Basic of Infertility
Every month, I am flooded with patients who desire to become pregnant. Their stories are often disturbing. They arrive with files full of innumerable papers and reports, with nothing arranged in chronological order. It is often a herculean task to reorganize everything and arrive at a meaningful conclusion, as many reports are doubtful or may not tally with the patient's history or clinical evaluation.
Are we supposed to teach our patients how to approach a doctor? I believe these basic principles should be taught in schools and colleges because orderly behavior and proper presentation are essential everywhere, even when appearing for a job interview.
I love discussing the basics of infertility with my patients, regardless of whether the couple is educated or not. I explain everything in the language they understand best—English, Hindi, or Gujarati. I begin by explaining the anatomy and physiology of the female and male reproductive systems, helping them understand the process of reproduction. My clinical approach is to ensure that patients gain a better understanding of the female reproductive system before beginning treatment.
The basic tests required for an initial assessment include semen analysis for the husband, along with fallopian tube testing and the study of folliculogenesis for the wife, before starting any medications. It is painful to see so many patients who have been prescribed multiple medicines without undergoing these essential primary assessments.
It is high time we adopted a standardized protocol for investigating infertile couples, one that can be followed by all gynecologists. After a proper diagnosis, each doctor may then choose the most appropriate line of treatment.
Such an approach can save couples from unnecessary medications of doubtful benefit and repeated investigations of little value. Come, join this crusade, because at the heart of everything we do is our patients' well-being.
