When Over testing is Harmful for Infertile Patients

Medical testing helps the diagnosis process by providing the physician with a clearer view of the patient’s problem. All patients expect the doctor to order tests when they go for a consultation – and this is true for infertile patients as well.

Ideally, tests should be ordered judiciously, in order to help improve the patient’s treatment and increase her chances of having a baby. However , these days doctors seem to mindlessly order a battery of tests for all their patients.  This is often because following a fixed protocol is much more cost-effective for them.  It also seems to provide reassurance to the patient that the doctor is very thorough - after all, the fact that the doctor has ordered so many tests means he must be a real expert ! Naïve patients still seem to believe that the number of tests ordered, and their expense, correlates directly with the expertise of the doctor !

Sadly, too many tests often create more problems for the unsuspecting patient ! The doctor then starts treating the test reports , rather than managing patient’s problem of infertility. Often, the tests pick up incidental red herrings, which are of no clinical importance, but patients are not sophisticated enough to realize this ! They are happy that the doctor has finally “diagnosed” their problem by finding an abnormality in their tests.

The truth is that while ordering tests is easy, interpreting the test results in the clinical context properly needs a lot of expertise . Many doctors do not have enough experience to do this and will often end up wasting the patient’s time and money by chasing incidental findings, which are just red herrings, and do not affect the patient’s treatment options.

While doctors are keen on making the “right diagnosis” and finding problems, patients are much more interested in finding solutions ! Overtreatment and unnecessary treatment because of overtesting can actually reduce fertility ( for example, when the doctor treats the patient for TB , just because the endometrial TB PCR result is positive !)  The patient is thus at both a financial loss, and may actually suffer harm because of these tests.

Fed up of having to do too many tests ? Please send me your medical details by filling in the form at www.drmalpani.com/malpaniform.htm so that I can guide you better !