Friday, August 07, 2015

Shades of grey and the IVF patient


No, this post is not going to talk about female sexuality and its impact on infertility.  It’s going to be a far more down to earth topic and I’m going to discuss the fact that decision making in infertility can be complicated , and options are rarely either black or white.

It's true that for some patients, treatment options are fairly straight forward and the absence of alternatives makes decision making simple for them.  Thus, for example, if a woman doesn’t have a uterus, her only medical choice would be surrogacy ; or if the man has a very low sperm count, his option would be ICSI.  That’s pretty much cut and dried and most doctors would give the same advice, if they followed good medical practice.

However, there are lots of times when decision making is not so straight forward.  This confuses patients and sometimes upsets them because they are getting conflicting advice from different doctors and they don’t know whom to trust.  Is the doctor being greedy because he wants to make more money, or is this doctor not able to offer the latest treatment advance, which is why he’s advising an old fashion treatment?  Is he an aggressive doctor because he’s young and needs to prove himself , or is he being conservative because he’s old and experienced and has seen lots more cases ? And how is the poor patient to decide?

It’s true, that there can be a lot of variability and this is why it’s so important that  patients do their homework, so that they understand what their options are . This way they clarify their own personal preference. It's equally important that doctors talk to patients , and ask them for their inputs, so that these can be factored into the decision making process.  Always remember that infertility is not a disease, it is a condition for which the patient seeks treatment because she wants to complete her family.  It’s elective treatment , and the last thing a doctor should do is end up over treating a patient and end up causing unnecessary harm.

If the patient doesn’t understand what’s happening or if the doctor doesn’t take the time to explain to the patient what the options are or why he’s selecting a particular option, the patient is likely to be quite unhappy if the treatment fails.

As I tell my patients, it takes two to tango and both the doctor and the patient need to provide their inputs. Instead  of thinking of grey as being dreary, remember that grey is a colour which combines the best of both black and white !

Not sure what to do ?  Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you !





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