Challenging the practice of IVF
Fighting for artistic licence
- By: Poonam Jani
Mohamed Taranissi is a consultant in obstetrics and gynaecology and an in vitro fertilisation (IVF) specialist. He obtained his medical degree at the University of Cairo, Egypt in 1976 and moved to the United Kingdom in 1983 where he undertook a fellowship programme in gynae-oncology with the Royal College of Obstetricians and Gynaecologists. He intended to move to the Middle East to practice but was prevented by the start of the first Gulf War. He decided to stay in the UK to pursue a career in developing new techniques in the field of IVF.
Today, he is the managing director of the Assisted Reproduction and Gynaecology Centre and the Reproductive Genetics Institute in London, which both claim to have higher than average success rates for women age 38 and older. His ongoing attempts to develop fertility treatment have been met with criticism from the Human Fertilisation and Embryology Authority (HFEA), the BBC, and medical colleagues who claim that his methods are not backed up with sufficient evidence.
What have you pioneered in the field of IVF?
I would never call myself a pioneer but I have certainly looked at current practice and used knowledge from my own experiences to optimise IVF treatment. When I started working in IVF, I was on my own. Everything from the consultations, scans, and blood tests, to the egg collection and transfer was done by myself. By practising this way, I was able to follow thousands of patients through the minutiae of their treatment. This is perhaps why I saw things that others in the field hadn’t cottoned on to.
Some new practices were basic, such as increasing assessments like blood tests and scans during cycles, individualising treatment protocols, and meticulously monitoring patients. Others were more complex. For example, my team and I also introduced egg freezing to the UK and aneuploidy screening.
Additionally, we searched for ways to optimise the grey area of implantation. Most clinicians concern themselves with embryo viability only, but this is only half of the story. Not only do you need a good embryo, you also need to have a receptive body to look after it. Implantation technology has always fascinated me, and I have tried to push what you might call “boundaries” within this field. Over time the practices we have adopted are being more accepted internationally and are becoming mainstream.
What is the secret to your success?
Success is a moving target so I constantly challenge myself and strive to improve. You can overcome any odds with passion, hard work, and skill. I work seven days a week. We start operating here at 7 am and I usually work till 8 pm or sometimes 10 pm in the evening. The fourth element to success is an opportunity, which can be elusive but will ultimately allow you to differentiate yourself. Success is also a team effort and I am fortunate to have a team of hardworking and committed people around me.
I don’t know what the future holds, but I would like to be able to get what we do into the mainstream, get more people to buy into it and hopefully improve it. If progress in a field ends with you, that is failure. If you believe that you have done or created something special, it needs to continue beyond you—that’s real success.
How did you overcome criticism from the HFEA, allegations of malpractice from the BBC’s Panorama television programme, and your reputation for being a maverick?
I have never stopped to analyse what people say because I am true to my art. You will have no time to perfect your craft if you are too preoccupied with defending and explaining yourself. The people I work with see my dedication on a daily basis and that is what counts. You may as well focus on what you are passionate about and believe in, and hope that will answer a few people.
My turbulent relationship with the HFEA still exists—little has changed with that—but I don’t mind because, for me, it’s not personal. I am human. I cannot get everything right but the duty of any doctor is to act in the best possible way, in the best interests of the patient.
Best and worst aspects of the job?
The satisfaction of giving happiness and hope to people when other treatment options have failed, and the unique emotional relationship you develop with patients is invaluable. However, being so committed has impinged on my personal life, particularly when I was a junior doctor. My eldest daughter is 32, and I regret that I didn’t spend as much time with her as I would have hoped during her childhood. I would have wanted more time with my father also during his last days. I feel guilty when I think back on these things.
You have mentioned in previous interviews that you follow Islam. To what extent does your religion conflict with your job?
It shouldn’t, because if it did, then religion will always take precedence. I am not interested in doing anything that conflicts with my religion. Rightly or wrongly, this is what I believe. Sex selection, for example, is not exactly an illness that you are trying to cure. This is outside what nature intended and is more of a lifestyle choice. At the end of the day, medicine is generally intended to facilitate what nature intended to happen. It is about helping people with diseases and finding cures for them. Anything that deviates from this is not medicine anymore.
What advice do you have for medical students?
- Medicine is a privileged profession. If you take it seriously, prioritise the interest of the patient and work hard, and you will succeed. But the journey is not easy.
- Patients trust and devote their hopes and expectations in you, so the decisions that you make for them have a huge impact on their lives, for better and for worse.
- Be disciplined but don’t let this prevent you from being imaginative and productive. Try to liberate yourself from the ball and chain and think outside of the box, even if it is hard to swim against the current.
- Even if you are the best doctor, if you don’t have a good team around you, you aren’t going to achieve much. There is an Arabic proverb that says that success should never stop at you. Knowledge has to be shared to benefit not only patients but also your colleagues who will take things to the next level. So look after your juniors and allow them to realise their potential, because they are the future.
1Hull York Medical School
Correspondence to: Poonam.firstname.lastname@example.org
Competing interests: None declared.
Provenance and peer review: Not commissioned; not externally peer reviewed.
Cite this as: Student BMJ 2014;22:g6708
- Published: 11 December 2014
- DOI: 10.1136/sbmj.g6708