Monday, May 10, 2010

Why do doctors "treat" men with normal sperm counts ?

I see many men with completely normal sperm reports who have been prescribed all sorts of medicines, presumably to "boost their fertility" . These include a wide variety of pills ( depending upon which part of the world they come from) , ranging from Proxeed to Speman to Manix to CoQ and antioxidants.

Why are doctors so keen to treat normal men who do not need any treatment
whatsoever ?

I feel there are multiple reasons.

First is ignorance. Many sperm testing labs and doctors still do not even know what a normal sperm count is. I still see labs which print the normal sperm count range as being from 60 - 150 million per ml ! This means that even men with normal counts of 40 million are " diagnosed " as having a low sperm
count !

Second is pressure from patients. Many men are petrified that they cannot get their wife pregnant because their sperm count is not good enough. They want medicines to "boost " their sperm count and enhance their fertility ( along the same lines of their eternal desire to increase the size of their penis and increase the volume of their ejaculate ! I wonder why men have this obsession with size and numbers ? Is this a result of the exposure to the trick photography they use in pornography films, which distorts their sense of what is normal and average ? )

This means that there is a lot of pressure on the doctor to treat ! Let's do something - anything ! They do not want to lose the patient and are quite happy to pander to their desire to consume medicines ! And it's easier to write a medicine ( even if it is useless) rather than sit and spend 10 minutes with the patient and explain that there is no need to prescribe anything !)

It's very easy to justify this prescription. Many doctors say - Yes, these medicines may not help, but at least they do no harm ! And doctors often fall prey to the " post hoc ergo propter hoc fallacy" . They remember their anecdotal successes - the men with completely normal sperm counts who got their wife pregnant after taking the tablet prescribed by the doctor ( it's quite likely that they would have achieved a pregnancy even without taking the tablet, but the doctor is always happy to take the credit !)

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