techniques etc. list goes on……..
Now another question will definitely arise in people’s mind   

 What is right and what is wrong?
How to decide use or misuse?

Where are  the guidelines…… where are rules and regulations?
Who will tell or whom to ask???

Friends …..This should be asked to your inner conscious and listen to your inner voice…..if you can?

   Every human being is unique and everyone has his/her own specialties and intersts.On nurturing your specialties you can become a distinguished person. Every individual can reach out his own niche.By comparing yourself to others and trying to become like them or better than them is simply waste of your resources and potential .Problem is created only due to comparison . As i said ,every doctor has some field of interest and specialty where they are good. If someone is good in delivering babies and find contentment, they should devote themselves in obstetric practice with full understanding. If someone is good in surgery then he/she should focus in OT work .Who wants to work in infertility then he has to learn every aspect of its management and excel in it .He should be capable of doing all the work from counseling ,reproductive endocrinology ,interventional sonography to embryology, so that he can conduct his team’s function properly. If anyone falls short at any place he can chip in so that work will go on smoothly. Like a captain of the army should be expert in handling all weapons, he makes the strategy of attack and organizes his team by deploying right person on right place with right weapon. Many times he does not go to  the battle field to fight the battle still if need arises he can use any weapon and support his team, uplift their moral and win the battle.

   Anybody who  is interested in field of infertility along with practical approach he should aim to work with dedication, motivation, passion, compassion and along with the sense of creativity. Everyone knows life and death is not in one’s hand but patient should sense that doctor has tried maximum till the end that is more important.

    If successful patients refer patients to you it is normal thing but your unsuccessful patients recommends your name for your sincerity and refer patients to you then in real sense you have succeeded.
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