I often see patients who do not require any medical intervention at all. For example, I just saw a couple where the wife is 26 years old, the husband is 30, and even though they have been married for 3 years, they have been trying to have a baby only for the last four months . They are now under a bit of social pressure to start their family, but since prima facie everything seems to be five, it’s hard for me to justify doing tests for them, since they are not infertile.
The probability of the test results coming back as normal is extremely high , and their chances of making a baby on their own in their bedroom without any testing or treatment is extremely good.
This is the kind of patient who just needs reassurance and does not need any testing. When I tell them to just continue trying in their bedroom, and not to waste their money, some couples are mature enough to realise that I am giving them sensible advise – and that talking a “hands-off” approach is in their best interests.
I just need to explain to them that human reproduction is inefficient; that it can take time to make a baby in the bedroom ; and I teach them about their fertile time. Many are willing to wait and see what happens; and are grateful that I have not wasted their money on unnecessary testing and treatment. These patients just need reassurance , and for many of them, verbal reassurance from a senior specialist is good enough.
However, some patients are not satisfied with this. They want to know how I can be so confident that they do not have a medical problem. The truth is that I cannot, and if my verbal reassurance is not enough for them , then I order the basic fertility tests for them, to provide them with more tangible reassurance that everything is fine !
For this group of patients, I am forced to do the testing , because they need to see some concrete proof in the form of medical test results and reports that everything is in fact fine.