Wednesday, July 29, 2015

How follicular studies ( ultrasound scanning) reduce your fertility



When couples get concerned about not getting pregnant , their first visit is usually to their gynaecologist. The first step the gynecologist advises is usually follicular monitoring . This means they refer the patient to a sonographer, who does serial ultrasound scans to track the growth of the follicle . The rationale is that this allows the doctor to track ovulation, so that she can advice the couple as to when to have baby making sex , and maximise the chances of their getting pregnant .

This is actually the worst of both possible worlds , because it converts a pleasurable bedroom activity into a clinical activity . It is no fun having to go to the doctor to get prodded with an ultrasound probe. The position itself is highly undignified , and having to strip for scans can be quite embarrassing.
Even worse, this scanning creates a lot of tension between the husband and wife . The husband is upset that the spontaneity of pleasurable sex is removed . Often the wife insists that they have sex only at the time which is prescribed by the doctor , which means the husband feels deprived. Scanning wastes a lot of time and energy , because the wife needs to commute to the scan center; wait for her turn; and then take the report to her gynecologist, who tells her what to do .

To add insult to injury, because the scanning is done by a sonographer and not by the gynaecologist , the advice patients get is of poor quality. Thus, most doctors will tell patients not to have sex until after the follicle ruptures –after ovulation. As a result of this monitoring, husbands are then forced to “store up their sperm” and then deposit them all at one shot after his wife ovulates. This is the only purpose which scanning achieves. This is actually bad advice, because after ovulation, the cervical mucus dries up, and the woman actually becomes infertile , because the sperm can now no longer swim up the egg. This means that follicular monitoring actually ends up causing infertility , rather than treating it.  This is one of the reasons so many women get pregnant when they stop doing these pointless scans !

The scanning also increases the wife’s anxiety . She has very unrealistic expectations every time she has well timed intercourse after the scans , because she feels that if the follicle has burst in the last 24 hours and the egg is in the tube and she then has sex at the right time , she is bound to get pregnant . When she doesn’t get pregnant, her mind starts playing all sorts of games with her, and she starts wondering if her tubes are blocked or if her eggs are bad. Doctors also contribute to this kind of unrealistic hope on the part of the patient by providing what they feel is reassurance by saying the cycle is perfect, and that she will definitely get pregnant this month. However, when she fails to conceive cycle after cycle, she starts losing confidence in her doctor. She gets fed up and frustrated, and once she has stopped trusting one doctor , she is no longer willing to trust any other doctor .

The husband often bears the brunt of the monitoring. He gets squashed , because he is forced to perform when his wife tells him to, whether or not he is “up” to it !  This wreaks havoc with his schedule, and this is  specially true for businessmen who need to travel a lot. When the wife calls up and says you need to fly down right now to have sex with me because the doctor told me I have ovulated and I need you stat, he has to change all his plans. This can be very hard, if he has lined up business meetings and is in another city ! He finds it very hard to be able to comply with her demands , and starts resenting being treated like a performing stud, whose only job is to act as a sperm donor.

The wife also feels upset , because she feels that her husband is being rigid and is refusing to cooperate. He wants to put business ahead of his family, and doesn’t understand how important  it is for her to get pregnant asap. Even worse, if he cannot fly down, she feels her entire cycle got wasted because of his lack of cooperation, and she will now have to start all over again from next month . This creates a lot of tension between husband and wife .

What’s worse is that often doctors are completely clueless about the harm which they cause to their patients by advising follicle monitoring . They think of it as being a simple , inexpensive, easy and non-invasive procedure , and cannot understand why the couple is making such a big deal out of it.  They  forget about the amount of anxiety which this causes – and the amount of time which the poor patient has to wait – travelling to the clinic and waiting for the scans .

Follicle monitoring actually serves no useful purpose at all in my opinion. If women do want to track their ovulation , they can do it much more easily by using online free fertility monitors; tracking their cervical mucus ; and by using LH ovulation test kits . These are more convenient and more reliable, since they let the wife know in advance that ovulation is going to occur, so she can time baby making sex much more  effectively - before she ovulates.

Even if the doctor does want to do follicle monitoring ( for example, to check the endometrial thickness), then one cycle is more than enough to educate the patient , because she can correlate the scan findings with her cervical mucus and LH test kit results. If your doctor asks you to go for follicular tracking month after month, you should look for another doctor !

Need more information ? Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you better !





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