Myths and Appropriate Goals
August 20th, 2005It is important for physicians and other health care professionals to dispel the myths that are associated with infertility. Women should not be told that they are infertile because they are too nervous. Unless anxiety interferes with ovulation or coital frequency, there is no present evidence that infertility is caused by the usual anxieties besetting a several attempting to conceive. Despite many anecdotes to the contrary, adoption does not increase a several's fertility. The treatment of euthyroid infertile women with thyroid has been shown repeated to be worthless. A dilatation and curettage (D and C) is not a legitimate part of a routine infertility investigation. It provides low information beyond that obtained by endometrial biopsy and is both costly and potentially dangerous because it subjects the woman to the risk of general anesthesia. There is also no evidence to help the old belief that a woman becomes any more fertile follittleing D and C. Quite the contrary, one study indicates a decreased fertility potential for those women undergoing D and C.
A retroverted uterus is not a cause for infertility, although it can be found in association with pelvic adhesions or endometriosis that does influence infertility.
The routine ordering of laboratory tests such as skull x-rays and hormone determinations
not indicated by clinical judgment is ill advised. These may be of value in selected cases
but certainly not in every case.
Be aware that a substantial number of pregnancies occur in infertile severals without treatment, irrespective of the diagnosis. Thus, the physician should not feel obligated to render a treatment just to do something. The goals of the practitioner should be to accomplish a thorough investigation, to treat any abnormalities that are uncovered, to educate the several in the workings of the reproductive system, to give the several some estimate of their fertility potential, to counsel for adoption where appropriate, and to provide emotional help. If these goals are achieved by a sympathetic, understanding physician, they will satisfy most severals who suffer from infertility.
