Mandavi Rai: Difficult IVF Cases – From Dilemma to Success
Mandavi Rai, Senior Gynaecologist and Fertility Specialist at Divine Women and IVF Clinic, shared on LinkedIn:
“Difficult IVF Cases -From Dilemma to Success
Managing difficult IVF cases is often not about following a single protocol – it is about individualised clinical decision – making, recognising the underlying challenges and choosing the right strategy at the right time.
I was privileged to speak on ‘Difficult IVF Cases: From Dilemma to Success’ at a CME organised by Motherhood Fertility and IVF Hospital, Noida, in association with NIMA Women’s Forum.
Complex fertility cases can involve multiple challenges, including:
- Repeated IVF failures
- Poor ovarian reserve and advanced reproductive age
- Recurrent implantation failure
- Poor embryo quality
- Endometrial and uterine factors
- Tubal pathology and hydrosalpinx
- Difficult decisions regarding embryo transfer and treatment strategy
Each case requires a careful assessment of the patient, ovarian reserve, uterine environment, embryo factors and previous treatment history rather than simply repeating the same approach.
The real challenge in IVF is often the clinical dilemma before the decision – and the key is to convert that dilemma into a structured, evidence – based and personalised treatment plan.
Academic discussions like these provide an excellent opportunity to share experiences, challenge conventional thinking and learn from the diverse perspectives of colleagues in reproductive medicine.
The CME was also made special by the beautiful Teej celebrations, bringing together academic learning, professional camaraderie and cultural tradition.
Difficult cases may not always have easy answers – but thoughtful clinical decision-making can create a pathway towards better outcomes.”

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