Monday, January 06, 2014

Unexplained Infertility and the Best Way to Handle it


At Malpani Infertility Clinic we often come across patients who have undergone millions of investigations for their infertility problem with no result. All the investigations come back normal with no traceable problem. This leaves the doctor as well as patients in a fix. These unexplained infertility patients become increasingly frustrated as time goes on , with no diagnosis in sight. Their logic is - if the doctor is not able to pin point the problem , then how will he find a solution? So they keep going from doctor to doctor to try to to get to the root of the problem.

The focus of these patients shifts from trying to conceive a baby to getting diagnosed. Their doctor shopping leads them nowhere. Every doctor comes up with an idiosyncratic perspective, and advises a host of unproven investigations . This often becomes a game of one-upmanship, where doctors compete in ordering the most expensive and exotic tests, to prove how much they know . Gullible patients, who don’t know any better, and also suitably impressed when the doctor orders tests no one else did in the past ! Doesn’t this prove this doctor is wiser than the others ? . The laboratory paperwork goes on piling up . The biggest tragedy is that these innumerable tests will invariably lead to detecting some unrelated minor problems . The doctor will the  take the credit for making the right diagnosis – even though the abnormality is just a common variant, which is also found in fertile women ! . Doctors, just like patients, feel at peace if they can put a name to the cause. Because of this nominal fallacy, all efforts are centralized to investigation, examination and diagnosis , rather than treating the basic issue of the inability to conceive.

The fact is that once a woman conceives, the cause of infertility is only of academic interest. The diagnosis of a particular disorder would not help the infertile couple. Naming a problem is only of academic interest ! It is important to focus all efforts on finding a solution, rather than trying to find a label for the problem . For example a woman with blocked fallopian tubes would benefit by in vitro fertilization therapy, rather than by doing a laparoscopy to find out the reason for the blocked tube. The laparoscopy will just waste the patient’s time and money, because it does not change the treatment options the doctor can offer her. . IVF is the modern day solution for couples with unexplained infertility. In simple terms, this is because it helps the doctor to get around any barrier which is preventing the process of fertilization inside the body.

Another common mistake that couples with unexplained infertility do is try to continue conceiving naturally. It is a well known fact that if a couple is unable to conceive after trying for 2 years they need some assistance. When a couple with unexplained infertility obstinately tries to conceive naturally , just because everything is “normal”, they may lose out on precious time. If time runs out, then even IVF may not be able to help them, because their egg quality has become poor. Having a success oriented approach towards the problem would help these patients.

Unexplained infertility is an inability on the part of the doctor to point out the cause of infertility . Fortunately, it is surmountable with treatments like in vitro fertilization !


Need help because your treatment is stuck ? Please send me your medical details by filling in the form at www.drmalpani.com/malpaniform.htm so that I can guide you better !




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